Cardiac Unit 1
elevated BNP
indicates a increase in fluid oressure in the heart, is secreted from the ventricle in response to heart failure
The blood flows from the areas of the body below the diaphragm into the:
inferior vena cava
elevated CRP
inflammation of coronary vessels
The blood flows through the tricuspid valve and into the:
right ventricle
factors that lead to heat attack and strokes that you can control
smoking inactivity HTN diabetes obesity stress
A client who has had a significant myocardial infarction receives a referral to the cardiac rehabilitation unit. During his first visit to the unit, he tells the nurse that he doesn't understand why he needs to be there because there is nothing more to do as the damage is done. Which of the following is an appropriate nursing response? "Cardiac rehabilitation cannot undo the damage to your heart but it can help you get back to your previous level of activity safely." "It's not unusual to feel that way at first, but once you learn the routine, you'll be fine." "You are probably right and I agree with you, but I still think you should go." "Your doctor is the expert here, and I'm sure he would only recommend what is best for you."
"Cardiac rehabilitation cannot undo the damage to your heart but it can help you get back to your previous level of activity safely."
A nurse at a provider's office receives a phone call from a client who reports unrelieved chest pain after taking a nitroglycerin (Nitrostat) tablet 5 minutes ago. Which of the following is an appropriate response by the nurse? Tell the client to take an aspirin. Instruct the client to call 911. Have the client take another nitroglycerin tablet in 15 min. Advise the client to come to office.
Instruct the client to call 911.
embolism
a clot that may originate in the heart and travel through the circulation to the lungs or the brain
ventricular fibrillation
a life threatening arrythmia that causes the ventricles to quiver rather then pump the blood through the body
aspirin
anti platelet
Atherosclerosis
fatty deposits in the blood vessels
A nurse is reinforcing teaching with a client who has angina pectoris about starting therapy with nitroglycerin (Nitrostat) sublingual tablets. The nurse verifies the client's understand when the client states which of the following? "I'll dial 911 if I still have pain after taking three tablets 5 minutes apart." "I'll dial 911 if I still have pain after taking four nitroglycerin tablets over a 20-minute period." "I'll dial 911 when I have pain and then take the nitroglycerin tablets." "I'll dial 911 if one tablet does not relieve my pain and then take up to two more 5 minutes apart while waiting.
"I'll dial 911 if one tablet does not relieve my pain and then take up to two more 5 minutes apart while waiting.
A client asks a nurse, "Why am I taking nitroglycerin?" Which of the following is the best response by the nurse? "Nitroglycerin relieves nausea and prevents vomiting which could lead to aspiration." "Nitroglycerin decreases chest pain by dissolving blood clots that are occluding the arteries." "Nitroglycerin acts as a bronchodilator to open small airways and decrease shortness of breath." "Nitroglycerin dilates cardiac blood vessels to deliver more oxygen to the heart."
"Nitroglycerin dilates cardiac blood vessels to deliver more oxygen to the heart."
A client is requesting information regarding a serum troponin test. Which of the following is the nurse's best response? "It is a protein found in the serum of healthy clients." "Lab results are used alone to diagnose heart disease." "Troponin levels have a narrow time frame, so it is important to obtain this test now." "The slightest elevation in troponin levels will prompt treatment to prevent complications of cardiovascular disease."
"The slightest elevation in troponin levels will prompt treatment to prevent complications of cardiovascular disease."
A normal heart rate for a newborn:
120-160
Holter monitor
24 EKG tracing while the patient is doing their usual daily routine keeps a diary of activities monitor irregularities
While auscultating a client's heart sounds, the nurse hears turbulence between the S1 and S2 heart sounds. The nurse should document this finding as which of the following? A cardiac murmur A third heart sound (S3) An expected heart sound A fourth heart sound (S4)
A cardiac murmur
A nurse is reinforcing teaching for a client about snacks that are appropriate on a low-fat, low-sodium, low-cholesterol diet. Which of the following client choices indicates the need for further teaching? A slice of cheese. A jam sandwich. A cup of plain popcorn. Applesauce.
A slice of cheese.
A nurse on a medical unit is caring for a client who has angina pectoris and reports chest pain with a severity of 6 on a 0 to 10 scale. The nurse administers sublingual nitroglycerin (Nitrostat). After 5 min, the client states that his chest pain is now a 2. Which of the following actions should the nurse take? Administer another nitroglycerin tablet. Measure the client's blood pressure. Check the client's apical heart rate. Obtain an ECG.
Administer another nitroglycerin tablet.
Cardiac output is:
Amount of blood pumped by the ventricles in one minute
Stroke volume is:
Amount of blood pumped in one beat of the ventricles
A patient with angina comes to the emergency room our first step would be:
Apply oxygen at 2 liters
The nurse is reinforcing teaching regarding diet to a client after a myocardial infarction. The nurse evaluates the reinforcement as effective if the client selects which of the following options? Barbecued beef, baked beans, potato chips and a tossed salad Baked turkey, mashed potatoes, squash and salad Bread, fried fish patty, potato salad and cole slaw Grilled pork chops, biscuits and brown gravy, sliced tomato
Baked turkey, mashed potatoes, squash and salad
A nurse is reinforcing teaching with a client about following a low-cholesterol diet after coronary artery bypass grafting. Which of the following food choices reflects the client's understanding of these dietary instructions? Liver Milk Beans Eggs
Beans
Beta adrenergic blockers cause:
Bradycardia
Calcium channel blockers cause:
Bradycardia
Exchange of nutrients and oxygen takes place in:
Capillaries
Digoxin is a / an:
Cardiotonic
A nurse is assisting with the care of an older adult client who just had a cardiac catheterization. Which nursing interventions should the nurse contribute to the client's plan of care for the next 8 hr? (Select all that apply.) Check peripheral pulses in the affected extremity. Place the client in high Fowler's position. Measure the client's vital signs every 4 hr. Keep the client's hip and leg extended. Have the client remain in bed up to 6 hr
Check peripheral pulses in the affected extremity. Keep the client's hip and leg extended. Have the client remain in bed up to 6 hr
A client receives clopidogrel (Plavix) after placement of a cardiac stent. Which of the following should the nurse recognize as a therapeutic response to the medication? Client's aPTT result is 40 seconds. Client denies evidence of bloody stools. Client denies difficulty swallowing. Client's platelet count is 125,000/mm³.
Client denies difficulty swallowing.
Digoxin is used to treat:
Congestive heart failure
An electrocardiogram is used to monitor:
Electrical activity within the myocardium
In fetal circulation the opening between the right and left atria is called:
Foramen ovale
The nurse is caring for a client who has just had a cardiac catheterization. The post procedure nursing care plan for this client should include which of the following nursing interventions? Have the client rest in bed for 2 to 6 hr. Keep the involved leg slightly flexed. Elevate the head of the bed 45 degrees. Keep the client NPO for 4 hr.
Have the client rest in bed for 2 to 6 hr.
A nurse is giving a presentation to a community group about preventing atherosclerosis. Which of the following should the nurse include as a modifiable risk factor for this disorder? (Select all that apply.) Genetic predisposition Hypercholesterolemia Hypertension Obesity Smoking
Hypercholesterolemia Hypertension Obesity Smoking
A client is telling the nurse in the clinic that he gets a headache after he takes sublingual nitroglycerin (Nitrostat). Which of the following should the nurse remind the client to do? Reduce the nitroglycerin dose. Ask the provider to prescribe a strong analgesic. Lie down in a cool environment and rest. Ask the provider to prescribe a different medication.
Lie down in a cool environment and rest.
A person that suffers from chronic angina pectoralis would most likely be taking daily:
Nitroglycerine transdermal
The test used to monitor coumadin is:
PT
Atherosclerosis may be treated by using:
Simvastatin
"pacemaker" of the heart is the:
Sinoatrial node
After the second dose of nitroglycerine (sublingual), the patient continues to have angina. The next step is to:
Take another nitroglycerine tablet sublingual
Streptokinase is a/an:
Thrombolytic
A person who has rheumatic heart must always remember:
To take antibiotics before invasive procedures
Which of the following is the most ominous heart rhythm?:
Ventricular fibrillation
A nurse is caring for a client who is prescribed aspirin (Ecotrin) 325 mg and has a history of a previous myocardial infarction. The nurse instructs the client that the aspirin is prescribed once daily due to its action as an analgesic. anti-inflammatory. antiplatelet aggregate. antipyretic.
antiplatelet aggregate.
The blood flows from the left ventricle through the:
aortic valve
ventricular aneurysm
when an MI damages the ventricle, the wall of the ventricle may thin and balloon out
The blood flows from the right atrium through the:
tricuspid valve
blood lipids
tryglyerides cholesterol phospholipids LDL-bad HDL-good
12 lead electrocardiogram EKG
used to diagnose heart rhythm irregularities and to monitor arrhythmia for response to medication
A nurse is providing discharge teaching to a client who is prescribed transdermal nitroglycerin paste (Nitro-Bid). Which of the following client statements indicates a need for additional teaching? "I should place the applicator printed side down, and then squeeze the paste on." "I should leave the patch in place until it is time for the next dose of Nitro-Bid." "I should get up slowly when I stand or get out of bed. " "I may have a headache when I first start taking Nitro-Bid."
"I should leave the patch in place until it is time for the next dose of Nitro-Bid."
A nurse at an urgent care clinic is caring for a client who is experiencing chest pain. While waiting for emergency services to arrive, the nurse administers a total of 3 nitroglycerin (Nitrostat) 0.4 mg tablets sublingually. The nurse should report that the client has received a total of how many mg of nitroglycerin? (Round to the tenth place.)
1.2 mg
S2
2nd intercostal to the right of the sternum pulmonic and aortic
S1
5th inter-costal mid-clavicular tricuspid and mitral
A normal heart rate for an adult:
60-100
A client has a new prescription for transdermal nitroglycerin (Nitro-Dur) to treat angina pectoris. When talking with the patient about using this drug, the nurse should include which of the following instructions? (Select all that apply.) Apply the patch to a hairless area and rotate sites. Apply a new patch each morning. Remove the patch for 10 to 12 hr daily. Apply the patch to dry skin and cover the area with plastic wrap. Apply a new patch at the onset of anginal pain.
Apply the patch to a hairless area and rotate sites. Apply a new patch each morning. Remove the patch for 10 to 12 hr daily
A client comes to the emergency department via ambulance to report severe radiating chest pain and shortness of breath. The client appears restless, frightened, and slightly cyanotic. The provider prescribes oxygen by nasal cannula at 4 L/min stat, cardiac enzyme levels, IV fluids, and a 12-lead ECG. Which of the following actions should the nurse assisting with this client's care take first? Attach the leads for a 12-lead ECG. Obtain the blood sample. Initiate oxygen therapy. Insert the IV catheter.
Initiate oxygen therapy.
A nurse is preparing to obtain an electrocardiogram (ECG). Which of the following actions should the nurse implement? (Select all that apply.) Keep the client NPO after midnight. Inspect the electrode pads. Interpret ECG results. Instruct the client to breath normally. Administer analgesics prior to the procedure.
Inspect the electrode pads. Instruct the client to breath normally.
The apical pulse is found:
Left side 5th intercostal space, mid clavicular
The thickest wall of myocardium is found in the:
Left ventricle
A nurse is caring for a client following a cardiac catheterization. Which of the following is an appropriate nursing action? Monitor pedal pulses every 15 min. Perform passive range of motion to the affected extremity. Ambulate the client when he is awake and alert. Keep the client in high-Fowler's position for 6 hr.
Monitor pedal pulses every 15 min.
A nurse is collecting data from a client who has an acute myocardial infarction (MI). Which of the following clinical manifestations should the nurse expect to find? (Select all that apply.) Orthopnea Headache Nausea Tachycardia Diaphoresis
Nausea Tachycardia Diaphoresis
While admitting a client for a cardiac catheterization, the nurse asks the client about allergies. The client states, "I always get a rash when I eat shellfish." Which of the following is the priority nursing intervention? Notify the provider of the client's allergy. Attach a wrist band indicating the client's allergy. Ask the client if any other foods cause such a reaction. Notify the dietary department of the client's allergy.
Notify the provider of the client's allergy.
A nurse is planning care for a client who has a suspected myocardial infarction. Which of the following should the nurse administer first? Nitroglycerin (Nitrostat) Aspirin (A.S.A.) Oxygen Morphine Sulfate
Oxygen
The test used to monitor heparin is:
Partial thromboplastin time (PTT)
A nurse is caring for a client who enters the emergency department complaining of sever chest pain. Which of the following interventions should the nurse implement to determine if the client is experiencing a myocardial infarction? Check the client's blood pressure. Auscultate heart tones. Perform a 12-lead ECG. Determine if pain radiats to the left arm.
Perform a 12-lead ECG.
An anticoagulant works by:
Preventing thrombus
A nurse is caring for a client who has a serum potassium level of 5.5 mEq/L. The provider prescribes polystyrene sulfonate (Kayexalate). If this medication is effective, the nurse should expect which of the following corrections on the client's ECG? Reduction of T-wave amplitude Reduction of P-wave duration Widening of the QRS complex Restoration of QRS-complex amplitude
Reduction of T-wave amplitude
A disease that precedes the development of rheumatic heart is:
Strep throat
Angina
chest pain caused by the reduced o2 supply to the heart
The nurse is completing a medication review of a client who has elevated cholesterol levels and takes an anticoagulant. Which of the following finding should the nurse report to the provider? Attempts to follow a low-fat diet Implements of cholesterol lowering agent Sprinkles flax seeds on breakfast food every day Uses garlic as a cholesterol-lowering agent
Uses garlic as a cholesterol-lowering agent
A nurse is collecting data on a client's cardiac functioning and auscultates an S₃ sound. The nurse is aware that this sound represents which of the following? Atrial gallop Ventricular gallop Closure of the aortic valve Closure of pulmonic valve
Ventricular gallop
elevated of decreased pH (arterial blood gases)
alkalosis when elevated acidosis when decreased
pericarditis
an inflammation of the sac that surrounds the heart, after an MI it damages the ventricle and inflammation may set in
CBC labs low hemoglobin increased WBC increased RBC
anemia infection/inflammation compensation of hypoxia
A nurse is talking with a client who is about to start using sublingual nitroglycerin (Nitrostat) to treat angina pectoris. The client asks the nurse how long he has to take the medication before his condition is cured. The nurse should first ask the client what he knows about his diagnosis. make sure the client knows how to take his medication. provide the client with written information about angina pectoris. explain that the medication may help control the client's symptoms.
ask the client what he knows about his diagnosis.
high or low serum electrolytes
can cause EKG changes and effect the ability of the heart to contract
cardiac enzymes elevated
can indicate heart damage
S&S of Cardiovascular disease
chest pain tachypnea palpitation cyanosis fatigue anxiety pallor edema
The blood is brought to the myocardium by way of the:
coronary artery
An thrombolytic works by:
destroying thrombus
collateral circulation
develops when there is decreased when there is decreased cardiac output. this is when surrounding
echocardiogram
done to detect the alve disorders and cardiomyopathy
basic metabolic panel
electrolytes
thallium scan
enter normal cells but not the damaged cells
increased INR
evaluates the ability of the blood to clot properly, the increased levels indicate prolonged bleeding times
factors that lead to heat attack and strokes that you can't control
family history age gender rage hereditary
cadiogenic shock
loss of blood pressure with other symptoms of shock
elevated erythrocyte sedimentation rate
may indicate MI or endocarditis
coronary artery disease
obstructed blood flow through the coronary arteries
manifestations of coronary artery disease
pain my radiate (into left arm/neck)
troponin 1 elevated
presence of dead cardiac cells in the blood stream, indicated myocardial injury
The blood flows from the right ventricle through the:
pulmonic valve
stress test
rate and rhythm are monitored
elevated PT/PTT
receiving coag. therapy
Arteriosclerosis
the arteries lose the elasticity and become hard and narrow
MI; myocardial infarction
the death of the heart tissue due to the ischemia