Med 2 test 3
A client is a candidate for percutaneous balloon valvuloplasty, but is concerned about how this procedure will affect the client's busy work schedule. Which guidance would the nurse provide to the client?
"Clients usually remain at the hospital for 24 to 48 hours."
A client with a confirmed DVT is being discharged from the ED. Which client statement indicates that the client has received proper nursing instruction and understands how to manage this condition?
"I need to do my leg exercises five times or more every hour."
A nurse is caring for a client with heart failure. The nurse knows that the client has left-sided heart failure when the client makes which statement?
"I sleep on three pillows each night."
The nurse is educating a client about the care related to a new diagnosis of mitral valve prolapse. What statement made by the client demonstrates understanding of the teaching?
"I will avoid caffeine, alcohol, and smoking."
The nurse instructs a client recovering from mechanical valve replacement surgery. Which client statement indicates that teaching has been effective?
"I will not drive until informed by my health care provider."
The nurse is admitting a client with heart failure. What client statement indicates that fluid overload was occurring at home?
"I'm having trouble going up the steps during the day."
A patient has been newly diagnosed with heart failure (HF) and has come to the meet with the nurse at the clinic for health education. What lifestyle recommendation should the nurse provide to this patient when discussing dietary modifications?
"It's in your best interests to avoid excessive fluids and sodium in your diet."
The nurse instructs a client with heart failure on restricting sodium in the diet. Which client statement indicates that teaching was effective?
"Lemon juice and herbs can be used to replace salt when cooking."
A client is being discharged home with a diagnosis of hypertrophic cardiomyopathy. Which statement by the client demonstrates that he understands the disease process?
"Since this is a heredity disorder, my family members should probably be evaluated for similar symptoms."
what question asked by the nurse is most important initially when obtaining the medical history of a client with endocarditis?
"have you recently been treated for strep throat?"
after having received instructions regarding thrombophlebitis, which statement made by the client indicates a need for further teaching?
"when I feel pain in my calf, I should rub it until the pain goes away"
A patient is being discharged to home. The nurse must emphasize the importance of being weighed daily. Which significant weight change would need to be reported to the patient's health care provider?
A weight gain of 2½ pounds in a day
Which of the following medications or drug classes is most commonly used as an intervention for patients with heart failure?
ACE inhibitors
Which of the following medications or drug classes is most commonly used as an intervention for patients with heart failure?
ARB's -Angiotensin II Receptor blockers
A client presents to the ED reporting increasing shortness of breath. The nurse assessing the client notes a history of left-sided heart failure. The client is agitated and occasionally coughing up pink-tinged, foamy sputum. The nurse should recognize the signs and symptoms of what health problem?
Acute pulmonary edema
Interventions in Treating Existing VTE
Administer anticoagulant medications and pain medications as prescribed Early ambulation Avoid recurrence by following the prevention methods Monitor for bleeding: melena, hematuria, epistaxis, bruising, etc. Assess for s/s of PE: dyspnea, tachypnea, cough, hypotension, abnormal lung sounds, chest pain Monitor labs like aPTT, PT/INR
The nurse is administering sublingual nitroglycerin to a client with chest pain. What action will the nurse take after administering two sublingual tablets if the client continues with chest pain and has a blood pressure of 120/82 mm Hg?
Administer the third sublingual nitroglycerin tablet.
Which of the following interventions is most likely indicated during an exacerbation of heart failure?
Advanced airway
Which mechanisms are part of the body's defenses against infection? -All options are correct. -immune system -skin, mucous membranes -inflammatory response
All options are correct
A client with a history of rheumatic heart disease knows that the client is at risk for bacterial endocarditis when undergoing invasive procedures. Prior to a scheduled cystoscopy, the nurse should ensure that the client knows the importance of taking which drug?
Amoxicillin
A 70-year-old man has been living with a diagnosis of heart failure (HF) for several years and has been vigilant about monitoring the trajectory of disease and adhering to his prescribed treatment regimen. The man has scheduled an appointment with his primary care provider because he has noted a weight gain of 6 pounds over the past week. The nurse should anticipate that this patient may benefit from which of the following treatment measures?
An increase in the dose of his prescribed diuretic
A nurse is caring for a client receiving warfarin therapy following a mechanical valve replacement. The client had a prothrombin time and International Normalized Ratio (INR) drawn before breakfast. The laboratory report shows the client's INR reading was 4. What is the nurse's first priority ?
Assess the client for bleeding and notify the health care provider of the results.
Which of the following medications or drug classes is most commonly used as an intervention for patients with heart failure?
Beta blockers
The nurse is caring for an older adult client who has just returned from the operating room (OR) after inguinal hernia repair. The OR report indicates that the client received large volumes of IV fluids during surgery, and the client has a history of coronary artery disease, increasing the risk for left-sided heart failure. Which signs and symptoms indicating this condition would the nurse look for?
Bibasilar fine crackles
A nurse is caring for a client who had an aortic balloon valvuloplasty. The nurse should inspect the surgical insertion site closely for which complication(s)?
Bleeding and infection
A client has been admitted to the medical unit with signs and symptoms suggestive of endocarditis. The health care provider's choice of antibiotics would be primarily based on what diagnostic test?
Blood cultures
A client with heart failure has met with the primary care provider and begun treatment with an angiotensin-converting enzyme (ACE) inhibitor. When the client begins treatment, the nurse would prioritize which assessment?
Blood pressure
An older adult client has been diagnosed with aortic regurgitation. Which change in blood flow should the nurse expect to see on this client's echocardiogram?
Blood to flow back from the aorta to the left ventricle
A patient has been admitted to the hospital with exacerbation of heart failure (HF) that has resulted in pulmonary and peripheral edema. The nurse has been carefully monitoring the trajectory of the patient's signs and symptoms of HF. How can the nurse best monitor the patient's fluid balance?
By performing daily weights at the same time each day
Signs & Symptoms
Calf pain - esp. if increases with dorsiflexion (Homan's sign) Warmth Erythema Edema Brisk capillary refill due to venous congestion (< 2 seconds) Fever, malaise, fatigue, anorexia
The nurse is caring for a patient diagnosed with pericarditis. What serious complication should this patient be monitored for?
Cardiac tamponade
Patho for Raynaud's
Characterized by brief spasms of the arteries and arterioles in the fingers (most commonly), ears, toes, noes, or chin Spasms last approximately 15 minutes and cause temporary ischemia (impaired oxygenation) to the tissues Vessels then dilate to compensate for the restriction Patchy necrosis can occur with prolonged ischemia Underlying cause is unclear - sometimes secondary to connective tissue disorders Anatomy of the arteries and arterioles is normal - just caused by spasms
Which nursing intervention should a nurse perform when a client with cardiomyopathy receives a diuretic?
Check regularly for dependent edema
A client has been prescribed furosemide 80 mg twice daily. The asymptomatic client begins to have rare premature ventricular contractions followed by runs of bigeminy with stable signs. What action will the nurse perform next?
Check the client's potassium level.
A nurse evaluates a client and suspects pericarditis. What indicator is considered the most characteristic symptom of pericarditis?
Chest pain
Drugs for intermittent claudication
Cilostazol (Pletal) - antiplatelet and vasodilator Pentoxifylline (Trental) - improves blood flow by increasing RBC flexibility and making blood less viscous
The nurse determines that a patient has a characteristic symptom of pericarditis. What symptom does the nurse recognize as significant for this diagnosis?
Constant chest pain
A patient is admitted to the intensive care unit (ICU) with left-sided heart failure. What clinical manifestations does the nurse anticipate finding when performing an assessment?
Cough Pulmonary crackles Dyspnea
The nurse is assessing a client who is known to have right-sided heart failure. What assessment finding is most consistent with this client's diagnosis?
Distended neck veins
Which of the following medications or drug classes is most commonly used as an intervention for patients with heart failure?
Diuretics
Diagnostics for blood clots
Doppler ultrasound to detect blockage of a vein. Venography - dye is instilled into the veins & can identify an area of clot Instruct client to drink extra fluids post dye to flush out of the system. D-dimer blood test - protein present when making & breaking down clots VQ Scan - ventilation/perfusion scan to assess for PE Spiral CT scan or CT angiogram to assess for PE
Which diagnostic study is usually performed to confirm the diagnosis of heart failure?
Echocardiogram
A client is admitted to the hospital with possible acute pericarditis and pericardial effusion. The nurse knows to prepare the client for which diagnostic test to confirm the client's diagnosis?
Echocardiography
Signs & Symptoms of Venous Insufficiency
Edema in the lower legs and feet Testing for pitting difficult - congested fluid cannot be displaced Dark red or darkly pigmented, ruddy skin Oozing of serous fluid through the skin Pain Pulses difficult to palpate due to edema
A client reporting heart palpitations is diagnosed with atrial fibrillation caused by mitral valve prolapse. To relieve the symptoms, the nurse should teach the client which dietary intervention?
Eliminate caffeine and alcohol
A client has a significant history of congestive heart failure. What should the nurse specifically assess during the client's semiannual cardiology examination?
Examine the client's neck for distended veins. Monitor the client for signs of lethargy or confusion.
Medical & Surgical Management of Varicose Veins
Exercise Lose weight Support stockings Avoid long sitting or standing Laser treatments for superficial veins Vein ligation or stripping procedure for larger veins
The nurse is auscultating the heart of a client diagnosed with mitral valve prolapse. Which is often the first and only manifestation of mitral valve prolapse?
Extra heart sound
An older adult client with heart failure is being discharged home on an ACE inhibitor and a loop diuretic. The client's most recent vital signs prior to discharge include oxygen saturation of 93% on room air, heart rate of 81 beats per minute, and blood pressure of 94/59 mm Hg. When planning this client's subsequent care, what nursing concern should be identified?
Falls risk related to hypotension
femoral artery in the leg is the vessel most often used for grafting in coronary artery bypass?
False
The nurse visits the home of a client with heart failure. Which assessment finding indicates to the nurse that the client's tolerance to activity is deteriorating?
Fatigue after walking to answer the door
The critical care nurse is caring for a client who is in cardiogenic shock. What assessments must the nurse perform on this client?
Fluid status Cardiac rhythm Action of medications
Loop diuretics are most likely to cause which of the following side effects?
Gout
Which classification of clients would be at greatest risk for hospital-acquired endocarditis?
Hemodialysis clients
An adult client with a tentative diagnosis of infective endocarditis is admitted to an acute care facility. The medical history reveals diabetes mellitus, hypertension, and pernicious anemia. The client underwent an appendectomy 20 years earlier and an aortic valve replacement 2 years before this admission. What history finding is a major risk factor for infective endocarditis?
History of aortic valve replacement
A client is already being treated for hypertension. The doctor is concerned about the potential for heart failure, and has the client return for regular check-ups. What does hypertension have to do with heart failure?
Hypertension causes the heart's chambers to enlarge and weaken.
Which New York Heart Association classification of heart failure has a poor prognosis and includes symptoms of cardiac insufficiency at rest?
IV
deep vein thrombosis (DVT).
If deep veins are affected, the condition is called
The nurse is creating a plan of care for a client with cardiomyopathy. Which goal would be a priority for the client?
Improved cardiac output
Risk Factors for Clot Formation
Inactivity Reduced cardiac output Compression of veins in the pelvis or legs Injury Irritation of the vein by drugs (vesicants or irritants) Insertion of an intravenous central line Peripheral arterial disease (plaque buildup) Use of oral contraceptives Smoking
What mechanism of action or pharmacological action is best associated with Loop Diuretics?
Inhibits Na+-K+-2Cl- (sodium, potassium, chlorine)
Signs & Symptoms of Raynaud's
Intermittent attacks, most often after exposure to cold Hands become cold, blanched, and sweaty Numbness and tingling Difficulty with coordination of movements After initial pallor of hands, fingers become deeply cyanotic and achy and painful In early disease, hands will appear normal between attacks As disease progresses, cyanosis persists & skin changes develop Painful ulcers & gangrene appear at fingertips Slow healing, vulnerable to infection
Signs & Symptoms of Buerger's Disease
Intermittent claudication - leg cramps that occur with exercise but are relieved with rest Numbness and tingling Cyanosis and redness of the feet; mottled; shiny Shallow, dry leg ulcers Black gangrenous areas on feet, toes, heels Thickened toenails Peripheral pulses diminish with activity Prolonged capillary refill
A nurse is assessing a client with congestive heart failure for jugular vein distension (JVD). Which observation is important to report to the physician?
JVD is noted 4 cm above the sternal angle.
The nurse identifies which symptom as a characteristic of right-sided heart failure?
Jugular vein distention (JVD)
In which of the following Types of Heart Failure is pulmonary congestion most likely to be seen?
Left sided
Signs & Symptoms of Varicose Veins
Legs feel heavy and tired, esp after prolonged standing Leg veins appear distended and tortuous and can be seen under the skin Feet, ankles, and legs may be edematous Changes in skin color Ulcerations Abnormal capillary refill
The nurse is caring for a client who is scheduled to undergo mechanical valve replacement. Client education would include coverage of which intervention?
Long-term anticoagulant therapy
Which nursing intervention should a nurse perform to reduce cardiac workload in a client diagnosed with myocarditis?
Maintain the client on bed rest
Signs & Symptoms of Aneurysm
May go unnoticed for some time until massive hemorrhage Can cause pain, discomfort, and affects on local structures: Thoracic aneurysm - respiratory symptoms, dysphagia AAA - nausea and vomiting or severe back pain Hypertension Pulsating mass around the umbilicus Bruit (wooshing sound) heard on auscultation Dissection of aneurysm can cause acute symptoms - signs of shock Imaging is used to identify location and size
Mary Seaver is admitted to the pediatrics unit where you practice nursing. She was admitted by her pediatrician due to suspected rheumatic fever. Aggressive antibiotic therapy and comfort measures have been instituted to minimize the long-lasting effects of the systemic inflammation. If Mary were to develop rheumatic carditis, which cardiac valve most likely would be affected?
Mitral valve
Anticoagulant Therapy
Monitor for bleeding when patient is on any of the following anticoagulants: Heparin Low-molecular-weight heparins: Enoxaparin (Lovenox) Dalteparin (Fragmin) Fondaparinux (Arixtra) Warfarin (Coumadin, Jantoven) The "bans": Apixaban (Eliquis) Edoxaban (Savaysa) Rivaroxaban (Xarelto) Dabigatran (Pradaxa)
The nurse is caring for a client with a history of endocarditis. Which topic would the nurse prioritize during health promotion education?
Oral hygiene
Which of the following describes difficulty breathing when lying flat?
Orthopnea
5 P's
Pain Pulse Pallor Paresthesia Paralysis
Raynaud's Disease
Periodic constriction of the arteries that supply the extremities Most common in young women
Common peripheral vascular disorders that reduce blood flow by various mechanisms include:
Peripheral arterial disease (PAD) Raynaud's disease Thrombosis Phlebothrombosis Embolism
Hattie Willoughby, a 62-year-old female, is two weeks CABG and is returning to her cardiologist due to new symptoms. She reports heaviness in her chest, and pain between her breasts. She reports that leaning forward decreases the pain. After his thorough examination, the cardiologist admits her to the hospital to rule out pericarditis. Which of the following is not a contributing cause to pericarditis?
Pneumonia
Which intervention is the most effective way to prevent rheumatic heart disease?
Recognizing and promptly treating streptococcal infections
The nurse recognizes which symptom as a classic sign of cardiogenic shock?
Restlessness and confusion
A nurse is conducting a health history on a client with a primary diagnosis of mitral stenosis. Which disorder reported by the client is the most common cause of mitral stenosis?
Rheumatic endocarditis
A client comes to the clinic reporting fever, chills, and sore throat and is diagnosed with streptococcal pharyngitis. A nurse knows that early diagnosis and effective treatment is essential to avoid which preventable disease?
Rheumatic fever
Which factor is the most common cause of mitral valve regurgitation in developing countries?
Rheumatic heart disease and its sequelae
Why does a client with left-sided heart failure require careful monitoring?
Right-sided heart failure is a risk.
A client is being discharged home after a heart transplant. The nurse is preparing to provide medication education on cyclosporine and tacrolimus. Which nursing diagnosis would be prioritized for this client?
Risk for infection
The nurse is providing discharge teaching for a client with rheumatic endocarditis but no valvular dysfunction. On which nursing diagnosis should the nurse focus her teaching?
Risk for infection
Blood flow of the heart starts here
Superior/inferior vena cava
A patient in cardiogenic shock after a myocardial infarction is placed on an intra-aortic balloon pump (IABP). What does the nurse understand is the mechanism of action of the balloon pump?
The balloon inflates at the beginning of diastole and deflates before systole to augment the pumping action of the heart.
The client asks the nurse why a stress test is needed. What statement best explains the rationale for the health care provider to order a cardiac stress test?
The health care provider wants to identify if the heart failure is from coronary artery disease.
The nurse is teaching a client with cardiomyopathy. Which statement is a valid teaching point?
The treatments include medications, medical devices, surgery, or transplantation.
The nurse is conducting a morning assessment of an 80-year-old female patient who has a longstanding diagnosis of heart failure (HF). The nurse notes an elevation in jugular venous pressure (JVP) greater than 4 cm above the woman's sternal angle, a finding that did not exist the day before. What conclusion should the nurse draw from this assessment finding?
The woman may be experiencing an exacerbation of right-sided HF.
The nurse is assisting in the care of a client who is receiving cardiopulmonary resuscitation (CPR). For which reason will the client be prescribed to receive amiodarone during the resuscitation efforts?
Treat pulseless ventricular tachycardia.
Medical & Surgical Management of Venous Occlusive Disease
Treated with: Elevation of the extremity Local heat - warm compresses Analgesics for pain Heparin, other oral anticoagulants DVT could require surgical removal via thrombectomy
Disorders of Blood Vessel Walls
Varicose veins Aneurysms
pulmonary embolism (PE).
When a thrombus forms in the leg, there is high risk for migration into the lungs, which results in
types of heart failure
acute and chronic
A client with left-sided heart failure reports increasing shortness of breath and is agitated and coughing up pink-tinged, foamy sputum. The nurse should recognize these findings as signs and symptoms of what condition?
acute pulmonary edema.
a client with left sided HF is admitted to the hospital for treatment. what nursing intervention is the first action the nurse should take?
administer 3L O2/NC
Buerger's Disease
also known as thromboangiitis obliterans. It involves recurrent inflammation of blood vessels associated with clot formation and fibrosis (scarring) of the blood vessel wall. Primarily affects the small and medium arteries and veins in the legs Involves arterial spasms that constrict the vessels, along with inflammatory lesions intermixed with healthy segments of vessel End result is occlusion of vessels with skin and soft tissue damage Can cause formation of ulcers and gangrene Unknown cause, but tobacco use is highly linked to this disease Occurs more often in men than women
after aortic valve
aorta
after left ventricle
aortic valve
Varicose veins
are dilated, tortuous veins
Anticoagulant drugs
are used to prevent further clot formation.
a client complains of intermittent claudication, pain when the legs are elevated, and cold and cold numb feet. the nurse notes several dry ulceration of the feet. does the client suffer sessment data must the nurse collect? what lifestyle habits might predispose the client to this disorder?
arterial insufficiency ask the pt to describe pain
The nurse is caring for a client with heart failure. What sign will lead the nurse to suspect right-sided and left-sided heart failure?
ascites
what health teaching is important for a client with a history of thrombophlebitis?
avoid sitting long periods avoid crossing knees wear Ted hose drink sufficient fluids take aspirin as needed
What are contributing causes to pericarditis?
cardiac surgery tuberculosis myocarditis chest trauma
Medical management of cardiac failure uses similar methodology whether it is right-sided or left-sided. Measures such as dietary modification, lifestyle changes, medications to reduce dyspnea and relieve anxiety, etc. are all used with one primary intention. The primary goal in the medical management of heart failure is to reduce:
cardiac workload
A nurse caring for a client recently admitted to the ICU observes the client coughing up large amounts of pink, frothy sputum. Lung auscultation reveals coarse crackles in the lower lobes bilaterally. Based on this assessment, the nurse recognizes this client is developing
decompensated heart failure with pulmonary edema.
A client asks the nurse if systolic heart failure will affect any other body function. What body system response correlates with systolic heart failure (HF)?
decrease in renal perfusion
The nurse is admitting a client with frothy pink sputum. What does the nurse suspect is the primary underlying disorder of pulmonary edema?
decreased left ventricular pumping
Loop diuretics are most likely to cause which of the following side effects?
dehydration
The physician writes orders for a patient to receive an angiotensin II receptor blocker for treatment of heart failure. What medication does the nurse administer?
digoxin
Which of the following medications is most commonly added to the regimen for patients who fail to respond to conventional pharmacotherapy for heart failure?
digoxin (lanoxin)
A client with a history of cardiomyopathy experiences dyspnea on exertion, fatigue, leg swelling, and chest pain. This client has which type of cardiomyopathy?
dilated cardiomyopathy
Which is a cerebrovascular manifestation of heart failure?
dizziness
Frequently, what is the earliest symptom of left-sided heart failure?
dyspnea on exertion
A client has been having cardiac symptoms for several months and is seeing a cardiologist for diagnostics to determine the cause. How will the client's ejection fraction be measured?
echocardiogram
The diagnosis of heart failure is usually confirmed by which of the following?
echocardiogram
Which of the following tests or diagnostic tools is most applicable when considering heart failure interventions
echocardiogram
what instruction is the most important for the nurse to include in the teaching plan for a client with right sided HF?
elevate legs while sitting
resection and removal of the lining of an artery
endarterectomy
S/S left side HF
fatigue paroxysmal nocturnal dyspnea orthopnea hypoxia crackles cyanosis S3 heart sounds cough with link frothy sputum elevated pulmonary capillary wedge pressure
The nurse suspects a client has developed pericarditis after a week of cold-like symptoms. Which of the client's signs and symptoms indicate pericarditis?
fever, chest discomfort, and elevated erythrocyte sedimentation rate (ESR)
The nurse is teaching a client about medications prescribed for severe volume overload from heart failure. What diuretic is the first-line treatment for clients diagnosed with heart failure?
furosemide
Which of the following medications is considered a Loop diuretic?
furosemide
when aucultating the chest of a client with pericarditis what will the nurse most likely hear?
grating friction rub
A nurse is administering digoxin. What client parameter would cause the nurse to hold the digoxin and notify the health care prescriber?
heart rate of 55 beats per minute
The nurse is caring for a client with advanced heart failure. What treatment will be considered after all other therapies have failed?
heart transplant
A nurse is caring for a client with end-stage cardiomyopathy and the client's spouse asks the nurse to clarify one of the last treatment options available that the health care provider mentioned. What is considered to be one of the last treatments for end-stage cardiomyopathy?
heart transplantation
Which position, movement, or direction is best used as an intervention for heart failure?
high fowlers
Which of the following Types of Heart Failure occurs when the heart cannot supply enough blood to meet the body's metabolic needs?
high output
prior to giving a client the morning dose of dioxin the nurse determines the apical pulse is less than 55 bpm, what nursing action is the priority?
hold the dos and assess for toxic findings
A nurse reviewing a client's echocardiogram report reads the following statements: "The heart muscle is asymmetrically thickened and the overall size and mass are increased, especially along the septum. The ventricular walls are thickened, reducing the size of the ventricular cavities. Several areas of the myocardium show evidence of scarring." The nurse knows these manifestations are indicative of which type of cardiomyopathy?
hypertrophic
Loop diuretics are most likely to cause which of the following side effects?
hypocalcemia
Loop diuretics are most likely to cause which of the following side effects?
hypokalemia
While receiving treatment in hospital for a DVT, a client has several interventions ordered. Complete rest, anticoagulant therapy, and procedures to determine the location and size of the thrombus are all utilized to decrease the danger from the blood clot. Continuous warm, wet packs are ordered to:
improve circulation.
The nurse is assessing a client with crackling breath sounds or pulmonary congestion. What is the cause of the congestion?
inadequate cardiac output
Warm compresses
increase circulation, ease pain and decrease inflammation.
Inferior vena cava filter (IVC filter)
inserted to trap emboli before they can reach the heart; prevents PE. May be referred to as a Greenfield filter.
Which of the following tests or diagnostic tools is most applicable when considering heart failure interventions?
invasive hemodynamic monitoring
Peripheral vascular disease (PVD)
is a general term for disorders that affect peripheral blood vessels
embolus
is a moving clot within the bloodstream - vein or artery
Venous insufficiency
is a peripheral vascular disorder in which venous blood flow is impaired Can affect both deep or superficial veins Most often affects lower extremities
thrombosis
is a state in which a thrombus has formed in a blood vessel - vein or artery
aneurysm
is a stretching or bulging out of an arterial wall
Thrombophlebitis
is inflammation of a vein accompanied by clot or thrombus formation
Thrombophlebitis
is inflammation of a vein with development of clot. Most serious form is called venous thromboembolism (VTE).
Phlebothrombosis
is the development of a clot within a vein without inflammation
Which of the following medications is considered a Loop diuretic?
lasix
after pulmonary veins
left atrium
after mitral valve
left ventricle
A client diagnosed with heart failure presents with a temperature of 99.1° F, pulse 100 beats/minute, respirations 42 breaths/minute, BP 110/50 mm Hg; crackles in both lung bases; nausea; and pulse oximeter reading of 89%. Which finding indicates a need for immediate attention?
lung congestion
after pulmonary artery
lungs
after left atrium
mitral valve
a client comes in complaining of shortness of breath, pink tinged sputum and a cough. the nurse suspects left sided HF, what assessment finding further confirms this?
moist crackles in the lungs
A client has been admitted to the cardiac step-down unit with acute pulmonary edema. Which symptoms would the nurse expect to find during assessment?
moist, gurgling respirations
what nursing interventions should a nurse perform when a client with cardiomyopathy receives a loop diuretic?
monitor I&O asses daily weight check for dependant edema encourage foods containing potassium
A client is prescribed digitalis medication. Which condition should the nurse closely monitor when caring for the client?
nausea and vomiting
Pulmonary embolism
occurs when a blood clot (thrombus) gets lodged in an artery in the lung and blocks blood flow to part of the lung.
chronic HF
occurs when the hearts ability to pump effectively is gradually compromised and its impaired contractibility remains prolonged
which category of anticoagulant drug therapy would a client be most able to manage independently?
oral anticoagulant drug therapy
Loop diuretics are most likely to cause which of the following side effects?
orthostatic hyotension
Loop diuretics are most likely to cause which of the following side effects?
ototoxicity from rapid injection
Which of the following is most likely indicated as an intervention in patients with severe heart failure?
pacemaker
intermittent claudication
pain and cramping in the thigh, calf, or buttock muscles during activity - and it typically subsides with rest
of the 3 major inflammatory disorders of the heart, endocarditis, myocarditits and Pericarditis, which has the fewest long term effects?
pericarditis
During your assessment of a patient with right-sided heart failure, which of the following is most likely to be seen?
peripheral edema
4th intercontinental space in the mid Axillary line
phlebostatic axis
The nurse completes an assessment of a client admitted with a diagnosis of right-sided heart failure. What will be a significant clinical finding related to right-sided heart failure?
pitting edema
Primary cause is atherosclerosis
plaque buildup, secondary to obesity, hypertension, hyperlipidemia, DM, chronic smoking, and family history
Left-sided heart failure results in several symptoms due to reduced cardiac output. Which symptom would NOT contribute to a diagnosis of heart failure?
polydipsia
Which term describes the degree of stretch of the ventricular cardiac muscle fibers at the end of diastole?
preload
after pulmonary valve
pulmonary artery
A client is admitted to the hospital with systolic left-sided heart failure. The nurse knows to look for which assessment finding for this client?
pulmonary congestion
During your assessment of a patient with left-sided heart failure, which of the following is most likely to be seen?
pulmonary congestion
A client with a history of an anterior wall myocardial infarction is being transferred from the coronary care unit (CCU) to the cardiac step-down unit (CSU). While giving a report to the CSU nurse, the CCU nurse says, "His pulmonary artery wedge pressures have been in the high normal range." What additional assessment information would be important for the CSU nurse to obtain?
pulmonary crackles
A client who was admitted to the hospital with a diagnosis of thrombophlebitis 1 day ago suddenly reports chest pain and shortness of breath and is visibly anxious. The nurse immediately assesses the client for other signs and symptoms of
pulmonary embolism.
after right ventricle
pulmonary valve
after lungs
pulmonary veins
The nurse completes an assessment of a client admitted with pericarditis. What client symptom will the nurse correlate with the diagnosis of pericarditis?
reports of constant chest pain
left sided HF
results from various conditions that impair the LV ability to eject blood into the aorta
after superior/inferior vena cava
right atrium
In which of the following Types of Heart Failure is peripheral edema most likely to be seen?
right sided
after tricuspid valve
right ventricle
thrombus
stationary blood clot
Acute HF
sudden change in the heart's ability to contract
Which of the following drug classes would be best associated with loop diuretics like furosemide?
sulfa drug
Thrombectomy
surgical removal of clot - may be performed if necessary
when the nurse checks the PTT lab result of a client who has been receiving a daily subcutaneous dose of heparin. it is 100 seconds. based on a normal PTT value of 60 to 70 seconds. which only the following can the nurse expect when the lab result is reported to the dr?
the dr will order the same daily dose of heparin b/c the client's PTT is within a therapeutic range
Where do medications like furosemide exert their effects?
thick ascending limb of the loop of henle
after aorta
to the body
after right atrium
tricuspid valve
Which of the following best describes the pathophysiology of high output heart failure?
unable to meet metabolic needs
A nurse suspects that a client has digoxin toxicity. The nurse should assess for:
vision changes
A client with chronic heart failure is receiving digoxin 0.25 mg by mouth daily and furosemide 20 mg by mouth twice daily. The nurse should assess the client for what sign of digoxin toxicity?
visual disturbances.
S/S right sided HF
weakness asciyes wt gain nausea, vomiting arrhythmias elevated central venous pressure jugular vein dissension
A client with heart failure must be monitored closely after starting diuretic therapy. What is the best indicator for the nurse to monitor?
weight
right sided HF
when the RV fails to eject its diastolic filling volume into the pulmonary artery causing congestion of blood in the venous vascular system
ankle-brachial index
which is a comparison of the systolic pressure in the brachial artery with that in the posterior tibial artery using Doppler ultrasound
