Med Surg #4

PT Therapeutic range for anticoagulant therapy

1.5-2 times the normal (normal 11 to 12.5)

PTT Therapeutic range for anticoagulant therapy

1.5-2 times the normal (normal 30-40 seconds)

A nurse is caring for a client who asks why the provider prescribed a daily aspirin. which of the following responses should the nurse make? A. "aspirin reduces the formation of blood clots that could cause heart attacks" B. "Aspirin relieves the pain due to myocardial ischemia" C." Aspirin dissolves clots that are forming in your coronary arteries" D. "Aspirin relieves headaches that are caused by other medications"

A. . "aspirin reduces the formation of blood clots that could cause heart attacks"

A nurse is caring for a client following peripheral bypass graft surgery of the left lower extremity. Which of the following findings pose an immediate concern? (select all that apply) A. trace of bloody drainage on dressing B. Capillary refill of affected limb of 6 seconds C. Mottled appearance of the limb D. Throbbing pain of affected limb that is decreased follwing IV bolus analgesic E. Pulse of 2+ in the affected limb

B. Capillary refill of affected limb of 6 seconds C. Mottled appearance of the limb

normal BP range

less than 120/80

Elevated BP range

120-129/<80

Stage 1 hypertension blood pressure

130-130/80-89

hypertension (HTN) stage 2

140/90

Platelets

150,000-400,000

INR theraputic range

2-3

LDL

<130 mg/dL

Total Cholesterol

<200 mg/dL

A nurse is caring for a client who experienced defibrillation. Which of the following should be included in the documentation of this procedure? Select all that apply A. Follow up ECG B. Energy settings used C. IV fluid intake D. Urinary output E. Skin condition under electrodes

A. Follow up ECG B. Energy settings used E. Skin condition under electrodes

A nurse is assisting in the care of a client who began having chest pain 2 hr ago. Which of the following laboratory findings should the nurse identify as an indication the client has sustained injury to the heart? A. Troponin T 0.8 ng/mL B. Creatine kinase (MB) 100 units/L C. Myoglobin 80mcg/L D. Triglycerides 120 mg/dL

A. Troponin T 0.8 ng/mL

A nurse is assisting with the care of a group of clients. The nurse should recognize which of the following clients as being at risk for the development of a dysrhythmia? (select all that apply) A. a client who has metabolic alkalosis B. A client who has a blood potassium level of 4.3 mEq/L C. a client who has an SaO2 of 96% D. A client who has alcohol use disorder E. A client who underwent stent placement in a coronary artery

A. a client who has metabolic alkalosis D. A client who has alcohol use disorder E. A client who underwent stent placement in a coronary artery

A nurse at a provider's office is reviewing the laboratory test results for a group of clients. The nurse should identify which of the following results indicates the client is at risk for heart disease? (select all that apply) A. cholesterol (total) 245mg/dL B. HDL 90 mg/dL C. LDL 140mg/dL D. Triglycerides 124mg/dL E. Troponin 0.02ng/mL

A. cholesterol (total) 245mg/dL C. LDL 140mg/dL

A nurse is assisting iwth the admission of a client who has a suspected myocardial infarction (MI) and a history of angina. Which of the following findings will help the nurse distinguish stable angina from MI? A. stable angina can be relived with rest and nitroglycerin B. The pain of an MI resolves in less than 15 minutes C. The type of activity that causes an MI can be identified. D. Stable angina can occur for longer than 30 minutes

A. stable angina can be relieved with rest and Nitroglycerin

A nurse is reinforcing teaching with a client who is scheduled for a stress test. Which of the following statements should the nurse include in the teaching? A. "you should not have anything to eat or drink for 8 hours prior to the test" B. "you will exercise your heart by walking on a treadmill" C. "A chest x-ray will be obtained following the test" D. "The test will be delayed if your troponin level is less than 0.5ng/mL

B. "you will exercise your heart by walking on a treadmill"

A nurse is caring for a client who is on telemetry the nurse recognizes the clients heart rate is 46/min and notifies the provider . Which of the following prescriptions might be appropriate for this client. A. defibrillation B. pacemaker insertion C. synchronized cardioversion D. administration of IV lidocaine

B. Pacemaker insertion

A nurse is reinforcing discharge teaching with a client following an atherectomy using the right femoral artery as an access. Which of the following client statements indicates an understanding of the information? A. "I should expect moderate swelling of the insertion site on my right groin" B. "I will limit fluid intake for the first 24 hours following the procedure" C. "I should restrict lifting to 5 pounds" D. "I can resume high impact aerobic exercises right away"

C. "I should restrict lifting to 5 pounds"

A nurse is reviewing the laboratory findings of a client who has a diagnosis of MI and reports that their dyspnea began 2 weeks ago. Which of the following cardiac enzymes would confirm the MI occurred 14 days ago? A. CK-MB B. Troponin I C. Troponin T D. Myoglobin

C. Troponin T

A nurse is assisting with the care of a client following an angioplasty that was inserted through the femoral artery. While turning the client the nurse discovers blood underneath the clients lower back. Which of the following findings should the nurse suspect? A. Retroperitoneal bleeding B. Cardiac tamponade C. bleeding from the incisional site D. Heart failure

C. bleeding from the incisional site

A nurse is is reinforcing teaching with a client who is scheduled for an echocardiogram. Which of the following statements should the nurse include in the teaching? A. "You may experience a warm feeling when the dye is injected" B. "the test will require 2 hours to complete" C. "you will be placed on your right side during the proceudre" D. "The test allows us to see how your heart valves work"

D. " the test allows us to see how your heart valves work"

A nurse is reinforcing teaching with a client who is scheduled for coronary angiography. Which of the following statements should the nurse include? A. "you should have nothing to eat or drink for 4 hours prior to the procedure. B. "you will be given general anesthesia during the procedure" C. "You should not have this procedure done if you are allergic to eggs" D. "You will need to keep your affected leg straight following the procedure"

D. "You will need to keep your affected leg straight following the procedure"

A nurse is reinforcing teaching with a client who is scheduled for synchronized cardioversion for treatment of atrial fibrillation. The client asks why it is necessary that an anticoagulant be taken for several weeks prior to the procedure. Which of the following responses should the nurse make? A " the medication will improve the effectiveness of the cardioversion" B. The medication may cause the heart to resume a normal rhythm so the procedure wouldn't be necessary C. "The medication will prevent an infection" D. "The medication will decrease the risk of blood clots causing further complications"

D. The medication will decrease the risk of blood clots causing further complications

A nurse is contributing to the plan of care for a client who has transferred from the coronary care unit following CABG surgery. Which of the following interventions should the nurse include? A. Provide percussion chest physiotherapy to loosen pulmonary secretion B. Report urinary output of less than 300mL in 8hr C. Limit administration of opioid analgesics for pain ratings greater than 7 out of 10 D. instruct the client to splint chest when deep breathing

D. instruct the client to splint the chest when deep breathing

A nurse is collecting date from a client who will undergo peripheral bypass graft surgery on the left leg. Which of the following finding should the nurse expect? A. Rubor of the affected leg when elevated B. 3+ dorsal pedal pulse in left foot C. Then, peeling toenails of the left foot D. report of intermittent claudication in the affected leg

D. report of intermittent claudication in the affected leg

Trigylcerides

Desirable <150 males 40-160 Female 35-135

HDL

Females: >55 mg/dL Males: > 45 mg/dL