MED SURG CH. 25

A client complains of leg pain brought on by walking several blocks — a symptom that first arose several weeks earlier. The client's history includes diabetes mellitus and a two-pack-per-day cigarette habit for the past 42 years. The physician diagnoses intermittent claudication and orders pentoxifylline (Trental), 400 mg three times daily with meals. Which instruction concerning long-term care should the nurse provide?

"Practice meticulous foot care."

To be effective, percutaneous transluminal coronary angioplasty (PTCA) must be performed within what time frame, beginning with arrival at the emergency department after diagnosis of myocardial infarction (MI)?

60 minutes

The nurse is caring for an older adult client who is in cardiac rehabilitation following heart surgery. The client has been walking on a regular basis for about a week and walks for 15 minutes 3 times a day. The client states that he has cramp-like pain in the legs every time he walks and that the pain gets "better when I rest." The client's care plan should address what problem?

Acute pain related to intermittent claudication

A client who has undergone a femoral to popliteal bypass graft surgery returns to the surgical unit. Which assessments should the nurse perform during the first postoperative day?

Assess pulse of affected extremity every 15 minutes at first.

A client presents to the ED reporting severe substernal chest pain radiating down his left arm. He is admitted to the coronary care unit (CCU) with a diagnosis of myocardial infarction (MI). What nursing assessment activity is a priority on admission to the CCU?

Begin ECG monitoring.

When caring for a patient with leg ulcers, the positioning of the legs depends on whether the patient's ulcer is arterial or venous in origin. How should the nurse position a patient who has leg ulcers that are venous in origin?

Elevate the patient's lower extremities.

Which statement is accurate regarding Reynaud disease?

Episodes may be triggered by unusual sensitivity to cold.

A nurse is educating a community group about coronary artery disease. One member asks about how to avoid coronary artery disease. Which of the following items are considered modifiable risk factors for coronary artery disease? Choose all that apply.

Hyperlipidemia Obesity Tobacco use

The nurse is taking a health history on a new patient. The patient reports experiencing pain in the left lower leg and foot when walking, but claims that the pain is relieved with rest. The nurse notes that the patient's left lower leg is slightly edematous and hairless. What should the nurse suspect that the patient may be experiencing?

Intermittent claudication

The triage nurse in the emergency department assesses a 66-year-old male patient who has presented to the emergency department with complaints of midsternal chest pain that has lasted for the last 5 hours. The care team suspects a myocardial infarction (MI). The nurse is aware that, because of the length of time the patient has been experiencing symptoms, the following may have happened to the myocardium:

May have developed an increased area of infarction

An adult client is admitted to the ED with chest pain. The client states that he had unrelieved chest pain for approximately 20 minutes before coming to the hospital. To minimize cardiac damage, the nurse should expect to administer which of the following interventions?

Morphine sulphate, oxygen, and bed rest

Which is a risk factor for venous disorders of the lower extremities?

Obesity

When assessing a client diagnosed with angina pectoris, it is most important for the nurse to gather what information?

The client's symptoms and the activities that precipitate attacks

A 66-year-old male patient with a high body mass index and a history of hypertension made an appointment with his primary care provider because of sudden, severe, and unprecedented fatigue over the past several days. The care provider referred the patient to the emergency department, where the patient underwent assessment for acute coronary syndrome. Assessment of the man's cardiac biomarkers revealed normal levels of myoglobin and CK-MB but elevated levels of troponin I. What conclusion is suggested by these data?

The man had an MI in the recent past.

The nurse is caring for a client who is diagnosed with Raynaud phenomenon. The nurse should plan interventions to address what nursing diagnosis?

The nurse is caring for a client who is diagnosed with Raynaud phenomenon. The nurse should plan interventions to address what nursing diagnosis?

Family members bring a client to the ED with pale cool skin, sudden midsternal chest pain unrelieved with rest, and a history of CAD. How should the nurse best interpret these initial data?

The symptoms indicate an acute coronary episode and should be treated as such.

The client has had biomarkers tested after reporting chest pain. Which diagnostic marker of myocardial infarction remains elevated for as long as 2 weeks?

Troponin

While receiving heparin to treat a pulmonary embolus, a client passes bright red urine. What should the nurse do first?

While receiving heparin to treat a pulmonary embolus, a client passes bright red urine. What should the nurse do first?

A client is admitted to the emergency department with chest pain and doesn't respond to nitroglycerin. The health care team obtains an electrocardiogram and administers I.V. morphine. The health care provider also considers administering alteplase. This thrombolytic agent must be administered how soon after onset of myocardial infarction (MI) symptoms?

Within 6 hours

The nurse is explaining the cause of angina pain to a client. What will the nurse say caused the pain?

a lack of oxygen in the heart muscle that causes the death of cells

In the effort to prevent CAD, the Centers for Disease Control and Prevention discovered a predictive risk factor unique to women. What is the name of this risk factor?

elevated C-reactive protein

The nurse is caring for a client with coronary artery disease. What is the nurse's priority goal for the client?

enhance myocardial oxygenation

A client's lipid profile reveals an LDL level of 122 mg/dL. This is considered a:

high LDL level.