Patho Exam 3
a client with atrial fibrillation is prescribed diltiazem. which client outcome would best indicate that the medication has had its intended effect
HR decreases from 152 bpm to 89 bpm
a client experiencing sickle cell crisis for the first time asks you why they are feeling so much pain all over their body. you understand that the primary reason for this generalized pain is
vascular occlusions leading to tissue hypoxia
which of the following is the most life-threatening of dysrhythmia
ventricular fibrillation
the nurse is administering packed red blood cells to a client with a hemoglobin of 4.7g/dL. the nurse should
use a 20 gauge peripheral intravenous catheter to administer PRBCs
which of the following statements is true regarding Pulseless Ventricular Tachycardia and its management
the client will have no cardiac output
a nurse is teaching a client who has a new prescription for ferrous sulfate. which of the following statements by the client indicates an understanding of the teaching
"I should expect constipation and need to increase my fiber intake"
a client is admitted to the hospital after a motor vehicle accident involving internal hemorrhaging in the abdomen. the client is alert and oriented, and asking the nurse whether or not a blood transfusion will be required. the client's most recent hemoglobin value was 4.3. which of the following is the most appropriate response?
"for someone who is actively bleeding and has a hemoglobin less than 8, yes, blood transfusions are necessary"
a nurse is caring for a client who has DVT and is receiving heparin by continuous IV infusion. the client asks the nurse how long it will take for the heparin to dissolve the clot. which of the following responses should the nurse give
"heparin does not dissolve clots. it stops new clots from forming"
a nurse is teaching the partner of a client who had an acute myocardial infarction about the reason blood was drawn from the client to test a troponin level. which of the following statements should the nurse make regarding this lab
"this test helps determine the degree of damage to the heart tissue"
a nurse is teaching a client who has a prescription for clopidogrel. which of the following instructions should the nurse include
"you might have to stop taking this med 5 days before any planned surgeries""
a client is being discharged home after the placement of an implanted cardioverter defibrillator. which of the following should be included in the nurse's discharge instructions to the client
"you must let your dentist know about your ICD at your next visit"
the nurse should instruct a client with sickle cell anemia to do which of the following?
- avoid cities that are at high elevations and therefore lower oxygen levels - drink plenty of fluids when outside in hot weather - in sickle cell crisis, severe abdominal pain should be reported to the HCP immediately
which of the following are consistent with a deep vein thrombosis
- calf pain - leg edema
the client in the question above, who is diagnosed as having a DVT, is prescribed Heparin 80units/kg IV bolus followed by heparin 18units/kg/hr IV fusion. which of the following additional actions would be indicated?
- check platelet count for this patient in the morning - monitor for hematuria and blood in the stool
a few days later, the client on the heparin infusion above achieved a therapeutic aPTT and was transitioned to Warfarin in anticipation of being discharged home soon. which health teaching will the nurse include as part of discharge planning related to Warfarin therapy
- contact your HCP if your stool is black and tarry - if you eat green, leafy vegetables, makes sure to eat a consistent amount each day - keep your schedule appointment at the Warfarin clinic where your INR will be tested - monitor your heart rate and blood pressure daily to assess for signs of bleeding
a client is being discharged home on PO Warfarin related to a history of chronic atrial fibrillation. which of the following should the nurse advise the patient to monitor for related to potential side of adverse effects of this medication
- petechiae on the trunk - hematuria - hematochezia - epistaxis - hemoptysis
which of the following are examples of venous clots
- pulmonary embolism - DVT
a client comes to the emergency department complaining of experiencing palpitations on and off for the past few months. what other signs or symptoms of a dysrhythmia might the client report?
- syncopal episodes - dizziness - weakness - activity intolerance
which of the following principles is accurate regarding administration of PRBCs
the nurse should remain with the patient for the first 15 mins of the infusion
which of the following is an example of a situation that would cause the extrinsic coagulation cascade to begin to form a fibrin clot
trauma causing injury to skin and muscle
a HCP wants to send a patient home with a slef-administered SQ anticoagulant that does not require frequent aPTT lab monitoring. which med is being described
Enoxaparin
a client with chronic liver disease is deficient in clotting factor VII. which lab value do you expect to be elevated for this client
INR
which of the following is the most appropriate intervention for the patient in the rhythm below? the patient has a pulse, but is lethargic. BP is 80/40, RR 26, pulse oxi 91% on 10L oxymask
IV amiodarone
which of the following shows the correct sequence of electrical conduction in a heart
SA node -> AV node -> bundle of his -> bundle branches -> purkinje fibers
which of the following is true regarding the hematologic system?
a functioning liver is needed to make certain clotting factors
a nurse is caring for a client who has congestive heart failure and is taking digoxin daily. the client refused breakfast and is complaining of nausea and vomiting. which of the following is the priority request from the nurse when speaking to the HCP regarding this client
an order for a STAT digoxin level
for the client admitted with new onset of atrial fibrillation, in addition to antidysrhythmics, what other medications need to be considered for this client to prevent a major complication of this rhythm
anticoagulants
a client who has a history a myocardial infarction (MI) is prescribed aspirin 325 mg. the nurse recognizes that the aspirin is given due to which of the following actions of the med
antiplatelet aggregate
a client who has a history of myocardial infarction is prescribed 81 mg. the nurse recognizes that the aspirin is given due to which of the following actions of the med
antiplatelet aggregation
the nurse notes that a client's HR drops from 63 to 50 bpm on the monitor. the nurse should first
assess level of consciousness
the nurse is caring for a client with end-stage heart failure. the nurse goes to check on that client and finds no pulse.
asystole
which of the following is the most common cause of ischemia stroke
atrial fibrillation
what is the reasoning behind why we can use heparin and warfarin to treat venous and arterial clots
because both of these clots contain fibrin
a patient is found in this rhythm. while waiting for defibrillator to arrive, which of the following is the most appropriate next intervention
begin CPR
a client with chest pain is prescribed IV nitroglycerin. which assessment is of greatest concern for the nurse initiating nitroglycerin drip
blood pressure is 81/44
client is admitted with 10/10 substernal chest pain. troponin level is 10.52. clients vital signs: BP 150/92, HR 91 bpm, Sp)2: 92% on 2L NC. which of the following is the priority intervention for this client
cardiac catherization
a client who recently experienced a myocardial infarction is being discharged home on an antiplatelet medication to prevent re-infarction. which med is being described
clopidogrel
a nurse completes assessments of clients with decreased cardiac output. which finding is the highest priority
confusion, urine output of 15mL/hr over past 2 hours, orthopnea
a client is on bedrest following bowel surgery for a small bowel obstruction. on the fourth post-operative day, the nurse is assessing the client and finds unilateral swelling pain, and erythema in the client's right calf. which does the nurse suspect?
deep vein thrombosis
a client with a history of heart failure is taking furosemide and digoxin daily. the client has nausea, blurred vision, and headache. the nurse also notes confusion. the nurse should further assess the client for sings of which of the following
digoxin toxicity
a nurse provides care to client who was admitted to the hospital reporting chest pain. which of the following diagnostic tests should the nurse prioritize
electrocardiogram
you are taking care of a patient who is having repeated episodes of hematemesis. which of the following diagnostic procedures do you anticipate being performed to make a diagnosis of this patient's condition
esophagogastroduodenoscopy
which of the following is an accurate list of the clotting factors that the liver produces
factors II, VII, IX, and X
a client is with chronic kidney disease is receiving Epoetin injections. what laboratory value should increase as a result of administering this med
hemoglobin count
a client is admitted to the hospital with sickle cell crisis after hypothermia in a cold climate. which of the following is an accurate list of interventions used to treat this condition
hydrate with IVF, severe pain management with opioids, supplemental oxygen therapy as needed
a nurse is preparing to administer verapamil by IV bolus to a client who is having cardiac dysrhythmias. for which of the following adverse effects should the nurse monitor when giving this med
hypotension
which of the following medications should be avoided in a client with chronic kidney disease stage 3
meloxicam
a nurse is collecting a medication history from a client who is scheduled to have a cardiac catheterization. which of the following medications taken by the client interacts with contrast material and places the client at risk for lactic acidosis as a result of contrast-induced acute kidney injury
metformin
a nurse is giving medications to a patient scheduled for a cardiac catheterization this afternoon. which medication should the nurse plan to withhold from the patient this morning
metformin
a client is being discharged home on simvastatin following a STEMI. the nurse should teach the client to report which of the following to the HCP immediately
muscle pains
for the client receiving the Heparin infusion above, the lab values for this client the following morning include an aPTT of 195. which action does the nurse anticipate performing next
place the Heparin on hold
a nurse us reviewing the laboratory data on a client who has a new prescription for heparin for treatment of a pulmonary embolism. which of the following data should the nurse report to the provider
platelets 54,000/mm3
which of the following occurs early in the clot formation process in the case of a blood vessel wall that has been cut/damaged
platelets begin to group together at the site of vessel injury
the patient below called 911 reporting severe epigastric pain. the patient chewed 325mg of aspirin given by EMS. This EKG was transmitted to the nearest hospital
prepare the patient for percutaneous coronary intervention
a nurse is caring for a client who has thrombophlebitis and is receiving a continuous heparin infusion. which of the following medications should the nurse have available to reverse heparins effects
protamine sulfate
the nurse on a rehabilitation floor enters a client's room and finds the client unconscious with no pulse. the nurse starts 2 minutes of CPR and calls a code. the defibrillator arrives and patches are attached to the patient, but no shock is advised. the pharmacist has not arrived yet, so no medications are available. what intervention in most appropriate at this time
resume chest compressions at a rate of 100/min
a nurse is reviewing laboratory for four clients. which of the following clients has manifestations of acute kidney injury
serum creatinine 6mg/dL
a client with a history of peripheral arterial disease is asking how to respond to episodes where they wake up in the middle of the night and their legs feel like "they are on fire" and there is extreme pain. which recommendation would be most appropriate for the nurse to give to this client
sit at the edge of the bed and have your legs in a dependent position
a client with iron-defieciency anemia is refusing to take the prescribed oral iron medication because client is convinced they are not absorbing the medication well enough to increase blood iron levels. the nurse should do which of the following
suggest the client take the medication with orange juice
a client reports to the emergency department stating his heart is "pounding out of his chest" after using cocaine. the client is connected to cardiac monitoring and is shown to be in the following rhythm. how is this rhythm interpreted
supraventricular tachycardia
a nurse is providing teaching for a client who has anemia and a new prescription for ferrous sulfate liquid. which of the following instructions should the nurse provide
take the medication with a vitamin C tablet to increase absorption