Cardio PrepU

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A nurse is preparing a teaching plan for a male client newly prescribed atenolol. Which information is important for the nurse to teach this client?

Call emergency medical services immediately if chest pain does not subside within 15 minutes.

A nurse is teaching a client how to take nitroglycerin to treat angina pectoris. What should the nurse include in the instructions?

the client admitted with first-degree atrioventricular (AV) block whose cardiac monitor now reveals type II second-degree AV block

A nurse just received a shift report for a group of clients on the telemetry unit. Which client should the nurse assess first?

The client reports increasing severe back pain.

A client arrives in the emergency department reporting intense pain in the abdomen and tells the nurse that it feels like a heartbeat in the abdomen. Which nursing assessment would indicate potential rupture of an aortic aneurysm?

Identify the time of onset of the stroke.

A client arrives in the emergency department with an ischemic stroke. What should the nurse do before the client receives tissue plasminogen activator (t-PA)?

"Client walks 4 miles (6.4 kilometers) in 1 hour every day."

A client comes to the physician's office for a follow-up visit 4 weeks after suffering a myocardial infarction (MI). The nurse takes this opportunity to evaluate the client's knowledge of the ordered cardiac rehabilitation program. Which evaluation statement suggests that the client needs more instruction?

anticoagulant.

A client has a blockage in the proximal portion of a coronary artery. After learning about treatment options, the client decides to undergo percutaneous transluminal coronary angioplasty (PTCA). During this procedure, the nurse expects to administer an

Dependent edema.

A client has been diagnosed with right-sided heart failure. The nurse should assess the client further for:

loss of hair on the lower leg

A client has severe arterial occlusive disease and gangrene of the left great toe. Which finding is expected?

Withhold the medication and notify the physician immediately.

A client is about to undergo cardiac catheterization for which informed consent was obtained. As the nurse enters the room to administer sedation for the procedure, the client states, "I'm really worried about having this open heart surgery." Based on this statement, how should the nurse proceed?

Position the left leg at or below the body's horizontal plane.

A client is admitted for a revascularization procedure for arteriosclerosis in the left iliac artery. What should the nurse do to promote circulation in the extremities?

tooth extraction

A client is discharged after an aortic aneurysm repair with a synthetic graft to replace part of the aorta. The nurse should instruct the client to notify the health care provider (HCP) before having which procedure?

Revascularize the blocked coronary artery.

36. The nurse is evaluating a client who received tissue plasminogen activator (t-PA) following a myocardial infarction (MI). What is the expected outcome of this drug?

showing the location of the obstruction and the collateral circulation.

A client is scheduled for an arteriogram. The nurse should explain to the client that the arteriogram will confirm the diagnosis of occlusive arterial disease by:

Keep the legs elevated when sitting or lying down.

A client is talking with the nurse about unsightly varicose veins and their discomfort. What information should the nurse provide to the client?

dorsal surface of the right foot

A client returns from a left heart catheterization. The right groin was used for catheter access. In which location should the nurse palpate the distal pulse on this client?

"I wonder if there is any other way to prevent these bad rhythms."

A client signed a consent form for participation in a clinical trial for implantable cardioverter-defibrillators. Which statement by the client indicates the need for further teaching before true informed consent can be obtained?

"It isn't a problem to rescind your DNR order; I'll let your physician know your wishes right away."

A client who requested a do-not-resuscitate (DNR) order upon admission to the hospital now states a desire for the medical team to do everything possible to help the client get better. The client is concerned about the DNR order. Which response by the nurse is best?

respiratory rate

A client whose condition remains stable after a myocardial infarction is to gradually increase activity. Which sign best indicates that the activity is appropriate for the client?

Bupropion.

A client with Buerger's disease has established a goal to stop smoking. Which medication would be the most helpful in attaining this goal?

"The pain is probably related to inadequately oxygenated blood getting through the arteries into the muscles of your legs."

A client with a history of angina and intermittent claudication reports pain in both legs with a need to stop and rest after ambulating down the hall. Which statement by the nurse best addresses this concern?

confusion and restlessness

A client with a ventricular dysrhythmia is receiving intravenous lidocaine. For which assessment finding should the nurse suspect the client is experiencing toxicity from the medication?

acute pulmonary edema.

A client with left-sided heart failure complains of 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

Maintain circulation.

A client with peripheral artery disease has femoral-popliteal bypass surgery. What goal should the nurse establish with the client immediately after surgery?

Discontinue the furosemide and notify the health care provider (HCP).

A client, hospitalized with heart failure, is receiving digoxin and furosemide intravenously and now has continuous ringing in the ears. What is the appropriate action for the nurse to take at this time?

Gradually increasing my exercise levels will help enhance circulation through the heart." "If I change my diet and lessen my intake of saturated fats and trans fatty acids, this may decrease my cholesterol levels." "As a borderline diabetic, if I lose weight and lessen my intake of simple carbohydrates, this should benefit my heart." "Walking is excellent exercise to strengthen my heart.

A group has asked the nurse to discuss how lifestyle factors affect heart health. Which statements by members of the group would indicate that the teaching was effective? Select all that apply.

assess the client for bleeding around the gums or in the stool and notify the physician of the laboratory results and most recent administration of warfarin.

A nurse is caring for a client receiving warfarin therapy following a mechanical valve replacement. The nurse completed the client's prothrombin time and International Normalized Ratio (INR) at 7 a.m. (0700), before the morning meal. The client had an INR reading of 4. The nurse's first priority should be to

Obtain an order for calcium gluconate 2 g I.V. push over 2-5 minutes.

A nurse is caring for a client with frequent episodes of ventricular tachycardia. The lab calls with a critically high magnesium level of 11 mg/dL on this client. What is the nurse's priority action?

potassium level of 3.1 mEq/L (3.1 mmol/L)

A physician orders digoxin for a client with heart failure. During digoxin therapy, which laboratory value may predispose the client to digoxin toxicity?

Explain to the client that the "ringing" may be related to the aspirin.

An older adult takes two 81-mg aspirin tablets daily to prevent a heart attack. The client reports having a constant "ringing" in both ears. How should the nurse respond to the client's comment?

myocardial necrosis.

Creatine kinase-MB isoenzyme (CK-MB) can increase as a result of:

diabetic neuropathy

Following cardiac bypass surgery, the client has been referred to a cardiac rehabilitation exercise program. The client has type 1 diabetes and has bilateral leg discomfort with walking. The client is exercising using a stationary bicycle. The nurse should evaluate the client's response to exercise by assessing the presence of which condition?

Seek consultation from the health care provider.

The nurse is conducting a health assessment of an older adult. The client tells the nurse about cramping leg pain that occurs when walking for 15 minutes; the pain is relieved with rest. The lower extremities are slightly cool to touch, and pedal pulses are palpable +1. What should the nurse instruct the client to do?

creatinine level and liver function tests

The nurse is preparing the client newly diagnosed with peripheral arterial disease for discharge with the medication atorvastatin. What laboratory work should the nurse obtain to establish a baseline before starting the medication?

to stop smoking

One goal in caring for a client with arterial occlusive disease is to promote vasodilation in the affected extremity. What should the nurse instruct the client to do to achieve this goal?

Notify the healthcare provider.

The nurse is reviewing the electrocardiogram of a client who has elevated ST segments visible in leads II, III, and aVf. Which choice is the nurse's best action?

hypokalemia

The nurse is reviewing the serum electrolyte levels of a client with heart failure who has been taking digoxin for 6 months. The nurse should report which finding from the lab report to the health care provider?

"I'll carefully massage the ointment into the skin."

The nurse is teaching a client how to apply nitroglycerin topical ointment. Which statement indicates that the client needs additional clarification of the instructions?

Flush the line each time a port is used.

The nurse is using evidence-based practice to ensure the patency of a client's arterial line. Which action should the nurse perform?

Notify the health care provider (HCP).

While caring for a client who has sustained a myocardial infarction (MI), the nurse notes eight premature ventricular contractions (PVCs) in 1 minute on the cardiac monitor. The client is receiving an IV infusion of 5% dextrose in water (D5W) at 125 mL/h and oxygen at 2 L/min. What should the nurse do first?

The client verbalizes safety precautions needed to prevent pacemaker malfunction.

The client who had a permanent pacemaker implanted 2 days earlier is being discharged from the hospital. What evidence will indicate to the nurse that the client understands the discharge plan?

blood pressure

The nurse has given a client a nitroglycerin tablet sublingually for angina. Which vital signs should be assessed following administration of nitroglycerin?

Call 911 when three nitroglycerin tablets taken every 5 minutes are not effective.

The nurse instructs a client with coronary artery disease in the proper use of nitroglycerin. The client has had 2 previous episodes of coronary artery disease. At the onset of chest pain, what should the client do?

development of congestive heart failure

The nurse is assessing a client admitted with a myocardial infarction with the following assessment: dyspnea, heart rate of 140 bpm, and crackles in the posterior chest. The nurse would interpret these findings as which condition?

client having an uneven smile and facial droop

The nurse is assessing a client with an atrial septal defect (ASD). Which finding requires immediate nursing intervention?

substernal pain

The nurse is caring for an older adult man who walks 2 miles every morning. The nurse notes that during his morning walk, he called his child and stated that he thought that he was having a heart attack. Which symptom, identified by the client, is the most common and consistent with that of a heart attack (myocardial infarction)?

a third heart sound (S3).

While auscultating the heart sounds of a client with heart failure, the nurse hears an extra heart sound immediately after the second heart sound (S2). The nurse should document this as

Promote arterial and venous circulation.

What is the highest nursing priority in the plan of care for a client with peripheral vascular problems?

Increase cardiac output.

What is the major goal of nursing care for a client with heart failure and pulmonary edema?

supine with lower extremities elevated

What position should the nurse use for the client with venous insufficiency to enhance blood supply?

"The leading cause of CAD is atherosclerosis."

Which client statement should the nurse evaluate as indicating the client's correct understanding of the causes of coronary artery disease (CAD)?