Ch 25: Assessment of Cardiovascular Function (2)

What is considered the pacemaker of the heart? pg. 675

The SA node

Each chamber of the heart has a particular role in maintaining cellular oxygenation. Which chamber is responsible for pumping blood to all the cells and tissues of the body? pg. 673

left ventricle

A nurse is performing a cardiac assessment on an elderly client. Which finding warrants further investigation? pg. 693

Irregularly irregular heart rate

The nurse is reviewing the morning laboratory test results for a client with cardiac problems. Which finding is a priority to report to the healthcare provider? pg. 694

K+ 3.1 mEq/L

The nurse is assessing vital signs on a client who is 3 months status post myocardial infarction (MI). While the healthcare provider is examining the client, the client's spouse approaches the nurse and states "We are too afraid he will have another heart attack, so we just don't have sex anymore." What is the nurse's best response? pg. 684

"The physiologic demands are greatest during orgasm and are equivalent to walking 3 to 4 miles per hour on a treadmill."

The nurse prepares to auscultate heart sounds. What nursing intervention will be most effective to assist with this procedure? pg. 690

Explain to the client that the nurse will be listening to different areas of the chest and may listen for a long time, but that does not mean that anything abnormal is heard.

The nurse is reviewing the results of the patient's echocardiogram and observes that the ejection fraction is 35%. The nurse anticipates that the patient will receive treatment for what condition? pg. 678

Heart failure

The nurse reviews discharge instructions with a client who underwent a left groin cardiac catheterization 8 hours ago. Which instructions should the nurse include? pg. 705

"Do not bend at the waist, strain, or lift heavy objects for the next 24 hours."

The nurse is caring for a client with an elevated blood pressure and no previous history of hypertension. At 0900, the blood pressure was 158/90 mm Hg. At 0930, the blood pressure is 142/82 mm Hg. The nurse is most correct when relating the fall in blood pressure to which structure? pg. 677

Baroreceptors

You are monitoring the results of laboratory tests performed on a client admitted to the cardiac ICU with a diagnosis of myocardial infarction. Which test would you expect to show elevated levels? pg. 693

Enzymes

A nurse is reviewing laboratory values for a client diagnosed with hyperlipidemia 6 months ago. Which results indicate that the client has been following a therapeutic regimen? pg. 682

High density lipoproteins (HDL) increase from 25 mg/dl to 40 mg/dl.

The nurse is performing an assessment of the patient's heart. Where would the nurse locate the apical pulse if the heart is in a normal position? pg. 689

Left 5th intercostal space at the midclavicular line

The nurse cares for a client with clubbing of the fingers and toes. The nurse should complete which action given these findings? pg. 687

Obtain an oxygen saturation level.

The client is admitted for a scheduled cardiac catheterization. On the morning of the procedure, while assessing the client's morning laboratory values, the nurse notes a blood urea nitrogen (BUN) of 34 mg/dL and a creatinine of 4.2 mg/dL. What priority reason will the nurse notify the healthcare provider? pg. 703

The client is at risk for renal failure due to the contrast agent that will be given during the procedure.

The patient has a heart rate of 72 bpm with a regular rhythm. Where does the nurse determine the impulse arises from? pg. 675

The sinoatrial node

The nurse is admitting an older adult client with heart failure. Which education will the nurse prepare for this client prior to discharge?" pg. 705

Try to avoid emotional stress and take part in mild physical stress only.

The balloon on the distal tip of a pulmonary artery catheter is inflated and the pressure is measured. What is the term for the measurement obtained? pg. 709

pulmonary artery wedge pressure

What does decreased pulse pressure reflect? pg. 687

reduced stroke volume

The electrical conduction system of the heart has several components, all of which are instrumental in maintaining polarization, depolarization, and repolarization of cardiac tissue. Which of the conductive structures is known as the pacemaker of the heart? pg. 675

sinoatrial node

Before a transesophageal echocardiogram, a nurse gives a client an oral topical anesthetic spray. When the client returns from the procedure, the nurse observes no active gag reflex. What nursing action is a priority? pg. 703

withhold food and fluids.