Ch 27 Hinckle MOFOS
A client with angina pectoris must learn how to reduce risk factors that exacerbate this condition. When developing the client's care plan, which expected outcome should a nurse include? "Client will verbalize the intention to avoid exercise." "Client will verbalize the intention to stop smoking." "Client will verbalize an understanding of the need to restrict dietary fat, fiber, and cholesterol." "Client will verbalize an understanding of the need to call the physician if acute pain lasts more than 2 hours."
"Client will verbalize the intention to stop smoking." Explanation: A client with angina pectoris should stop smoking at once because smoking increases the blood carboxyhemoglobin level; this increase, in turn, reduces the heart's oxygen supply and may induce angina. The client must seek immediate medical attention if chest pain doesn't subside after three nitroglycerin doses taken 5 minutes apart; serious myocardial damage or even sudden death may occur if chest pain persists for 2 hours. To improve coronary circulation and promote weight management, the client should get regular daily exercise. The client should eat plenty of fiber, which may decrease serum cholesterol and triglyceride levels and minimize hypertension, in turn reducing the risk for atherosclerosis (which plays a role in angina).
A client with a strong family history of coronary artery disease asks the nurse how to reduce the risk of developing the disorder. Which is the best response by the nurse? "Increase the soy in your diet." "Ask your physician to prescribe the new reverse lipid drug." "Exercise, keep your blood sugar in check, and manage your stress." "Moderation is the key to everything."
"Exercise, keep your blood sugar in check, and manage your stress." Explanation: Although moderation is the key, this does not provide *specific options* for this client such as regular exercise and managing stress and cholesterol levels. The reverse lipid drug sounds good but is not available or approved by the FDA. Soy products have limited benefits for cholesterol control.
When providing discharge instructions for a client who has been prescribed sublingual nitroglycerin for angina, the nurse should plan to include which instructions? "See if rest relieves the chest pain before using the nitroglycerin." "Place the nitroglycerin tablet between cheek and gum." "Only take one nitroglycerin tablet for each episode of angina." "Call 911 if you develop a headache following nitroglycerin use."
"See if rest relieves the chest pain before using the nitroglycerin." Explanation: *Decreased activity may relieve chest pain; sitting will prevent injury should the nitroglycerin lower BP and cause fainting. The client should expect to feel dizzy or flushed or to develop a headache following sublingual nitroglycerin use. The client should place one nitroglycerin tablet under the tongue if 2-3 minutes of rest fails to relieve pain. Clients may take up to three nitroglycerin tablets within 5 minutes of each other to relieve angina. However, they should call 911 if the three tablets fail to resolve the chest pain.*
Heparin therapy is usually considered therapeutic when the client's activated partial thromboplastin time (aPTT) is how many times normal? .25 to .75 .75 to 1.5 2.0 to 2.5 2.5 to 3.0
2.0 to 2.5 Explanation: Heparin = anticoagulant, blood thinner Partial Thromboplastin Time = test that measures the time it takes your blood to clot The amount of heparin administered is based on aPTT results, which should be obtained during the follow-up to any alteration of dosage. The client's aPTT value would have to be greater than .25 to .75 or .75 to 1.5 times normal to be considered therapeutic. An aPTT value that is 2.5 to 3 times normal would be too high to be considered therapeutic.
A nurse is reevaluating a client receiving IV fibrinolytic therapy. Which finding requires immediate intervention by the nurse? Chest pain 2 of 10 (on a 1-to-10 pain scale) Minimal oozing of blood from the IV site Presence of reperfusion dysrhythmias Altered level of consciousness
Altered level of consciousness Explanation: A client receiving fibrinolytic therapy is at risk for complications associated with bleeding. Altered level of consciousness may indicate hypoxia and intracranial bleeding, and the infusion should be discontinued immediately. Minimal bleeding requires manual pressure. *Reperfusion dysrhythmias are an expected finding*. A chest pain score of 2 is low and indicates the client's chest pain is subsiding, an expected outcome of this therapy.
After percutaneous transluminal coronary angioplasty (PTCA), the nurse suspects that a patient, who is on bed rest, may be experiencing the complication of bleeding. The nurse's initial action should be to do which of the following? Apply manual pressure at the site of the insertion of the sheath. Notify the health care provider. Decrease anticoagulant or antiplatelet therapy. Review the results of the latest blood cell count, especially the hemoglobin and hematocrit.
Apply manual pressure at the site of the insertion of the sheath. Explanation: The immediate nursing action would be to apply pressure, which may stop the bleeding. If the bleeding does not stop, the health care provider needs to be notified.
The laboratory values for a client diagnosed with coronary artery disease (CAD) have just come back from the lab. The client's low-density lipoprotein (LDL) level is 112 mg/dL. This nurses recognizes that this value is low. normal. extremely high. high.
High. If the LDL level ranges from 100 mg/dL to 130 mg/dL, it is considered to be high. The goal is to decrease the LDL level below 100 mg/dL.
A patient's elevated cholesterol levels are being managed with Lipitor, 40 mg daily. The nurse practitioner reviews the patient's blood work every 6 months before renewing the prescription. The nurse explains to the patient's daughter that this is necessary because of a major side effect of Lipitor that she is checking for. What is that side-effect? Gastrointestinal distress Hyperglycemia Hyperuricemia Increased liver enzymes
Increased liver enzymes Explanation: Lipitor is a statin / HMG-Coa that lowers cholesterol for heart health. Statins have been clearly shown to reduce blood cholesterol and prevent atherosclerosis, or heart disease. They work by reducing the liver's production of cholesterol. *They block an enzyme called HMG CoA Reductase that the liver uses to make cholesterol.*
Which technique is used to surgically revascularize the myocardium? Peripheral bypass Balloon bypass Minimally invasive direct coronary bypass Gastric bypass
Minimally invasive direct coronary bypass Peripheral bypass = for peripherals on leg vessels Balloon bypass = balloon in stomach Minimally invasive direct coronary bypass = does not open up chest to work on heart. Uses cameras poked through chest to work on Explanation: Several techniques are used to surgically revascularize the myocardium; one of them is minimally invasive direct coronary bypass. Balloon bypass is not used to revascularize the myocardium. If the client is experiencing acute pain in the leg, peripheral bypass is performed. Gastric bypass is a surgical procedure that alters the process of digestion.
Which s the analgesic of choice for acute myocardial infarction (MI)? Ibuprofen Morphine Meperidine Aspirin
Morphine Explanation: The analgesic of choice for acute MI is morphine administered in IV boluses to reduce pain and anxiety. Aspirin is an antiplatelet medication. Meperidine and Ibuprofen are not the analgesics of choice.
A client reports pain and cramping in the thigh when climbing stairs and numbness in the legs after exertion. Which diagnostic test with the physician likely perform right in the office to determine PAD? photoplethysmography exercise electrocardiography ankle-brachial index electron beam computed tomography
PAD = peripheral vascular disease photoplethysmography = detect blood volume changes exercise electrocardiography = checks for changes in your heart while you exercis (stress test) ankle-brachial index = Compares ankle BP to your brachial BP electron beam computed tomography = test for detecting calcium build-up in the arteries of the heart.
A patient, who is resting quietly in a step-down cardiac care unit, reports chest pain. The cardiac monitor indicates the presence of reversible ST-segment elevation. The nurse understands that the patient may be experiencing coronary artery vasospasm. This is a type of angina known as: Silent Intractable Variant Stable
Variant Explanation: Variant or Prinzmetal's angina is distinguished by its occurrence during rest, as opposed to stable angina, which occurs with activity. Silent angina occurs without symptoms, and intractable angina is evidenced by incapacitating pain.
An obese white male client, age 49, is diagnosed with hypercholesterolemia. The physician orders a low-fat, low-cholesterol, low-calorie diet to reduce blood lipid levels and promote weight loss. This diet is crucial to the client's well-being because his race, sex, and age increase his risk for coronary artery disease (CAD). To determine whether the client has other major risk factors for CAD, the nurse should assess for: elevated high-density lipoprotein (HDL) levels. alcoholism. a history of diabetes mellitus. a history of ischemic heart disease.
a history of diabetes mellitus. Explanation: Diabetes mellitus, smoking, and hypertension are other major risk factors for CAD. Elevated HDL levels aren't a risk factor for CAD; in fact, increased HDL levels seem to protect against CAD. Ischemic heart disease is another term for CAD, not a risk factor. Alcoholism hasn't been identified as a major risk factor for CAD.
A client's lipid profile reveals an LDL level of 122 mg/dL. This is considered a: fasting LDL level. low LDL level. normal LDL level. high LDL level.
high LDL level. Explanation: LDL levels above 100 mg/dL are considered high. The goal is to decrease the LDL level below 100 mg/dL.
A client, who has undergone a percutaneous transluminal coronary angioplasty (PTCA), has received discharge instructions. Which statement by the client would indicate the need for further teaching by the nurse? "I should avoid taking a tub bath until my catheter site heals." "I should avoid prolonged sitting." "I should expect bruising at the catheter site for up to 3 weeks." "I should expect a low-grade fever and swelling at the site for the next week."
"I should expect a low-grade fever and swelling at the site for the next week." Explanation: Fever and swelling at the site are signs of infection and should be reported to the physician. Percutaneous transluminal coronary angioplasty = blowing up a balloon in the coronary artery to widden atherosclerosis bloackage Showers should be taken until the insertion site is healed. Prolonged sitting can result in thrombosis formation. Bruising at the insertion site is common and may take from 1 to 3 weeks to resolve.
The nurse has been asked to teach a patient how to self-administer nitroglycerin. The nurse should instruct the patient to do which of the following? Select all that apply. -Take the tablet in anticipation of any activity that can produce pain. -Call emergency services if, after taking three tablets (one every 5 minutes), pain persists. -Let the tablet dissolve in the mouth and keep the tongue still. The tablet can be crushed between the teeth but not swallowed. -Put some of the tablets in a small metal or plastic pillbox that can be easily carried at all times and be accessible quickly, when needed. -Renew the supply every 6 months. -Keep the tablets at home on the kitchen counter or bedside table so they can be reached quickly.
-Let the tablet dissolve in the mouth and keep the tongue still. The tablet can be crushed between the teeth but not swallowed. -Renew the supply every 6 months. -Take the tablet in anticipation of any activity that can produce pain. -Call emergency services if, after taking three tablets (one every 5 minutes), pain persists. Explanation: Nitroglycerine is very unstable and should be carried securely in its original container (capped, dark, glass bottle). The tablets should never be removed and stored in metal or plastic pillboxes. Nitroglycerine is also volatile and is inactivated by heat, moisture, air, light, and time. Therefore, storage and replacement is recommended every 6 months.
A client has just arrived in the ER with a possible myocardial infarction (MI). The electrocardiogram (ECG) should be obtained within which time frame of arrival to the ER? 20 minutes 5 minutes 15 minutes 10 minutes
10 minutes Explanation: The ECG provides information that assists in diagnosing acute MI. It should be obtained within 10 minutes from the time a client reports pain or arrives in the emergency department. *By monitoring serial ECG changes over time, the location, evolution, and resolution of an MI can be identified and monitored.*
Following a percutaneous transluminal coronary angioplasty, a client is monitored in the postprocedure unit. The client's heparin infusion was stopped 2 hours earlier. There is no evidence of bleeding or hematoma at the insertion site, and the pressure device is removed. With regards to partial thromboplastin time (PTT), when should the nurse plan to remove the femoral sheath? 75 seconds or less. 50 seconds or less. 125 seconds or less. 100 seconds or less.
50 seconds or less. Explanation: Heparin causes an elevation of the PTT and, thereby, increases the risk for bleeding. With a large cannulation such as a sheath used for angioplasty, the PTT should be 50 seconds or less before the sheath is removed. Removing the sheath before the PTT drops below 50 seconds can cause bleeding at the insertion site. The other PTT results are incorrect for determining when to remove the sheath.
Post-cardiac surgery assessment of renal function should be performed hourly for the first 12 to 24 hours. Identify the laboratory result that the nurse knows is a primary indicator of possible renal failure. A urine specific gravity reading of 1.021 An hourly urine output of 50 to 70 mL A serum BUN of 70 mg/dL A serum creatinine of 1.0 mg/dL
A serum BUN of 70 mg/dL BUN = Blood Urea in blood urine specific gravity = compares the density of urine with the density of water serum creatinine = level of creatinine in your blood Explanation: These four laboratory results should always be assessed, post cardiac surgery. Serum osmolality (N = >800 mOsm/kg) should also be included. A BUN reading of greater than 21 mg/dL is abnormal; a reading of greater than 60 mg/dL is indicative of renal failure. The lab results in the other choices are all within normal range.
A client asks the clinic nurse what the difference is between arteriosclerosis and atherosclerosis. What is the nurse's best response? -Arteriosclerosis is a loss of elasticity, or hardening of the arteries, that happens as we age. -Atherosclerosis is a loss of elasticity, or hardening of the arteries, that happens as we age. -Arteriosclerosis is a formation of clots in the inner lining of the arteries. -Atherosclerosis is a formation of clots in the inner lining of the arteries.
Arteriosclerosis is a loss of elasticity, or hardening of the arteries, that happens as we age. Explanation: Arteriosclerosis is the stiffening or hardening of the artery walls, that accompanies the aging process. Art = hARd Atherosclerosis is the narrowing of the artery because of plaque build-up. Ath = THick
The nurse administers propranolol hydrochloride to a patient with a heart rate of 64 beats per minute (bpm). One hour later, the nurse observes the heart rate on the monitor to be 36 bpm. What medication should the nurse prepare to administer that is an antidote for the propranolol? Digoxin Atropine Sodium nitroprusside Protamine sulfate
Atropine Explanation: propranolol hydrochloride = Beta-blocker, treats high BP via blocking adrenaline to slow heartrate. Sheath removal and the application of pressure on the vessel insertion site may cause the heart rate to slow and the blood pressure to decrease (vasovagal response). A dose of IV atropine is usually given to treat this response. Protamine sulfate is an antidote to heparin. Digoxin and Sodium nitroprusside also lower bp so its the opposite of what we want.
A patient has had cardiac surgery and is being monitored in the intensive care unit (ICU). What complication should the nurse monitor for that is associated with an alteration in preload? Elevated central venous pressure Hypertension Cardiac tamponade Hypothermia
Cardiac tamponade Elevated central venous pressure = blood backing up into the venous circulation (leads to decrease in cardiac output) Cardiac tamponade = fluid build up in pericardial sac (=reduced ventricular filling) *Preload alterations occur when too little blood volume returns to the heart as a result of persistent bleeding and hypovolemia.* Excessive postoperative bleeding can lead to decreased intravascular volume, hypotension, and low cardiac output. Bleeding problems are common after cardiac surgery because of the effects of cardiopulmonary bypass, trauma from the surgery, and anticoagulation. Preload can also decrease if there is a collection of fluid and blood in the pericardium (cardiac tamponade), which impedes cardiac filling. Cardiac output is also altered if too much volume returns to the heart, causing fluid overload.
A client comes to the emergency department (ED) complaining of precordial chest pain. In describing the pain, the client describes it as pressure with a sudden onset. What disease process would the nurse suspect in this client? Cardiogenic shock Raynaud's disease Coronary artery disease Venous occlusive disease
Cardiogenic shock = heart is damaged so much that it is unable to supply enough blood to the vital organs, organ failure. Complicatio of an MI. Raynaud's disease = Vasoconstriction of the toes/fingers when you are cold or feeling stressed Coronary artery disease = reduction of blood flow (ischemia) to the heart muscle due to buildup of plaque in corany arteries Venous occlusive disease = small blood vessels that lead into the liver and are inside the liver become blocked
A client is admitted for treatment of Prinzmetal's angina. When developing this client's care plan, the nurse should keep in mind that this type of angina is a result of what trigger? The same type of activity that caused previous angina episodes. Coronary artery spasm. Activities that increase myocardial oxygen demand. An unpredictable amount of activity.
Coronary artery spasm. Explanation: Prinzmetal's angina results from coronary artery spasm. Activities that increase myocardial oxygen demand may trigger angina of effort. An unpredictable amount of activity may precipitate unstable angina. Worsening angina is brought on by the same type or level of activity that caused previous angina episodes; anginal pain becomes increasingly severe.
Which is a modifiable risk factor for coronary artery disease (CAD)? Hyperlipidemia Increasing age Family history Male gender
Hyperlipidemia Explanation: Other modifiable risk factors for CAD include tobacco use, hypertension, diabetes, metabolic syndrome, obesity, and physical inactivity. Increasing age, male gender, and family history are nonmodifiable risk factors for CAD.
A client admitted to the coronary care unit (CCU) diagnosed with a STEMI is anxious and fearful. Which medication will the nurse administer to relieve the client's anxiety and decrease cardiac workload? Atenolol IV morphine IV nitroglycerin Amlodipine
IV morphine Explanation: IV morphine is the analgesic of choice for the treatment of an acute MI. It is given to reduce pain and treat anxiety. It also reduces preload and afterload, which decreases the workload of the heart. IV nitroglycerin is given to alleviate chest pain. Administration of atenolol and amlodipine are not indicated in this situation. Atenolol = treats high blood pressure and chest pain Amlodipine = high blood pressure and chest pain
The nurse is educating a patient diagnosed with angina pectoris about the difference between the pain of angina and a myocardial infarction (MI). How should the nurse describe the pain experienced during an MI? (Select all that apply.) It is substernal in location. It subsides after taking nitroglycerin. It is relieved by rest and inactivity. It is sudden in onset and prolonged in duration. It is viselike and radiates to the shoulders and arms.
It is substernal in location. It is sudden in onset and prolonged in duration. It is viselike and radiates to the shoulders and arms. Explanation: substernal = behind or below the sternum Chest pain that occurs suddenly, continues despite rest and medication, is substernal, and is sometimes viselike and radiating to the shoulders and arms is associated with an MI. Angina pectoris pain is generally relieved by rest and nitroglycerin. In MI: the pain is prolonged, SOB, GI sypmtoms, dysrhythmia is prolonged. Clot is completely blocking vessel and part of heart dies. Angina: Pain is short and may be relieved by rest or nitroglycerin. Tachycardia and hypertension. Oxygen demand too big to supply heart with what it needs. Partial heart block (thrombus).
Severe chest pain is reported by a client during an acute myocardial infarction. Which of the following is the most appropriate drug for the nurse to administer? Isosorbide mononitrate (Isordil) Morphine sulfate (Morphine) Nitroglycerin transdermal patch Meperidine hydrochloride (Demerol)
Morphine sulfate (Morphine) Explanation: Morphine sulfate not only decreases pain perception and anxiety but *also helps to decrease heart rate, blood pressure, and demand for oxygen*. Nitrates are administered for vasodilation and pain control in clients with angina-type pain, but oral forms (such as isosorbide dinitrate) have a large first-pass effect, and transdermal patch is used for long-term management. Meperidine hydrochloride is a synthetic opioid usually reserved for treatment of postoperative or migraine pain.
Postpericardiotomy syndrome may occur in patients who undergo cardiac surgery. The nurse should be alert to which of the following clinical manifestations associated with this syndrome? Decreased white blood cell (WBC) count Pericardial friction rub Decreased erythrocyte sedimentation rate (ESR) Hypothermia
Pericardial friction rub Explanation: immune response to surgery so the body creates an inflamation response. The syndrome is characterized by fever, pericardial pain, pleural pain, dyspnea, pericardial effusion, pericardial friction rub, and arthralgia. Leukocytosis (elevated WBCs) occurs, along with elevation of the ESR.
A 45-year-old adult male patient is admitted to emergency after he developed unrelieved chest pain that was present for approximately 20 minutes before he presented to the emergency department. The patient has been subsequently diagnosed with a myocardial infarction (MI). To minimize cardiac damage, what health care provider's order will the nurse expect to see for this patient? -Oxygen administration, anticoagulants, and bed rest -Bed rest, albuterol nebulizer treatments, and oxygen administration -Thrombolytics, oxygen administration, and bed rest -Morphine sulfate, oxygen administration, and bed rest
Morphine sulfate, oxygen administration, and bed rest Explanation: *Morphine sulfate reduces preload and decreases workload of the heart*, along with increased oxygen from oxygen therapy and bed rest. With decreased cardiac demand, this provides the best chance of decreasing cardiac damage. Thrombolytics and anticoagulants are contraindicated in patients who are bleeding or have a bleeding disorder. Albuterol is a medication used to manage asthma and respiratory conditions and will increase the heart rate.
A nurse reviews a client's medication history before administering a cholinergic blocking agent. Adverse effects of a cholinergic blocking agent may delay absorption of what medication? Amantadine Diphenhydramine Digoxin Nitroglycerin
Nitroglycerin cholinergic blocking agent = blocks the action of acetylcholine (ACh slows heartrate) Explanation: A cholinergic blocking agent may cause dry mouth and delay the sublingual absorption of nitroglycerin. The nurse should offer the client sips of water before administering nitroglycerin. Amantadine, digoxin, and diphenhydramine can interact with a cholinergic blocking agent but not through delayed absorption. Amantadine and diphenhydramine enhance the effects of anticholinergic agents.
A client with Raynaud's disease complains of cold and numbness in the fingers. Which of the following would the nurse identify as an early sign of vasoconstriction? Cyanosis Clubbing of the fingers Pallor Gangrene
Pallor Explanation: Pallor is the initial symptom in Raynaud's *followed by cyanosis* and aching pain. Gangrene can occur with persistent attacks and interference of blood flow. Clubbing of the fingers is a symptom associated with chronic oxygen deprivation to the distal phalanges.
A client presents to the ED with a myocardial infarction. Prior to administering a prescribed thrombolytic agent, the nurse must determine whether the client has which absolute contraindication to thrombolytic therapy? use of heparin recent consumption of a meal shellfish allergy prior intracranial hemorrhage
Prior intracranial hemorrhage Explanation: Thrombolytic agent = anticoagulent. Breaks down fibrin in clots to disovle. -Giving something that breaks down clotting for a hemorrhage will make it keep bleeding and can't fix- Administration of a thrombolytic agent with heparin increases risk of bleeding; the primary healthcare provider usually discontinues the heparin until thrombolytic treatment is completed. History of a prior intracranial hemorrhage is an absolute contraindication for thrombolytic therapy. An allergy to iodine, shellfish, radiographic dye, and latex are of primary concern before a cardiac catheterization but not a known contraindication for thrombolytic therapy.
In arteriosclerosis, commonly referred to as hardening of the arteries, the rigid arterial vessels fail to stretch. This has the potential for what? -Increasing the flow of blood throughout the body -Sending a reduced volume of oxygenated blood to the major organs of the body -Slowing the flow of blood throughout the body -Decreasing the flow of unoxygenated blood through the body
Sending a reduced volume of oxygenated blood to the major organs of the body Explanation: As the left ventricle contracts, sending oxygenated blood from the heart, the rigid arterial vessels fail to stretch. The potential result is a reduced volume of oxygenated blood delivered to organs such as the myocardium, brain, kidneys, and extremities. Arteriosclerosis does not decrease the flow of unoxygenated blood throughout the body; it does not slow or increase the flow of blood throughout the body.
The nurse is caring for a client with abdominal aortic aneurysm (AAA). Which assessment finding is most likely to indicate a dissection of the aneurysm? Hematemesis Severe back pain Hypertensive crisis Rectal bleeding
Severe back pain Explanation: dissection = layers of the wall of the aorta separate or are torn, blood then flows in between those layers Hematemesis = Vomiting blood ( -emesis = vomit) Hypertensive crisis = severe increase in blood pressure Pressure from an enlarging or dissecting abdominal aortic aneurysm is likely to be exhibited as severe back pain. A decrease in blood pressure will result as the client goes into shock from hemorrhaging. Blood in emesis or rectal bleeding is not associated with rupture of AAA.
A client was transferring a load of fire wood from his front driveway to his backyard woodpile at 10 a.m. when he experienced a heaviness in his chest and dyspnea. He stopped working and rested, and the pain subsided. At noon, the pain returned. At 1:30 p.m., his wife took him to the emergency department. Around 2 p.m., the emergency department physician diagnoses an anterior myocardial infarction (MI). The nurse should anticipate which orders by the physician? Morphine administration, stress testing, and admission to the cardiac care unit Sublingual nitroglycerin, tissue plasminogen activator (tPA), and telemetry Streptokinase, aspirin, and morphine administration Serial liver enzyme testing, telemetry, and a lidocaine infusion
Sublingual nitroglycerin, tissue plasminogen activator (tPA), and telemetry Explanation: The nurse should anticipate an order for sublingual nitroglycerin, tPA, and telemetry. (The client's chest pain began 4 hours before diagnosis.) The preferred choice is tPA, which is more specific for cardiac tissue than streptokinase. Stress testing shouldn't be performed during an MI. The client doesn't exhibit symptoms that indicate the use of lidocaine.
Which nursing actions would be of greatest importance in the management of a client preparing for angioplasty?' Remove hair from skin insertion sites. Withhold anticoagulant therapy. Inform client of diagnostic tests. Assess distal pulses.
Withhold anticoagulant therapy. Explanation: The nurse knows to withhold the anticoagulant therapy to *decrease chance of hemorrhage during the procedure.* The nurse does inform the client of diagnostic test, will assess pulses, and prep the skin prior to the angioplasty, but this is not the most important action to be taken.
A client who has been diagnosed with Prinzmetal's angina will present with which symptom? -prolonged chest pain that accompanies exercise -chest pain that occurs at rest and usually in the middle of the night -radiating chest pain that lasts 15 minutes or less -chest pain of increased frequency, severity, and duration
chest pain that occurs at rest and usually in the middle of the night Explanation: Prinzmetal's angia is because of vasospasm of coronary arteries and happens at rest or sleeping. Classic angina is triggered by excerise or stress and is because of a clot getting lodged (thromusis). A client with Prinzmetal's angina will complain of chest pain that occurs at rest, usually between 12 and 8:00 AM, is sporadic over 3-6 months, and diminishes over time. Clients with stable angina generally experience chest pain that lasts 15 minutes or less and may radiate. Clients with Cardiac Syndrome X experience prolonged chest pain that accompanies exercise and is not always relieved by medication. Clients with unstable angina experience chest pain of increased frequency, severity, and duration that is poorly relieved by rest or oral nitrates.
The nurse is reviewing the laboratory results for a client diagnosed with coronary artery disease (CAD). The client's low-density lipoprotein (LDL) level is 115 mg/dL. The nurse interprets this value as low. high. critically high. within normal limits.
high. Explanation: The normal LDL range is 100 to 130 mg/dL. A level of 115 mg/dL is considered to be high. The goal of treatment is to decrease the LDL level below 100 mg/dL (*less than 70 mg/dL for very high-risk clients*).
The nurse recognizes that the treatment for a non-ST-elevation myocardial infarction (NSTEMI) differs from that for a STEMI, in that a STEMI is more frequently treated with IV heparin. thrombolytics. percutaneous coronary intervention (PCI). IV nitroglycerin.
percutaneous coronary intervention (PCI). percutaneous coronary intervention (PCI)= putting a stent and widdening the artery Kinds of heart attacks NSTEMI = usually caused by a severely narrowed artery but the artery is usually not completely blocked STEMI = caused by a sudden complete (100 percent) blockage of a coronary artery
