Chapter 27: Disorders of Cardiac Function, and Heart Failure... Patho Prep U

A client with heart failure asks, "Why am I taking a 'water pill' when it's my heart that is having a problem?" While educating the client about the Frank-Starling mechanism, which explanation is most appropriate to share?

"Since your heart is not pumping efficiently, the kidneys are getting less blood flow; therefore, the kidneys are holding on to sodium and water."

A client asks the purpose of an exercise stress test. What is the nurse's best response?

"The test is used to measure functional status during stress."

When a physician suspects a client has suffered an acute myocardial infarction, which serum biomarkers should he order? Select all that apply.

- Troponin 1 - Creatine kinase - Troponin T

Coronary artery bypass grafting (CABG) is a treatment modality for which disorder of cardiac function?

Atherosclerosis and unstable angina

A nurse preceptor is evaluating the skills of a new registered nurse (RN) caring for clients experiencing shock. Which action by the new RN indicates a need for more education?

Raising the head of the bed to a high Fowler's position

The nurse is developing a plan of care for a client with heart failure. The most important information for the nurse to consider would be:

decreased cardiac output

A client with a suspected MI is brought to the emergency department by ambulance. The nurse caring for this client would expect to receive an order for which laboratory test to confirm a diagnosis of MI?

Troponin level

A client awaiting a heart transplant is experiencing decompensation of her left ventricle that will not respond to medications. The health care providers (HCP) suggest placing the client on a ventricular assist device (VAD). The client asks what this equipment will do. Which response by the HCP most accurately describes the purpose of a VAD?

"Decreases the workload of the myocardium while maintaining cardiac output and systemic arterial pressure."

A client diagnosed with diastolic heart failure asks the nurse to explain why this has developed. The nurse knows that which conditions are often associated with diastolic failure? Select all that apply.

- Constrictive pericarditis - Myocardial hypertrophy - Ischemic heart disease

A 60-year-old woman has just been diagnosed with heart failure and her primary care provider is describing the concept of adaptation. Which compensatory mechanisms may have masked the client's heart failure? Select all that apply.

- Hypertrophy of the myocardium - Sympathetic nervous stimulation - Increased renin-angiotensin-aldosterone system (RAAS) function - Increased preload

ST-elevated myocardial infarction (STEMI) is accompanied by severe, crushing pain. Morphine is the drug of choice used to treat the pain of STEMI when the pain cannot be relieved with oxygen and nitrates. Why is morphine considered the drug of choice in STEMI?

Action decreases metabolic demands of the heart.

Which statement regarding heart failure is true?

Compensated congestive heart failure may be clinically asymptomatic.

For clients with heart failure, which pathophysiologic response helps maintain the cardiac reserve?

Compensatory mechanisms

When an acute MI occurs, many physiologic changes occur very rapidly. What causes the loss of contractile function of the heart within seconds of the onset of an MI?

Conversion from aerobic to anaerobic metabolism

A client has developed pericarditis. The nurse knows this condition will increase the risk for developing which condition?

Diastolic dysfunction

A client who has been admitted to the emergency room with symptoms of a STEMI is given nitroglycerine. The nurse explains to the client's wife that this medication is given for which reason? Select all that apply.

For its vasodilation effect and To relieve coronary pain

A nurse educator explains a type of cardiac condition as "a heterogeneous group of diseases of the myocardium associated with mechanical and/or electrical dysfunction that usually exhibit inappropriate ventricular hypertrophy or dilation and often lead to cardiovascular death or progressive heart failure." Which condition fits this definition?

cardiomyopathy

Which disease is caused by calcified scar tissue that develops between the visceral and parietal layers of the serous pericardium?

constrictive pericarditis

A nurse is teaching a client with newly diagnosed dilated cardiomyopathy (DCM) about associated treatments. The nurse determines that the knowledge is understood when the client correctly matches which drug category to the primary action of decreasing preload by suppressing renal reabsorption of sodium and increasing salt and water excretion?

diuretics

Which health condition can contribute to diastolic dysfunction heart failure?

myocardial hypertrophy

The plaques in a client's coronary arteries are plentiful, and most have small- to moderate-sized lipid cores with thick fibrous caps. This form of atherosclerosis is most closely associated with which diagnosis?

stable angina

Levels of endothelins may be increased in clients with heart failure. Which of the following is the primary action of endothelins?

vasoconstriction

The nursing student has learned in class that pericarditis is an inflammatory process of the pericardium. What is known to be the main cause of pericarditis?

viral infections

A nurse is performing client health education with a 68-year-old man who has recently been diagnosed with heart failure. Which statement demonstrates an accurate understanding of his new diagnosis?

"I'm trying to think of ways that I can cut down the amount of salt that I usually eat."

Which statements regarding heart failure are true? Select all that apply

- In uncompensated left-sided heart failure, there is pulmonary congestion and edema. - In compensated heart failure, cardiac output is normal. - In uncompensated right-sided heart failure, there is peripheral venous congestion and

The nurse is monitoring hourly urine output of a client diagnosed with hypovolemic shock. The nurse is most concerned if the client's output is:

20 mL/hour

Football fans at a college have been shocked to learn of the sudden death of a star player, an event that was attributed in the media to "an enlarged heart." Which disorder was the player's most likely cause of death?

Hypertrophic cardiomyopathy (HCM)

An 86-year-old client is disappointed to learn that he or she has class II heart failure despite a lifelong commitment to exercise and healthy eating. Which age-related change predisposes older adults to the development of heart failure?

Increased vascular stiffness

A client has just returned from his surgical procedure. During initial vital sign measurements, the nurse notes that the client's heart rate is 111 beats/minute and the BP is 100/78 (borderline low). In this early postoperative period, the nurse should be diligently monitoring the client for the development of:

hypovolemic shock due to acute intravascular volume loss.

A client has developed cardiogenic shock. The most frequent cause of this type of shock is:

myocardial infarction

A client reports severe indigestion that has been intermittent; however, the pain is now constant and feels like a vise. The nurse does an ECG and recognizes that the situation is possibly emergent due to ST-segment elevation, which could indicate:

myocardial infarction

The nurse is developing a plan of care for a client diagnosed with stable angina. Select the most important goal for this client.

myocardial infarction prevention

A client has been experiencing increasing fatigue in recent months, a trend that has prompted an echocardiogram. The results suggest that the client's end-diastolic volume is insufficient. Which parameter of cardiac performance will directly decrease as a result of this finding?

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