disorders of cardiac function and heart failure and circulatory shock
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."
A client is transported to the emergency department in respiratory distress after eating peanuts. The following interventions are ordered by the health care provider. Which intervention should the nurse complete first?
Administer epinephrine (adrenaline).
A client with a history of acute coronary syndrome asks why she needs to take aspirin 81 mg every day. The most appropriate response by the nurse would be:
Aspirin will help prevent blood clotting
Following several weeks of increasing fatigue and a subsequent diagnostic workup, a client has been diagnosed with mitral valve regurgitation. Failure of this heart valve would have which hemodynamic consequences?
Backflow from the left ventricle to left atrium
Nearly everyone with pericarditis has chest pain. With acute pericarditis, the pain is abrupt in onset, sharp, and radiates to the neck, back, abdomen, or sides. What can be done to ease the pain of acute pericarditis?
Have the client sit up and lean forward.
The health care provider is discussing major risk factors for coronary artery disease (CAD) with a client. The most important information for the provider to include would be:
History of cigarette smoking and elevated blood pressure
A 17-year-old athlete died suddenly during a track meet and it was subsequently determined that he had heart disease. Which condition was the most likely cause of his heart failure?
Hypertrophic cardiomyopathy
Which statement regarding heart failure is true?
In compensated heart failure an increase of end-diastolic volume causes increased force of left ventricular contraction.
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
While discussing the heart, the nursing instructor teaches about pericarditis. Which statement does the instructor state best defines this disease?
It is an inflammatory process
Anaphylactic shock is the most severe form of systemic allergic reaction. Immunologically medicated substances are released into the blood, causing vasodilation and an increase in capillary permeability. What physiologic response often follows the vascular response in anaphylaxis?
Laryngeal edema.
A 30-year-old client arrives with these vital signs: Blood pressure 50/30 mm Hg, pulse 100 beats/min, respiratory rate 12 breaths/min, temperature 101°F (38.3°C). The nurse interprets these results as the client being in shock based on which reading?
Low blood pressure
On a holiday trip home, the nurse's mother states that the nurse's father was diagnosed with right-sided heart failure. Which manifestation exhibited by the father does the nurse know might have preceded this diagnosis?
Peripheral edema, weight gain
A client is at high risk for the development of rheumatic heart disease. The most important information for the nurse to provide would be:
Prompt diagnosis and treatment of streptococcal infections
A preventive measure to decrease the risk of developing rheumatic heart disease includes:
Prompt diagnosis of streptococcal infections with a throat culture
Which client is at the greatest risk of developing rheumatic heart disease?
Teenager with untreated strep throat
How can the health care provider determine if the client has "aerobic fitness"?
Tests help to determine aerobic fitness by measuring heart rate while under the stress of exercise.
A client has been diagnosed with aortic stenosis and asks the nurse what this means. The most appropriate response would be:
The valve opening is narrowed and produces increased resistance to blood flow out of the left ventricle and into the aorta.
Heart failure and circulatory shock are both conditions of circulatory system failure. Which statement regarding these conditions is correct?
They have the same compensatory mechanisms.
A client is told that she has cardiac valve leaflets, or cusps, that are floppy and fail to shut completely, permitting blood flow even when the valve should be completely closed. The nurse knows that this condition can lead to heart failure and is referred to as:
Valvular regurgitation
A client who lives with angina pectoris has taken a sublingual dose of nitroglycerin to treat the chest pain he experiences while mowing his lawn. This drug facilitates release of nitric oxide, which will have what physiologic effect?
Vasodilating effects reducing preload and afterload
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
Chronic stable angina, associated with inadequate blood flow to meet the metabolic demands of the myocardium, is caused by:
fixed coronary obstruction
The health care team is developing a plan of care for a client diagnosed with congestive heart failure (CHF). The primary treatment goal would be:
improving quality of life by relieving symptoms.
While teaching a client with new-onset right-sided heart failure, the nurse should educate the client to monitor for fluid accumulation by:
recording weight every day at the same time with same type of clothing.
Assessment of an older adult client reveals bilateral pitting edema of the client's feet and ankles; difficult to palpate pedal pulses; breath sounds clear on auscultation; oxygen saturation level of 93% (0.93); and vital signs normal. What is this client's most likely health problem?
right-sided heart failure
A client is being discharged following a percutaneous transluminal coronary angioplasty (PTCA) with stent placement. The nurse explains that the acetylsalicylic acid (ASA) and clopidogrel are both prescribed to reduce the risk of which complication?
stent occlusion
What is the primary cause of heart failure in infants and children?
structural heart defects
The nursing instructor is teaching her nursing students about cardiac function and different heart diseases. Which disease does she tell the students is caused by calcified scar tissue that develops between the visceral and parietal layers of the serous pericardium?
Constrictive pericarditis
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.
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)
The health care provider is reviewing lab results of a client diagnosed with heart failure. The provider notes that the client's ANP and BNP levels have been increasing and remain significantly elevated. These results would be interpreted as:
The condition is getting progressively worse.
A client comes to the emergency room with all the symptoms of a myocardial infarction. Which lab value, known to have a high specificity for myocardial tissue considered the primary biomarker test for diagnosing an MI, does the nurse suspect the physician will order?
Troponin assays
Following cardiac surgery, the nurse suspects the client may be developing a cardiac tamponade. Which clinical manifestations would support this diagnosis? Select all that apply.
• Low BP—84/60 .• Narrowed pulse pressure .• Muffled heart tones.
