nursing care 2 exam 1
A client who has started therapy for drug-resistant tuberculosis demonstrates understanding of tuberculosis transmission when he says:
"I'll stop being contagious when I have a negative acid-fast bacilli test."
The nursing student learning on a cardiac unit asks the instructor why loss of the "atrial kick" causes a decrease in cardiac output, because the ventricles are still contracting. What is the nursing instructor's best response?
"The atrial contraction fills the ventricles and accounts for nearly one-third of the volume ejected during ventricular contraction."
The client asks the nurse to explain what is meant by a ventricular bigeminy cardiac rhythm. What is the best response by the nurse?
"The rhythm has a normal beat, then a premature beat pattern."
client with chronic obstructive pulmonary disease (COPD) and cor pulmonale is being prepared for discharge. The nurse should provide which instruction?
"Weigh yourself daily and report a gain of 2 lb in 1 day."
cor pulmonale
"heart of the lungs", enlargement of the right ventricle from hypertrophy or dilation or as a secondary response to disorders that affect the lungs
In which grade of COPD is the forced expiratory volume in 1 second (FEV1) greater than 80% predicted?
1
A nurse is assessing the injection site of a client who has received a purified protein derivative test. Which finding indicates a need for further evaluation?
15 mm induration
A patient has missed 2 doses of digitalis. What laboratory results would indicate to the nurse that the patient is within therapeutic range?
2.0 mg/mL
The nurse is educating a patient who will be started on an antituberculosis medication regimen. The patient asks the nurse, "How long will I have to be on these medications?" What should the nurse tell the patient?
6 to 12 months
The goal for oxygen therapy in COPD is to support tissue oxygenation, decrease the work of the cardiopulmonary system, and maintain the resting partial arterial pressure of oxygen (PaO2) of at least ______ mm Hg and an arterial oxygen saturation (SaO2) of at least ___%.
60 mm Hg; 90%
The nurse is assigned the following client assignment on the clinical unit. For which client does the nurse anticipate cardioversion as a possible medical treatment?
A client with atrial dysrhythmias
On auscultation, which finding suggests a right pneumothorax?
Absence of breath sounds in the right thorax
The nurse caring for a 2-year-old near-drowning victim monitors for what possible complication?
Acute respiratory distress syndrome
A nurse is caring for a client with status asthmaticus. Which medication should the nurse prepare to administer?
An inhaled beta2-adrenergic agonist
The nurse knows that electrocardiogram (ECG) characteristics of atrial fibrillation include what?
Atrial rate of 300 to 400
A client with heart failure is having a decrease in cardiac output. What indication does the nurse have that this is occurring?
Blood pressure 80/46 mm Hg
A victim has sustained a blunt force trauma to the chest. A pulmonary contusion is suspected. Which of the following clinical manifestations correlate with a moderate pulmonary contusion?
Blood-tinged sputum
Which statement is true about both lung transplant and bullectomy?
Both procedures improve the overall quality of life of a client with COPD.
A client has been prescribed furosemide 80 mg twice daily. The asymptomatic client begins to have rare premature ventricular contractions followed by runs of bigeminy with stable signs. What action will the nurse perform next?
Check the client's potassium level.
A nurse is caring for a client who has just been diagnosed with lung cancer. What is a cardinal sign of lung cancer?
Cough or change in chronic cough
A patient is undergoing a pericardiocentesis. Following withdrawal of pericardial fluid, which assessment by the nurse indicates that cardiac tamponade has been relieved?
Decrease in central venous pressure (CVP)
After evaluating a client for hypertension, a health care provider orders atenolol, 50 mg P.O. daily. Which therapeutic effect should atenolol have in treating hypertension?
Decreased cardiac output and decreased systolic and diastolic blood pressure
A nurse evaluates a client with a temporary pacemaker. The client's ECG tracing shows each P wave followed by the pacing spike. What is the nurse's best response?
Document the findings and continue to monitor the client
A patient is admitted to the hospital with pulmonary arterial hypertension. What assessment finding by the nurse is a significant finding for this patient?
Dyspnea
A nurse is assessing a client who comes to the clinic for care. Which findings in this client suggest bacterial pneumonia?
Dyspnea and wheezing
The nurse is assessing a client with mitral regurgitation. The nurse expects to note what finding in this client?
Dyspnea, fatigue, and weakness
A nurse is caring for a patient diagnosed with empyema. Which of the following interventions does a nurse implement for patients with empyema?
Encourage breathing exercises.
A client hospitalized with pneumonia has thick, tenacious secretions. Which intervention should the nurse include when planning this client's care?
Encouraging increased fluid intake
A client with chronic obstructive pulmonary disease (COPD) expresses a desire to quit smoking. The first appropriate response from the nurse is:
Have you tried to quit smoking before?
A client with congestive heart failure is admitted to the hospital after reporting shortness of breath. How should the nurse position the client in order to decrease preload?
Head of the bed elevated 45 degrees and lower arms supported by pillows
When caring for a client with acute respiratory failure, the nurse should expect to focus on resolving which set of problems?
Hypercapnia, hypoventilation, and hypoxemia
Asthma is cause by which type of response?
IgE-mediated
The clinical manifestations of cardiogenic shock reflect the pathophysiology of heart failure (HF). By applying this correlation, the nurse notes that the degree of shock is proportional to which of the following?
Left ventricular function
Which community-acquired pneumonia demonstrates the highest occurrence during summer and fall?
Legionnaires disease
The nurse is providing discharge instructions to a client with heart failure preparing to leave the following day. What type of diet should the nurse request the dietitian to discuss with the client?
Low-sodium diet
Which nursing intervention must a nurse perform when administering prescribed vasopressors to a client with a cardiac dysrhythmia?
Monitor vital signs and cardiac rhythm
A client develops cardiogenic pulmonary edema and is extremely apprehensive. What medication can the nurse administer with physician orders that will relieve anxiety and slow respiratory rate?
Morphine sulfate
To evaluate a client's atrial depolarization, the nurse observes which part of the electrocardiogram waveform?
P wave
A nursing instructor is reviewing the parts of an EKG strip with a group of students. One student asks about the names of all the EKG cardiac complex parts. Which of the following items are considered a part of the cardiac complex on an EKG strip?
P wave P-R interval T wave
The client with cardiac failure is taught to report which symptom to the physician or clinic immediately?
Persistent cough
A client who has just had a triple-lumen catheter placed in his right subclavian vein complains of chest pain and shortness of breath. His blood pressure is decreased from baseline and, on auscultation of his chest, the nurse notes unequal breath sounds. A chest X-ray is immediately ordered by the physician. What diagnosis should the nurse suspect?
Pneumothorax
Which term describes the degree of stretch of the ventricular cardiac muscle fibers at the end of diastole?
Preload
Which ECG waveform characterizes conduction of an electrical impulse through the left ventricle?
QRS complex
The nurse analyzes the electrocardiogram (ECG) tracing of a client newly admitted to the cardiac step-down unit with a diagnosis of chest pain. Which finding indicates the need for follow-up?
QT interval that is 0. 46 seconds long
As status asthmaticus worsens, the nurse would expect which acid-base imbalance?
Respiratory acidosis
In chronic obstructive pulmonary disease (COPD), decreased carbon dioxide elimination results in increased carbon dioxide tension in arterial blood, leading to which of the following acid-base imbalances?
Respiratory acidosis
The nurse recognizes which symptom as a classic sign of cardiogenic shock?
Restlessness and confusion
The nurse is placing electrodes for a 12-lead electrocardiogram (ECG). The nurse would be correct in placing an electrode on which area for V1?
Right side of sternum, fourth intercostal space
You are caring for a client status post lung resection. When assessing your client you find that the bubbling in the water-seal chamber for the chest tubes is more than you expected. What should you check when bubbling in the water-seal chamber is excessive?
See if there are leaks in the system.
The nurse is teaching a beginning EKG class to staff nurses. As the nurse begins to discuss the parts of the EKG complex, one of the students asks what the normal order of conduction through the heart is. What order does the nurse describe?
Sinoatrial (SA) node, atrioventricular (AV) node, bundle of His, right and left bundle branches, and the Purkinje fibers
A patient comes to the emergency department with reports of chest pain after using cocaine. The nurse assesses the patient and obtains vital signs with results as follows: blood pressure 140/92, heart rate 128, respiratory rate 26, and an oxygen saturation of 98%. What rhythm on the monitor does the nurse anticipate viewing?
Sinus tachycardia
A nurse is discussing asthma complications with a client and family. What complications should the nurse include in the teaching?
Status asthmaticus Respiratory failure Atelectasis
The patient with a chest tube is being transported to X-ray. Which complication may occur if the chest tube is clamped during transportation?
Tension pneumothorax
A client has been hospitalized for treatment of acute bacterial pneumonia. Which outcome indicates an improvement in the client's condition?
The client has a partial pressure of arterial oxygen (PaO2) value of 90 mm Hg or higher.
A client has a myocardial infarction in the left ventricle and develops crackles bilaterally; 3-pillow orthopnea; an S3 heart sound; and a cough with pink, frothy sputum. The nurse obtains a pulse oximetry reading of 88%. What do these signs and symptoms indicate for this client?
The development of left-sided heart failure
While caring for a client with a chest tube, which nursing assessment would alert the nurse to a possible complication?
The tissues give a crackling sensation when palpated.
Which technique does the nurse suggest to a client with pleurisy while teaching about splinting the chest wall?
Turn onto the affected side.
For a client with advanced chronic obstructive pulmonary disease (COPD), which nursing action best promotes adequate gas exchange?
Using a Venturi mask to deliver oxygen as ordered
The nurse caring for a client with tuberculosis anticipates administering which vitamin with isoniazid (INH) to prevent INH-associated peripheral neuropathy?
Vitamin B6
Which nursing intervention should the nurse perform when a client with valvular disorder of the heart has a heart rate less than 60 beats/min before administering beta-blockers?
Withhold the drug and inform the primary health care provider
A nurse is preparing dietary recommendations for a client with a lung abscess. Which statement would be included in the plan of care?
You must consume a diet rich in protein, such as chicken, fish, and beans."
troponin
a cardiac muscle biomarker; measurement is used as an indicator of heart muscle injury
heart failure (HF)
a clinical syndrome resulting from structural or functional cardiac disorders that impair the ability of a ventricle to fill or eject blood
metabolic syndrome
a cluster of metabolic abnormalities including insulin resistance, obesity, dyslipidemia, and hypertension that increase the risk of cardiovascular disease
acute coronary syndrome
a constellation of signs and symptoms due to the rupture of atherosclerotic plaque and resultant partial or complete thrombosis within a diseased coronary artery; leads to unstable angina or acute myocardial infarction
hypotension
a decrease in blood pressure to less than 100/60 mm Hg that compromises systemic perfusion
implantable cardioverter defibrillator (ICD)
a device implanted into the chest wall to treat dysrhythmias
emphysema
a disease of the airways characterized by destruction of the walls of overdistened alveoli
chronic bronchitis
a disease of the airways defined as the presence of cough and sputum production for at least a combined total of 3 months in each 2 consecutive years
paroxysmal
a dysrhythmia that has a sudden onset and terminates spontaneously; usually of short duration, but may recur
congestive heart failure (CHF)
a fluid overload condition (congestion) associated with heart failure
asthma
a heterogenous disease, usually characterized by chronic airway inflammation; defined by history of symptoms such as wheeze, shortness of breath, chest tightness, and cough that vary over time and in intensity
stent
a metal mesh that provides structural support to a coronary vessel, preventing its closure
thrombolytic
a pharmacologic agent that breaks down blood clots; alternatively referred to as a fibrinolytic
desaturate
a precipitous drop in the saturation of hemoglobin with oxygen
high density lipoprotein (HDL)
a protein-bound lipid that transports cholesterol to the liver for excretion in the bile; composed of a higher proportion of protein to lipid than low-density lipoprotein; exerts a beneficial effect on the arterial wall
low density lipoprotein (LDL)
a protein-bound lipid that transports cholesterol to tissues in the body; composed of a lower proportion of protein to lipid than high-density lipoprotein; exerts a harmful effect on the arterial wall
electrocardiogram (ECG)
a record of a test that graphically measures the electrical activity of the heart, including each phase of the cardiac cycle
elective replacement indicator (ERI)
a signal produced by a pacemaker when it is interrogated to indicate a near-depleted battery
postural (orthostatic) hypotension
a significant drop in BP (20 mm Hg systolic or 10 mm Hg diastolic or more) after an upright posture is assumed
hypertonic solution
a solution with an osmolality higher than that of serum
hypotonic solution
a solution with an osmolality lower than that of serum
isotonic solution
a solution with the same osmolality as serum and other body fluids
coronary artery bypass graft (CABG)
a surgical procedure in which a blood vessels from another part of the body is grafted onto the occluded coronary artery below the occlusion in such a way that blood flow bypasses the block
cardiac stress test
a test used to evaluate the functioning of the heart during a period of increased oxygen demand; test may be initiated by exercise or medications
ascites
a type of edema in which fluid accumulates in the peritoneal cavity
percutaneous transluminal coronary angioplasty (PTCA)
a type of percutaneous coronary intervention in which a balloon is inflated within a coronary artery to break an atheroma and open the vessel lumen, improving coronary artery blood flow
automaticity
ability of the cardiac cells to initiate an electrical impulse
contractility
ability of the cardiac muscle to shorten in response to an electrical impulse
pulmonary edema
abnormal accumulation of fluid in the interstitial spaces and alveoli of the lungs
pleural effusion
abnormal accumulation of fluid in the pleural space
atherosclerosis
abnormal accumulation of lipid deposits and fib
opening snaps
abnormal diastolic sound generated during opening of a rigid atrioventricular valve leaflet
summation gallop
abnormal sounds created by the presence of an S3 and S4 during periods of tachycardia
systolic click
abnormal systolic sound created by the opening of a calcified aortic or pulmonic valve during ventricular contraction
sudden cardiac death
abrupt cessation of effective heart activity
empyema
accumulation of purulent material in the pleural space
acute decompensated heart failure
acute exacerbation of heart failure, with signs and symptoms of severe respiratory distress and poor systemic perfusion
The ICU nurse is caring for a client who was admitted with a diagnosis of smoke inhalation. The nurse knows that this client is at increased risk for which of the following?
acute respiratory distress syndrome
A client has a medical diagnosis of an advanced first-degree atrioventricular block and is symptomatic. What initial treatment will the nurse be prepared to complete?
administer an IV bolus of atropine
he nurse is assessing a client with left-sided heart failure. What assessment finding is expected?
air hunger
Which is the strongest predisposing factor for asthma?
allergy
stroke volume
amount of blood ejected from one of the ventricles per heartbeat
cardiac output
amount of blood pumped by each ventricle in liters per minute
S3
an abnormal heart sound detected early in diastole as resistance is met to blood entering either ventricle; most often due to volume overload associated with heart failure
S4
an abnormal heart sound detected late in diastole as resistance is met to blood entering either ventricle during atrial contraction; most often caused by hypertrophy of the ventricle
induration
an abnormally hard lesion or reaction, as in a positive tuberculin skin test
alkalosis
an acid-base imbalance characterized by a reduction in H+ concentration (increased blood pH) (a high arterial pH with increased bicarbonate concentration is called metabolic alkalosis, a high arterial pH due to reduced PCO2 is called respiratory alkalosis)
acidosis
an acid-base imbalance characterized by an increase in H+ concentration (decreased blood pH) (a low arterial pH due to reduced bicarbonate concentration is called metabolic acidosis; a low arterial pH due to increased PCO2 is called respiratory acidosis)
cardiac catheterization
an invasive procedure used to measure cardiac chamber pressures and assess patency of the coronary arteries
acute lung injury
an umbrella term for hypoxemia respiratory failure; acute respiratory distress syndrome is a severe form of acute lung injury
open lung biopsy
biopsy of the lung tissue performed through a limited thoracotomy incision
cardiac resynchronization therapy (CRT)
biventricular pacing used to correct interventricular, intraventricular, and atrioventricular conduction disturbances that occur in patients with heart failure
hypertension
blood pressure that is persistently greater than 140/90mm Hg
central cyanosis
bluish discoloration of the skin or mucous membranes due to hemoglobin carrying reduced amounts of oxygen
Which is not a likely origination point for cardiac dysrhythmias?
bundle of His
The clinic nurse is caring for a client with acute bronchitis. The client asks what may have caused the infection. What may induce acute bronchitis?
chemical irritation
angina pectoris
chest pain brought about by myocardial ischemia
bronchiectasis
chronic, irreversible dilation of the bronchi and bronchioles that results from the destruction of muscles and elastic connective tissue; dilated airways become saccular and are a medium for chronic infection
A nurse is caring for a client after a thoracentesis. Which sign, if noted in the client, should be reported to the physician immediately?
client is becoming agitated and complains of pleuritic pain
atelectasis
collapse or airless condition of the alveoli caused by hypoventilation, obstruction to the airways, or compression
A young adult with cystic fibrosis is admitted to the hospital for an acute airway exacerbation. Aggressive treatment is indicated. What is the first action by the nurse?
collects sputum for culture and sensitivity
pulseless electrical activity (PEA)
condition in which electrical activity is present on an electrocardiogram, but there is not an adequate pulse or blood pressure
myocardial ischemia
condition in which heart muscle cells receive less oxygen than needed
dromotropy
conduction velocity
purulent
consisting of, containing, or discharging pus
Which term refers to lung tissue that has become more solid in nature as a result of a collapse of alveoli or an infectious process?
consolidation
Which medication is contraindicated in acute asthma exacerbations?
cromolyn sodium
myocardial infarction (MI)
death of heart tissue caused by lack of oxygenated blood flow
The nurse is admitting a client with frothy pink sputum. What does the nurse suspect is the primary underlying disorder of pulmonary edema?
decreased left ventricular pumping
preload
degree of stretch of the cardiac muscle fibers at the end of diastole
asbestosis
diffuse lung fibrosis resulting from exposure to asbestos fibers
A nurse is assisting with a subclavian vein central line insertion when the client's oxygen saturation drops rapidly. He complains of shortness of breath and becomes tachypneic. The nurse suspects the client has developed a pneumothorax. Further assessment findings supporting the presence of a pneumothorax include:
diminished or absent breath sounds on the affected side.
oliguria
diminished urine output; less than 0.5 mL/kg/h
restrictive lung disease
disease of the lung that causes a decrease in lung volumes
dysrhythmia
disorder of the formation or conduction (or both) of the electrical impulses within the heart, alerting the heart rate, heart rhythm, or both and potentially causing altered blood flow (also referred to as arrhythmia)
artifact
distorted, irrelevant, and extraneous electrocardiographic (ECG) waveforms
The nurse assessing a client with an exacerbation of heart failure identifies which symptom as a cerebrovascular manifestation of heart failure (HF)?
dizziness
A client has been having cardiac symptoms for several months and is seeing a cardiologist for diagnostics to determine the cause. How will the client's ejection fraction be measured?
echocardiogram
The nurse is caring for a client with atrial fibrillation. What procedure would be recommended if drug therapies did not control the dysrhythmia?
elective cardio version
depolarization
electrical activation of a cell caused by the influx of sodium into the cell while potassium exits the cell
sinus rhythm
electrical activity of the heart initiated by the sinoatrial node
cardioversion
electrical current given in synchrony with the patient's own QRS complex to stop a dysrhythmia
defibrillation
electrical current given to stop a dysrhythmia, not synchronized with the patient's QRS complex
A client with unresolved hemothorax is febrile, with chills and sweating. He has a nonproductive cough and chest pain. His chest tube drainage is turbid. A possible explanation for these findings is:
empyema
Class 1 with regard to TB indicates
exposure and no evidence of infection
The nurse knows the mortality rate is high in lung cancer clients due to which factor?
few early symptoms
atheroma
fibrous cap composed of smooth muscle cells that forms over lipid deposits within arterial vessels and protrudes into the lumen of the vessel, narrowing the lumen and obstructing blood flow; also called plaque
A patient arrives in the emergency department after being involved in a motor vehicle accident. The nurse observes paradoxical chest movement when removing the patient's shirt. What does the nurse know that this finding indicates?
flail chest
tonicity
fluid tension or the effect that osmotic pressure of a solution with impermeable solutes exerts on cell size because of water movement across the cell membrane
inotropy
force of myocardial contraction
alpha1-antitrypsin deficiency
genetic disorder resulting from deficiency of alpha1-antitrypsin, a protective age for the lung; increases patient's risk for developing panacinar emphysema even in the absence of smoking
A client diagnosed with asthma is preparing for discharge. The nurse is educating the client on the proper use of a peak flow meter. The nurse instructs the client to complete which action?
if coughing occurs during the procedure, repeat it.
A nurse is caring for a client with chest trauma. Which nursing diagnosis takes the highest priority
impaired gas exchange
A client with bronchiectasis is admitted to the nursing unit. The primary focus of nursing care for this client includes
implementing measures to clear pulmonary secretions
apical impulse
impulse normally palpated at the fifth intercostal space, left midclavicular line; caused by contraction of the left ventricle; also called the point of maximal impulse
systolic heart failure
inability of the heart to pump sufficiently because of an alteration in the ability of the heart to contract; term used to describe a type of heart failure
left sided heart failure
inability of the left ventricle to fill or eject sufficient blood into the systemic circulation
right sided heart failure
inability of the right ventricle to fill or eject sufficient blood into the pulmonary circulation
air trapping
incomplete emptying of alveoli during expiration due to loss of lung tissue elasticity (emphysema), bronchospasm (asthma), or airway obstruction
Which measure may increase complications for a client with COPD?
increased oxygen supply
In a client with amyotrophic lateral sclerosis (ALS) and respiratory distress, which finding is the earliest sign of reduced oxygenation?
increased restlessness
aspiration
inhalation of either oropharyngeal or gastric contents into the lower airways
thoracentesis
insertion of a needle into the pleural space to remove fluid that has accumulated and decrease pressure on the lung tissue; may also be used diagnostically to identify potential causes of a pleural effusion
fine-needle aspiration
insertion of a needle through the chest wall to obtain cells of a mass or tumor; usually performed under fluoroscopy or chest computed tomography guidance
ischemia
insufficient tissue oxygenation
A client with dilated cardiomyopathy is having frequent episodes of ventricular fibrillation. What medical treatment does the nurse anticipate the client will have to terminate the episode of ventricular fibrillation?
internal cardioverter defibrillator insertion
A client diagnosed with acute respiratory distress syndrome (ARDS) is restless and has a low oxygen saturation level. If the client's condition does not improve and the oxygen saturation level continues to decrease, what procedure will the nurse expect to assist with in order to help the client breathe more easily?
intubate the client and control breathing with mechanical ventilation
pleural friction rub
localized grating or creaking sound caused by the rubbing together of inflamed parietal and visceral pleurae
homeostasis
maintenance of a constant internal equilibrium in a biologic system that involves positive and negative feedback mechanisms
What is histamine, a mediator that supports the inflammatory process in asthma, secreted by?
mast cells
The classification of Stage II of COPD is defined as
moderate COPD
myocardium
muscle layer of the heart responsible for the pumping action of the heart
A client is prescribed digitalis medication. Which condition should the nurse closely monitor when caring for the client?
nausea and vomiting
baroreceptors
nerve fibers located in the aortic arch and carotid arteries that are responsible for control of the blood pressure
acute respiratory distress syndrome (ARDS)
nonspecific pulmonary response to a variety of pulmonary and nonpulmonary insults to the lung; characterized by interstitial infiltrates, alveolar hemorrhage, atelectasis, decreased compliance, and refractory hypoxemia
A client is being seen in the emergency department for exacerbation of chronic obstructive pulmonary disease (COPD). The first action of the nurse is to administer which of the following prescribed treatments?
oxygen through nasal cannula at 2L/minute
A nurse assesses arterial blood gas results for a patient in acute respiratory failure (ARF). Which results are consistent with this disorder?
pH 7.28, PaO2 50 mm Hg
Which is a key characteristic of pleurisy?
pain
hemothorax
partial or complete collapse of the lung due to blood accumulating in the pleural space; may occur after surgery or trauma
pneumothorax
partial or complete collapse of the lung due to positive pressure in the pleural space
pressurized metered dose inhaler
patient-activated medication canister that provides aerosolized medication that the patient inhales into the lungs
ejection fraction (EF)
percentage of blood volume in the ventricles at the end of diastole that is ejected during systole; a measurement of contractility
ejection fraction
percentage of the end- diastolic blood volume ejected from the ventricle with each heartbeat
The nurse is assigned the care of a 30-year-old client diagnosed with cystic fibrosis (CF). Which nursing intervention will be included in the client's care plan?
performing chest physiotherapy as ordered
systole
period of ventricular contraction resulting in ejection of blood from the ventricles into the pulmonary artery and aorta
diastole
period of ventricular relaxation resulting in ventricular filling
active transport
physiologic pump that moves fluid from an area of lower concentration to one of higher concentration; requires adenosine triphosphate for energy
A physician stated to the nurse that the client has fluid in the pleural space and will need a thoracentesis. The nurse expects the physician to document this fluid as
pleural effusion.
tension pneumothorax
pneumothorax characterized by increasing positive pressure in the pleural space with each breath; this is an emergency situation, and the positive pressure needs to be decompressed or released immediately
In COPD, the body attempts to improve oxygen-carrying capacity by increasing the amount of red blood cells. Which term refers to this process?
polycythemia
sinoatrial (SA) node
primary pacemaker of the heart, located in the right atrium
pericardiocentesis
procedure that involves aspiration of fluid from the pericardial sac
repolarization
process by which cardiac muscle cells return to a more negatively charged intracellular condition, their resting state
What does a positive Mantoux test indicate?
production of an immune response
You are caring for a client with chronic respiratory failure. What are the signs and symptoms of chronic respiratory failure?
progressive loss of lung function associated with chronic disease
The nurse is assigned to care for a patient with COPD with hypoxemia and hypercapnia. When planning care for this patient, what does the nurse understand is the main goal of treatment?
providing sufficient oxygen to improve oxygenation
Which diagnostic test is the most accurate in assessing acute airway obstruction?
pulmonary function studies
spirometry
pulmonary function tests that measures specific lung volumes and rates may be measured before and after bronchodilator administration
A 28-year-old client presents to the emergency department, stating severe restlessness and anxiety. Upon assessment, the client's heart rate is 118 bpm and regular, the client's pupils are dilated, and the client appears excitable. Which action should the nurse take next?
question the client about alcohol and illicit drug use
chronotropy
rate of impulse formation
ablation
removal of material, by mechanical means, from the surface of an object; in the context of cardiology, it is the purposeful destruction of heart muscle cells, usually in an attempt to correct or eliminate a dysrhythmia
systemic vascular resistance
resistance to blood flow out of the left ventricle created by the systemic circulatory system
pulmonary vascular resistance
resistance to blood flow out of the right ventricle created by the pulmonary circulatory system
A nurse administers albuterol (Proventil), as ordered, to a client with emphysema. Which finding indicates that the drug is producing a therapeutic effect?
respiratory rate of 22 breaths/minute
repolarization
return of the cell to resting state, caused by reentry of potassium into the cell while sodium exits the cell
atrioventricular (AV) node
secondary pacemaker of the heart, located in the right atrial wall near the tricuspid valve
The classification of Stage III of COPD is defined as
severe COPD
paroxysmal nocturnal dyspnea (PND)
shortness of breath that occurs suddenly during sleep
orthopnea
shortness of breath when lying flat
A client asks a nurse a question about the Mantoux test for tuberculosis. The nurse should base her response on the fact that the:
skin test doesn't differentiate between active and dormant tuberculosis infection
murmors
sounds created by abnormal, turbulent flow of blood in the heart
normal heart sounds
sounds produced when the valves close; normal heart sounds are S1 (AV valves) and S2 (semilunar valves)
cardiac conduction system
specialized heart cells strategically located throughout the heart that responsible for methodically generating and coordinating the transmission of electrical impulses to the myocardial cells
A patient comes to the clinic for the third time in 2 months with chronic bronchitis. What clinical symptoms does the nurse anticipate assessing for this patient?
sputum and a productive cough
pericardiotomy
surgically created opening of the pericardium
pulsus paradoxus
systolic blood pressure that is more than 10 mm Hg lower during inhalation than during exhalation; difference is normally less than 10 mm Hg
The nurse assesses a patient for a possible pulmonary embolism. What frequent sign of pulmonary embolus does the nurse anticipate finding on assessment?
tachypnea
A mediastinal shift occurs in which type of chest disorder?
tension pneumothorax
afterload
the amount of resistance to ejection of blood from the ventricle
hemoptysis
the coughing up of blood from the lower respiratory tract
pulse deficit
the difference between the apical and radial pulse rates
PP interval
the duration between the beginning of one P wave and the beginning of the next P wave; used to calculate atrial rate and rhythm
RR interval
the duration between the beginning of one QRS complex and the beginning of the next QRS complex; used to calculate ventricular rate and rhythm
S1
the first heart sound produced by closure of the atrioventricular (mitral and tricuspid) valves
diastolic heart failure
the inability of the heart to pump sufficiently because of an alteration in the ability of the heart to fill; term used to describe a type of heart failure
osmolality
the number of milliosmoles (standard unit of osmotic pressure) per kilogram of solvent; expressed as milliosmoles per liter; describes the concentration of solutes or dissolved particles
osmolarity
the number of milliosmoles (standard unit of osmotic pressure) per liter of solution; describes the concentration of solutes or dissolved particles
U wave
the part of an ECG that may reflect Purkinje fiber repolarization; usually, it is not seen unless a patient's serum potassium level is low
PR interval
the part of an ECG that reflects conduction of an electrical impulse from the sinoatrial node through the atrioventricular node
P wave
the part of an ECG that reflects conduction of an electrical impulse through the atrium; atrial depolarization
QRS complex
the part of an ECG that reflects conduction of an electrical impulse through the ventricles; ventricular depolarization
T wave
the part of an ECG that reflects repolarization of the ventricles
ST segment
the part of an ECG that reflects the end of the QRS complex to the beginning of the T wave
TP interval
the part of an ECG that reflects the time between the end of the T wave and the beginning of the next P wave; used to identify the isoelectric line
QT interval
the part of an ECG that reflects the time from ventricular depolarization through repolarization
hydrostatic pressure
the pressure created by the weight of fluid against the wall that contains it. In the body, hydrostatic pressure in blood vessels results from the weight of fluid itself and the force resulting from cardiac contraction.
osmosis
the process by which fluid moves across a semipermeable membrane from an area of low solute concentration to an area of high solute concentration; the process continues until the solute concentrations are equal on both sides of the membrane
diffusion
the process by which solutes move from an area of higher concentration to one of lower concentration; does not require expenditure of energy
telemetry
the process of continuous electrocardiographic monitoring by the transmission of radio waves from a battery-operated transmitter worn by the patient
ventilation-perfusion ratio
the ratio between ventilation and perfusion in the lung; matching of ventilation to perfusion optimizes gas exchange
S2
the second heart sound produced by closure of the semilunar (aortic and pulmonic) valves
The client asks the nurse to explain the reason for a chest tube insertion in treating a pneumothorax. Which is the best response by the nurse?
the tube will drain air from the space around the lung
hemodynamic monitoring
the use of pressure monitoring devices to directly measure cardiovascular function
transbronchial
through the bronchial wall, as in a trans bronchial lung biopsy
conduction
transmission of electrical impulses from one cell to another
The nurse is caring for a client with suspected ARDS with a pO2 of 53. The client is placed on oxygen via face mask and the PO2 remains the same. What does the nurse recognize as a key characteristic of ARDS?
unresponsive arterial hypoxemia
radioisotopes
unstable atoms that give off small amounts of energy in the form of gamma rays as the decay; used in cardiac nuclear medicine studies
anuria
urine output of less than 50mL/24 h
A nurse is caring for a client admitted with an exacerbation of asthma. The nurse knows the client's condition is worsening when he:
uses the sternocleidomastoid muscles.
The classification of Stage IV of COPD is defined as
very severe COPD
A client at risk for pneumonia has been ordered an influenza vaccine. Which statement from the nurse best explains the rationale for this vaccine?
viruses like influenza are the most common cause of pneumonia
A patient with hypertension has a newly diagnosed atrial fibrillation. What medication does the nurse anticipate administering to prevent the complication of atrial thrombi?
warfarin