PrepU Med surg assignment 14

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A 79-year-old female is a client in the cardiac unit where you practice nursing. With her diagnosis of pulmonary congestion secondary to left ventricular dysfunction, you would expect her physician to order supplemental oxygen therapy. At what minimum level would you expect to maintain her SpO2?

90

Eunice Henderson, a 79-year-old female, is a client in the cardiac unit where you practice nursing. With her diagnosis of pulmonary congestion secondary to left ventricular dysfunction, you would expect her physician to order supplemental oxygen therapy. At what minimum level would you expect to maintain her SpO?

90

A patient is being discharged to home. The nurse must emphasize the importance of being weighed daily. Which significant weight change would need to be reported to the patient's health care provider?

A weight gain of 2½ pounds in a day

A patient presents to the ED complaining of increasing shortness of breath. The nurse assessing the patient notes a history of left-sided heart failure. The patient is agitated and occasionally coughing up pink-tinged, foamy sputum. The nurse should recognize the signs and symptoms of what health problem?

Acute pulmonary edema

A patient has been experiencing increasing shortness of breath and fatigue. The physician has ordered a diagnostic test in order to determine what type of heart failure the patient is having. What diagnostic test does the nurse anticipate being ordered?

An echocardiogram

The nurse is reviewing a newly admitted patient's electronic health record, which notes a history of orthopnea? What nursing action is most clearly indicated?

Avoid positioning the patient supine.

A patient has been admitted to the hospital with exacerbation of heart failure (HF) that has resulted in pulmonary and peripheral edema. The nurse has been carefully monitoring the trajectory of the patient's signs and symptoms of HF. How can the nurse best monitor the patient's fluid balance?

By performing daily weights at the same time each day

The nurse hears the alarm sound on the telemetry monitor and observes a flat line. The patient is found unresponsive, without a pulse, and no respiratory effort. What is the first action by the nurse?

Call for help and begin chest compressions.

The nurse has completed a head-to-toe assessment of a patient who was admitted for the treatment of heart failure (HF). Which of the following assessment findings should signal to the nurse a possible exacerbation of the patient's condition?

Crackles are audible on chest auscultation.

The nurse is assessing a patient who is known to have right-sided heart failure. What assessment finding is most consistent with this patient's diagnosis?

Distended neck veins

Frequently, what is the earliest symptom of left-sided heart failure?

Dyspnea on exertion

A client has been symptomatic for several months and is seeing a cardiologist for diagnostics to determine the cause of his cardiac symptoms. You review the diagnostic procedures the cardiologist will perform. How will the client's ejection fraction be measured?

Echocardiogram

Which of the following medications is categorized as a loop diuretic?

Furosemide (Lasix)

A nurse is caring for a client experiencing dyspnea, dependent edema, hepatomegaly, crackles, and jugular vein distention. What condition should the nurse suspect?

Heart failure

Which of the following is a characteristic of right-sided heart failure?

Jugular vein distention

In a client with chronic bronchitis, which sign would lead the nurse to suspect right-sided heart failure?

Leg edema

A client diagnosed with heart failure presents with the following assessment data: temperature 99.1° F, pulse 100 beats/minute, respirations 42 breaths/minute, BP 110/50 mm Hg; crackles in both lung bases; nausea; pulse oximeter reading of 89%. Following the completion of your assessment, you prioritize your findings. Which findings indicate a need for immediate attention?

Lung congestion

A 73-year-old client has been admitted to the cardiac step-down unit where you practice nursing. After diagnostics, she was brought to your unit with acute pulmonary edema. Which of the following symptoms would you expect to find during your assessment?

Moist, gurgling respirations

Which of the following medications is a human brain natriuretic peptide (BNP) preparation?

Natrecor

The nurse notes that a patient has developed a cough productive for mucoid sputum, is short of breath, has cyanotic hands, and has noisy, moist-sounding, rapid breathing. These symptoms and signs are suggestive of what health problem?

Pulmonary edema

Which of the following would be inconsistent as a lifestyle change directive for the patient diagnosed with heart failure?

Push fluids

The nurse is administering nitroglycerin, which he knows decreases preload as well as afterload. Preload refers to which of the following?

The amount of blood presented to the ventricles just before systole

The nurse is caring for a 68-year-old patient who the nurse suspects has digoxin toxicity. What should the nurse assess for?

Vision changes.

A nurse suspects that a client has digoxin toxicity. The nurse should assess for:

vision changes.


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