realize right sided heart failure

The nurse is educating a patient about the care related to a new diagnosis of mitral valve prolapse. What statement made by the client demonstrates understanding? "This disorder will progress and I will need a heart transplant." "I shouldn't get a tattoo but I can get my tongue pierced." "I will take antibiotics before getting my teeth cleaned." "I will avoid caffeine, alcohol, and smoking."

"I will avoid caffeine, alcohol, and smoking.

Which teaching point does the nurse include for a client with peripheral arterial disease (PAD)? "Apply a heating pad to the legs if they feel cold" "Elevate your legs above heart level to prevent swelling" "Inspect your legs daily for brownish discoloration around the ankles" "Walk to the point of leg pain, resuming when the pain stops"

"Walk to the point of leg pain, resuming when the pain stops Exercise may improve arterial blood flow by building collateral circulation; instruct the client to walk until the point of claudication, stop and rest, and then walk a little farther.

What is the normal duration of a QRS complex? 0.12 seconds (3 small squares) 0.04 seconds (1 small square) 0.08 seconds (2 small squares) 0.16 seconds (4 small squares)

0.12 seconds (3 small squares) In most healthy individuals you would expect QRS complexes to be around 0.12 second or slightly less. If the QRS lasts longer it is described as a "wide QRS" and can be a sign of inefficient conduction of the ventricle's such as bundle branch block

What is the duration of a normal PR-interval? 0.04-0.08 seconds (1-2 small squares 0.04 - 0.12 seconds (1-3 small squares) 0.8-0.12 (2-3 small square) 0.12-0.2 seconds (3-5 small squares)

0.12-0.2 seconds (3-5 small squares)

If there were 3 large squares in an R-R interval what would the heart rate be? 70 bpm 90 bpm 80 bpm 100 bpm

100 bpm To calculate heart rate from an ECG you count the number of large squares in an R-R interval then divide 300 by this number. Therefore 300/3 = 100 bpm

The nurse has attended a conference on heart failure. The nurse understands that heart failure is which of the following? A heart attack A condition in which the patient experiences chest pain A condition in which the heart cannot pump enough blood to meet the bodies needs A condition in which the heart stops beating

A condition in which the heart cannot pump enough blood to meet the bodies need Heart failure does not necessarily mean the heart has stopped working. It simply describes a condition in which the heart fails to work as it should, and it cannot pump blood to sufficiently meet the body's needs

In the patient with a dysrhythmia, which assessment indicates decreased cardiac output (CO)? Chest pain and decreased mentation Bounding pulses and a ventricular heave Abdominal distention and hepatomegaly Hypertension and bradycardia

Chest pain and decreased mentation symptoms of decreased cardiac output (CO) related to cardiac dysrhythmias include a sudden drop in BP and symptoms of hypoxemia, such as decreased mentation, the HR may be increased or decreased, depending on the type of dysrhythmia present.

What is the definitive test used to diagnose an abdominal aortic aneurysm? Abdominal X-ray Arteriogram CT Scan Ultrasound

Abdominal X-ray

Which is a priority nursing intervention for a patient during the acute phase of rheumatic fever? Encouragement of fluid intake for hydration Performance of frequent active range-of-motion exercises Administration of antibiotics as ordered Management of pain with opioid analgesics

Administration of antibiotics as ordered Antibiotic therapy does not change the course of the acute disease or the development of carditis. It does eliminate residual group A streptococci remaining in the tonsils and pharynx and prevents the spread of organisms to close contacts.

A female patient is diagnosed with deep-vein thrombosis. Which nursing diagnosis should receive the highest priority at this time? Altered peripheral tissue perfusion related to venous congestion Risk for injury related to edema Impaired gas exchange related to increased blood flow Fluid volume excess related to peripheral vascular disease

Altered peripheral tissue perfusion related to venous congestion Venous inflammation and clot formation impede blood flow in a patient with deep-vein thrombosis

When teaching a patient about risk factors for AAA, which of the following, if stated by the patient indicates correct understanding? Genetic disorder Taking ACE inhibitors or ARBS Being female Straining while pooping

Genetic disorder Aortic Aneurysm can be caused by being male, smoking, family history or congenital weakness, and hypertension

The nurse is assessing a patient and feels a pulse with quick, sharp strokes that suddenly collapse. The nurse knows that this type of pulse is diagnostic for which disorder? Tricuspid stenosis Aortic regurgitation Tricuspid insufficiency Mitral Insufficiency

Aortic regurgitation

Which of the following heart muscle diseases is unrelated to other cardiovascular disease? Myocardial Infarction Coronary heart disease Pericardial effusion Cardiomyopathy

Cardiomyopathy Cardiomyopathy isn't usually related to an underlying heart disease such as atherosclerosis. The etiology in most cases is unknown. CAD and MI are directly related to atherosclerosis. Pericardial effusion is the escape of fluid into the pericardial sac, a condition associated with Pericarditis and advanced heart failure

The telemetry nurse is unable to read the telemetry monitor at the nurse's station. Which intervention should the telemetry nurse implement first? Contact the client on the client call system Go to the client's room to check the client. Request the nursing assistant to take the crash cart to the client's room. Instruct the primary nurse to assess the client

Contact the client on the client call system If the client answers the call light and is not experiencing chest pain, then there is probably a monitor artifact, which is not a life-threatening emergency. After talking with the client, send a nurse to the room to check the monitor.

The nurse is caring for a client with left sided heart failure. The nurse understands that which of the following symptoms is most commonly associated with left-sided heart failure? Arrhythmias Hypotension Hepatic Engorgement Crackles

Crackles Crackles in the lungs are a classic sign of left-sided heart failure. These sounds are caused by fluid backing up into the pulmonary system. Arrhythmias can be associated with both left and right sided heart failure. Left-sided heart failure causes hypertension secondary to an increased workload on the system.

A patient has had a successful heart transplant for end-stage heart disease. What immunosuppressant will be necessary for this patient to take to prevent rejection? Vancocin Calan Procardia Cycloporine

Cycloporin

The nurse is caring for a client admitted with heart failure. The nurse is filling out the care plan and understand that which of the following are appropriate nursing diagnosis for clients with heart failure? Select all that apply Decreased cardiac output related to altered contractility, altered preload and/or altered stroke volume. Activity intolerance related to a balance between O2 supply and demand secondary to cardiac sufficiency and pulmonary congestion Excess fluid volume related to increased venous pressure and decreased renal perfusion secondary to heart failure Impaired gas exchange related to increased preload and alveolar-capillary membrane changes

Decreased cardiac output related to altered contractility, altered preload and/or altered stroke volume. Excess fluid volume related to increased venous pressure and decreased renal perfusion secondary to heart failure Impaired gas exchange related to increased preload and alveolar-capillary membrane changes

The nurse is administering an angiotensin converting enzyme (ACE) inhibitor to a patient diagnosed with heart failure. Which of the following describe the ways in which the ACE inhibitor is therapeutic for the patient who has heart failure? Select all that apply Decreases myocardial remodelling Decreases cardiac workload Decreases cardiac preload Decreases cardiac output Increases myocardial contractility Increases peripheral vascular resistance

Decreases myocardial remodelling Decreases cardiac workload Decreases cardiac preload Decreased pumping ability of the heart causes decreased renal perfusion. Decreased renal perfusion causes sympathetic nervous system (SNS) activation and initiation of the renin-angiotensin-aldosterone system (RAAS). RAAS and SNS activation cause increased peripheral vascular resistance, increased preload, and increased afterload

Venous Thromboembolism is a term for what type of condition? Deep Vein Thrombosis and Pulmonary Embolism Ventricular Tachycardia Pulmonary Hypertension and Post Thrombotic Syndrome Vancomycin Resistant Enterococcus

Deep Vein Thrombosis and Pulmonary Embolism A venous thrombus is a blood clot (thrombus) that forms within a vein. Thrombosis is a term for a blood clot occurring inside a blood vessel. A common type of venous thrombosis is a deep vein thrombosis (DVT), which is a blood clot in the deep veins of the leg.

Which of the following aneurysms is the most likely to dissect? Abdominal Aortic Peripheral Thoracic They are all equally likely

Thoracic The thoracic region of the aorta often has the highest pressure and force due to being closest to the heart.

The nurse is caring for a patient who has been diagnosed with heart failure. The patient complains of sudden vision changes that include seeing yellowish-green halos around the lights. Which of the following medications should the nurse suspect is causing this issue? Lisinopril Lasix Digoxin Losartan

Digoxin Yellow-green halos/vision changes are classic signs of Digoxin toxicity

The nurse is caring for a patient who has been diagnosed with heart failure. Which statement, if made by the patient, supports the diagnosis of heart failure? "I often feel pain in my lower legs when I take my walk." "I get out of breath when I go up a flight of stairs." "I sometimes feel pain in the middle of my chest during exercise." "I get hot and break out in a sweat during the night."

Each of these statements are associated with common alterations in health. Think about how decreased pumping ability of the heart can cause problems during the patient's daily activities. Decreased pumping ability of the heart results in decreased cardiac output and pulmonary congestion, causing shortness of breath.

The nurse is educating a client on dietary therapy prior to discharge for a diagnosis of heart failure. Which of the following should the nurse include in her teaching plan? Select all that apply Examine labels to determine sodium content Eat large, spaced out meals Weigh yourself at the same time every day Avoid using salt when preparing food

Examine labels to determine sodium content Weigh yourself at the same time every day Avoid using salt when preparing foods A client with heart failure should eat small, spaced meals.

Which of the following aneurysms is composed of a collection of blood leaking completely out of an artery or vein but confined to the vessel by the surrounding tissue? False Dissecting Fusiform Saccular

False A false aneurysm, or pseudoaneurysm, is a collection of blood leaking completely out of an artery or vein, but confined next to the vessel by the surrounding tissue.

The nurse is education a group of student nurses on cardiac disease. A student asks if Congestive Heart Failure and Heart Failure are the same. What should the nurse say? False or True

False. Heart failure and congestive heart failure are often used interchangeably, but they are not the same. Congestive heart failure (CHF) refers to a specific type of heart failure where fluid "congestion" collects in the lungs and other body tissues. When the heart is not able to pump efficiently, the kidneys don't receive as much blood so they work less efficiently and less fluid is filtered out of the body as urine. This fluid backs up throughout the body, especially the lungs, legs and ankles, and the abdomen.

Dyspnea, cough, expectoration, weakness, and edema are classic signs and symptoms of which of the following conditions? Myocardial Infarction (MI) Pericarditis Heart Failure Hypertension

Heart Failure These are the classic signs of failure. Pericarditis is exhibited by a feeling of fullness in the chest and auscultation of a pericardial friction rub. Hypertension is usually exhibited by headaches, visual disturbances, and a flushed face. MI causes heart failure but isn't related to these symptoms

Dyspnea, cough, expectoration, weakness, and edema are classic signs and symptoms of which of the following conditions? Heart Failure Pericarditis Hypertension Myocardial Infarction (MI)

Heart Failure These are the classic signs of failure. Pericarditis is exhibited by a feeling of fullness in the chest and auscultation of a pericardial friction rub. Hypertension is usually exhibited by headaches, visual disturbances, and a flushed face. MI causes heart failure but isn't related to these symptoms.

Which of the following recurring conditions most commonly occurs in clients with cardiomyopathy? Heart Failure Pericardial Effusion Myocardial Infarction (MI) Diabetes

Heart failure Because the structure and function of the heart muscle is affected, heart failure most commonly occurs in clients with cardiomyopathy. MI results from prolonged myocardial ischemia due to reduced blood flow through one of the coronary arteries. Pericardial effusion is most predominant in clients with pericarditis

If medical treatments fail, which of the following invasive procedures is necessary for treating cardiomyopathy? Cardiac catheterization Coronary artery bypass graph (CABG) Heart transplant Intra-aortic balloon pump (IABP)

Heart transplant The only definitive treatment for cardiomyopathy that can't be controlled medically is a heart transplant because the damage to the heart muscle is irreversible

The nurse is teaching a group of senior citizens about risk factors for heart failure. Which of these factors will the nurse include in the teaching? Select all that apply High Sodium Intake Hypertension History of Pre-eclampsia Increased high density lipoproteins (HDL) Obesity Sleep apnea

High Sodium Intake Hypertension History of Pre-eclampsia Obesity Sleep apnea Untreated hypertension increases peripheral vascular resistance and cardiac workload. Women who were diagnosed with preeclampsia during pregnancy are at increased risk for developing hypertension later in life. High sodium intake increases circulating volume and preload. Sleep apnea is associated with diastolic dysfunction. Obesity increases cardiac workload.

Which of the following is of the greatest VTE risk to an individual? Long haul flight History of VTE Immobility Dehydration Oral Contraception (The Pill)

History of VTE

Septal involvement occurs in which type of cardiomyopathy? Hypertrophic Dilated Restrictive Congestive

Hypertrophic In hypertrophic cardiomyopathy, hypertrophy of the ventricular septum—not the ventricle chambers—is apparent. This abnormality isn't seen in other types of cardiomyopathy

When teaching a patient about the long-term consequences of rheumatic fever, the nurse should discuss the possibility of? Pulmonary hypertension Valvular heart disease Hypertrophy of the right ventricle Superior Vena Cava Syndrome

Valvular heart disease Rheumatic endocarditis is found mainly in the valves, with swelling and erosion of the valve leaflets.

The nurse is caring for a patient who has physiological changes common in geriatric patients. The nurse understands that which of these factors may increase the risk of heart failure in older patients? Increased stroke volume Impaired diastolic filling Increased myocardial contractility Decreased sympathetic activity

Impaired diastolic filling As a person ages, the myocardium becomes less compliant. Decreased myocardial compliance results in impaired filling of the cardiac chambers during diastole. Impaired filling during diastole may result in diastolic heart failure.

A patient is being assessed for possible heart failure. Which of these laboratory results will provide support this diagnosis? Decreased C-reactive protein Increased creatinine kinase Decreased serum sodium Increased brain natriuretic peptide (BNP)

Increased brain natriuretic peptide (BNP) Think about how heart failure affects the circulation of blood through the heart. Heart failure is associated with increased cardiac filling pressures and stretch of the myocardium. The actions of the renin-angiotensin system is increased in heart failure. Increased fluid volume causes an increased stretch of the myocardium, causing the cells to release BNP. BNP is a peptide that opposes the actions of the renin-angiotensin system.

The nurse is assessing a patient with chronic heart failure. The nurse would expect to identify which of these clinical manifestations? Expiratory wheezing Subcutaneous crepitus Inspiratory crackles Asymmetrical chest expansion

Inspiratory crackles When the heart's pumping ability is impaired it can cause respiratory problems. There are no valves to protect the pulmonary system from increased pressure in the left atrium. When there is decreased pumping ability of the heart fluid backs up into the pulmonary system. Inspiratory crackles are caused when air collides with fluid in the lungs.

The nurse is caring for a patient with chronic constrictive pericarditis. Which assessment finding reflects a more serious complication of this condition? Fatigue Thickened pericardium on echocardiography Jugular venous distention Peripheral edema

Jugular venous distention Decreased CO accounts for many of the clinical manifestations. These include dyspnea on exertion, peripheral edema, ascites, fatigue, anorexia, and weight loss. The most prominent finding on physical examination is jugular venous distention (JVD).

In preparation for discharge of a client with arterial insufficiency and Raynaud's disease, client teaching instructions should include: Wearing TED hose during the day Walk several times each day as an exercise program Keeping the heat up so that the environment is warm Using hydrotherapy for increasing oxygen

Keeping the heat up so that the environment is warm

In preparation for discharge of a client with arterial insufficiency and Raynaud's disease, client teaching instructions should include: Walk several times each day as an exercise program Using hydrotherapy for increasing oxygen Wearing TED hose during the day Keeping the heat up so that the environment is warm

Keeping the heat up so that the environment is warm The client's instructions should include keeping the environment warm to prevent vasoconstriction. Wearing gloves, warm clothes, and socks will also be useful when preventing vasoconstriction, but TED hose would not be therapeutic. Walking would most likely increase pain

Mitral regurgitation involves blood flowing back from the _________________ into the ________________ during systole. Left ventricle, left atrium Aorta, left ventricle Right ventricle, right atrium Pulmonary artery, right ventricl

Left ventricle, left atrium

Buerger"s disease is characterized by all the following except: Redness or cyanosis in the limb when it is dependent Arterial thrombosis formation and occlusion Lipid deposits in the arteries Venous inflammation and occlusion

Lipid deposits in the arteries

Which of the following are signs of a rupturing AAA? Select all that apply Low Back Pain Increased BP Decreased BP Decreased Hct Intermittent abdominal pain

Low Back Pain, Decreased BP, Decreased Hct The patient is losing blood pressure and dropping hematocrit due to bleeding. Pain is a key sign of a rupturing (or close to rupturing) Aortic Abdominal Aneurysm. Usually, when rupturing, the pain becomes constant rather than intermittent.

The nurse has attended an education session on aging and cardiac problems. The nurse understands which of the following are most likely to be early signs of cardiac problems in older persons? Select all that apply. Mental status changes Frequent Falls Sudden changes in GI function Agitation

Many cardiovascular functions are complicated in that they involve many other systems. Mental status changes, agitation, and falls can be early signs of cardiac problems in the older person. Changes in function in the GI system are not typical signs of a cardiac problem

Priority nursing management for a patient with myocarditis includes interventions related to which of the following? Tight glycemic control Meticulous skin care Antibiotic prophylaxis Oxygenation and ventilation

Oxygenation and ventilation Focus your interventions on managing the signs and symptoms of HF. Select nursing measures to decrease cardiac workload

What are the signs & symptoms of DVT? Select all that apply. Pain Swelling Redness Bruising Heat

Pain, swelling, redness, heat 7 early warning signs and symptoms of DVT Leg cramps, often starting in the calf. Leg pain that worsens when bending the foot. Bluish or whitish skin discoloration.

The nurse is assessing a client who has been admitted to the cardiac unit with a diagnosis of right ventricular failure. Which of the following assessment findings would the nurse expect to observe? Fatigue and hemoptysis Dyspnea and pulmonary crackles Peripheral edema and jugular vein distension Bradycardia and circumoral cyanosis

Peripheral edema and jugular vein distension The right ventricle receives blood from the right atrium. If right ventricular pumping is impaired, blood will back up through the right atrium and into the venous system.

A patient is admitted with myocarditis. While performing the initial assessment, the nurse may find which clinical signs and symptoms. Select all that apply. Myocarditis Pericardial friction rub Presence of Osler's nodes Splinter hemorrhages Pleuritic chest pain

Pleuritic chest pain Pericardial friction rub Myocarditis These include pleuritic chest pain with a pericardial friction rub and effusion because pericarditis often accompanies myocarditis.

The nurse is caring for a patient who has been diagnosed with patient is diagnosed with heart failure and is prescribed digoxin (Lanoxin) and furosemide (Lasix). Before administering the furosemide to the patient, which laboratory result should the healthcare provider to review? Serum Potassium Blood urea nitrogen (BUN) Serum Sodium Serum Troponin

Potassium Digoxin is a high risk medication with a narrow therapeutic index. Think about possible drug-drug interactions between digoxin and furosemide. Furosemide may cause hypokalemia, which increases the risk of digoxin toxicity.

With aortic stenosis, the patient should receive _____________ antibiotics to prevent endocarditis. Palliative Inductive Operative Prophylactic

Prophylactic

The nurse is caring for a patient who has been diagnosed with a recent diagnosis of heart failure has been prescribed furosemide (Lasix) in an effort to physiologically do what for the patient? Reduce preload Promote vasodilation Decrease afterload Increase contractility

Reduce preload Diuretics such as furosemide are used in the treatment of heart failure to mobilize edematous fluid, reduce pulmonary venous pressure, and reduce preload. They do not directly influence afterload, contractility, or vessel tone.

The nurse is caring for a client with peripheral arterial disease (PAD). For which of symptoms does the nurse assess? Decreased pain when legs are elevate Reproducible leg pain with exercise Unilateral swelling of affected leg Pulse oximetry reading of 90%

Reproducible leg pain with exercise Claudication (leg pain with ambulation due to ischemia) is reproducible in similar circumstances. Unilateral swelling is typical of venous problems such as deep vein thrombosis. With PAD, pain decreases with legs in the dependent position. Pulse oximetry readings reflect the amount of oxygen bound to hemoglobin; PAD results from atherosclerotic occlusion of peripheral arteries.

The nurse is caring for clients in the nursing home setting who are bedridden. In which of the following disorders would the nurse expect to assess sacral edema in a bedridden client? Right-sided Heart failure Pulmonary embolism Diabetes Renal failure

Right-sided heart failure The most accurate area on the body to assess dependent edema in a bed-ridden client is the sacral area. Sacral or dependent edema is secondary to right-sided heart failure

The nurse is caring for a patient who has been diagnosed with heart failure and has been prescribed digoxin (Lanoxin). Which of the following will the nurse include when teaching the patient about this medication? Select all that apply "Call the doctor's office if you experience nausea or lack of appetite." "Increase dietary sodium to maintain your fluid balance." "If you miss a dose, you should double the dose next time." "Report any visual changes to the doctor's office immediately." "You should keep a record of your daily weights." "If your pulse is less than 60 beats per minute, do not take the medication.".

The nurse will teach the patient about how the medication helps treat problems caused by heart failure. The patient should be taught how to self-administer the medication safely. The patient needs to know how to recognize signs and symptoms of digoxin toxicity. Doubling the dose of digoxin is not safe because it has a narrow therapeutic index. Increased dietary sodium adds to the circulatory volume and can increase the workload on the heart

The nurse is educating a client on dietary therapy prior to discharge for a diagnosis of heart failure. Which of the following should the nurse include in her teaching plan? Select all that apply Weigh yourself at the same time every day Avoid using salt when preparing foods Examine labels to determine sodium content Eat large, spaced out meals

Weigh yourself at the same time every day Avoid using salt when preparing foods Examine labels to determine sodium content

When a patient has a confirmed acute DVT what should they wear on their legs? Intermittent pneumatic compression devise compression stockings Nothing ace bandage

compression stockings To help prevent swelling associated with deep vein thrombosis, these are worn on the legs from the feet to about the level of the knees.

The nurse has attended an education session on types of heart failure. The nurse understands which of the following is not one of the types of heart failure? Congestive heart failure Right-sided heart failure Myocardial heart failure Left-sided heart failure

myocardial heart failure There is no such thing as myocardial heart failure. There are three types of heart failure: - Left-sided heart failure: The heart cannot effectively pump blood out to the body.- Right-sided heart failure: Usually occurs as a result of left-sided heart failure. The right side of the heart becomes damaged, and blood starts backing up in the body. - Congestive heart failure: Fluid collects mainly in the lungs and other body tissues

A patient can have heart failure without being aware of it? True or False

true It's common for people to be in the early stages of heart failure and not be aware of it. Early on, there may be no symptoms because the body and heart can often compensate for any deficits.