Cardiac

A client diagnosed with stable angina is being discharged home on rovustatin. The nurse should teach the client to report which side effect to the hcp?

Muscles aches or weakness

The nurse is planning care for a client who has just returned to the medical-surgical unit following repair of aortic aneurysm. What is a priority assessment for this client?

decreased urinary output

The nurse has just administered adenosine via IV push and sees the following rhythm on the monitor. What is the nurse's priority intervention? asystole

document the finidngs and continue to monitor

A client on telemetry has a pattern of uncontrolled atrial fibrillation with a rapid ventricular response. Based on this finding, the nurse anticipates assisting the physician with which treatment?

preform synchronized cardioversion

When preparing a client for discharge after surgery for a CABG, the nurse should teach the client that there will be:

some increase in edema in the leg used for the donor graft when activity increases

What would be the treatment option of choice for an AAA that is 6 cm?

surgery

A client has been admitted to the hospital with a diagnosis of suspected bacterial endocarditis. The complication the nurse will constantly observe for is:

systemic emboli

A client recently diagnosed with heart failure is being discharged on Lisinopril. Which client teaching related to the new medication is important to review?

teach client to rise slowly and sit on side of the bed for several minutes before rising

A client is scheduled for elective cardioversion to treat chronic high-rate atrial fibrillation. Which finding indicates that further preparation is needed for the procedure?

the client is wearing a nasal cannula delivering oxygen at 2L/min

The nurse is assigned the care of a client with a diagnosis of heart failure who is receiving intravenous doses of furosemide. The client is attached to cardiac telemetry, and the nurse is monitoring the client's cardiac status. The nurse notes that the client's cardiac rhythm has changed to this pattern. The nurse determines that the most likely cause of this cardiac rhythm in the client is which problem? Refer to Figure

the presence of hypokalemia

A client had a repair of a thoracoabdominal aneurysm 2 days ago. Which findings should the nurse consider unexpected and report to the health care provider immediately?

weakness and numbness in the lower extremeties

Captopril, furosemide, and metoprolol are prescribed for a client with systolic heart failure. The client's blood pressure is 136/82 mm Hg, and the heart rate is 65 bpm. Prior to medication administration at 0900, the nurse reviews the following lab tests (see chart). What should the nurse do first?

withold the catopril

A hospitalized client has been diagnosed with heart failure as a complication of hypertension. In explaining the disease process to the client, the nurse identifies which chamber of the heart as primarily responsible for the symptoms?

Left ventricle

The nurse prepares the client for insertion of a pulmonary artery catheter (Swan-Ganz catheter). The nurse teaches the client that the catheter will be inserted to provide information about

Left ventricular functioning

The nurse is providing community health screening. Which of the following clients should be referred to a health care provider for further evaluation?

55 year old client missing all the hair on the lower legs and failing the pinprick test

Which of the following assessment data should be collected for a patient who has had a myocardial infarction? SATA

A full set of current vital signs. Indication of heart failure. Characteristic and location of discomfort. Activites of ADL assessments. Follow up of electrocardiogram.

The patient at highest risk for venous thromboembolism (VTE) is

A 32 year old women who smokes, takes oral contraceptives, and is planning a trip to Europe

Which of the following patients are MOST at risk for developing heart failure? Select-all-that-apply:

A 69-year-old male with a history of alcohol abuse and is recovering from a myocardial infarction. A 30-year-old male with a history of endocarditis and has severe mitral stenosis. A 58-year-old female with uncontrolled hypertension and is being treated for influenza

The clinic nurse reviews the record of a child just seen by the pediatrician and diagnosed with suspected aortic stenosis. The nurse expects to note documentation of which clinical manifestation specifically found in this disorder?

Activity intolerance

A patient admitted with heart failure appears very anxious and complains of shortness of breath. Which nursing actions would be appropriate to alleviate this patient's anxiety (select all that apply)?

Administer ordered morphone sulfate. Position patient in a semi-fowlers position. Instruct pateint on the use of relaxation techniques. Use a calm, reassuring apporach while talking to patient.

A client has atrial fibrillation and a heart rate of 165 bpm. In which order from first to last should the nurse implement these prescriptions?

Administer oxygen via nasal cannula. Place client on a cardiac monitor. Obtain vital signs including BP, P, R, T and O2 saturation. Gather supplies for an IV infusion

Which of the following medications are used to treat hypertension? Select all that apply.

Lostartan. Lisinopril. Diltiazem

An older adult is admitted to the emergency department at 2000 hours wth syncope, shortness of breath, and reported palpitations (see nurse's notes below). At 2015, the nurse places the client on the EKG monitor and identifies the following rhythm (see below). What should the nurse do? Select all that apply.

Apply oxygen. Monitor vital signs. Have the client sign consent for cardioversion as prescribed

An older adult client, 4 hours after coronary artery bypass graft (CABG), has a blood pressure of 80/50 mm Hg. What action does the nurse take?

Assess pulmonary artery wedge pressure

The nurse is assessing a client who has had a myocardial infarction (MI). The nurse notes the cardiac rhythm on the monitor. What should the nurse do first? PVCs

Assess the client for changes in the rhythm

The client is one day postoperative coronary artery bypass surgery. The client complains of chest pain. Which intervention should the nurse implement first?

Assess the client's chest dressing and vital signs

Cardiac telemetry shows that a client who is up to the bathroom has converted from normal sinus rhythm to atrial fibrillation with a ventricular response rate of 100 bpm. In what order from first to last should the nurse perform these interventions? All options must be used.

Assist the client to the bed. Assess vital signs. Initiate IV access. Obtain a stat 12-lead ECG

A client with chest pain is prescribed intravenous nitroglycerin. Which finding is of greatest concern for the nurse initiating the nitroglycerin drip?

Blood pressure is 88/46

A client is brought to the emergency department complaining of substernal chest pain. To distinguish between angina and myocardial infarction, the nurse assesses for which characteristics of angina? Select all that apply.

Chest pain that resolves with rest. Chest pain that is relieved by nitroglycerin. Chest pain that is usally precipitated by exertion.

The client diagnosed with congestive heart failure is complaining of leg cramps at night. Which nursing interventions should be implemented?

Monitor the client's potassium level and assess the client's intake of bananas and orange juice

The nurse is monitoring a client with hypertension who is taking propranolol. Which assessment finding indicates a potential adverse complication associated with this medication?

Development of expiratory wheezes

Patients with rupturing AAA are at risk for hypovolemic shock. Select all that apply the signs and symptoms that may be present in the case of hypovolemic shock.

Diaphoresis. Decreased LOC. Loss of pulse distal to rupture

The nurse is caring for a patient who has had an arterial line inserted. To reduce the risk of complications, what is the priority nursing intervention?

Ensure all tubing connections are tightened

Which of the following signs and symptoms would most likely be found in a client with mitral regurgitation?

Exertional dyspnea

The nurse obtains a health history from a 65-year-old patient with a prosthetic mitral valve who has symptoms of infective endocarditis (IE). Which question by the nurse is most appropriate?

Have you had dental work done recently?

A patient has an arterial ulcer on the lower extremity. What risk factors for peripheral arterial disease are in the patient's health history? Select all that apply:

High cholesterol. Diabetes mellitus. uncontrolled hypertension. smoking

The physician's order says to administered Lasix 40 mg IV twice a day. The patient has the following morning labs: Na+ 148, BNP 900, K+ 2.0, and BUN 10. Which of the following is a nursing priority?

Hold the dose and notify the physician about the potassium level

Which information should the nurse include when teaching a patient with newly diagnosed hypertension?

Hypertension is usually asymptomatic until significant organ damage occurs

A client has developed atrial fibrillation, which has a ventricular rate of 150 beats per minute. A nurse assesses the client for:

Hypotension and dizziness

What should the nurse recognize as an indication for the use of dopamine (Intropin) in the care of a patient with heart failure?

Hypotension and tachycardia

A nurse is assessing a client with a diagnosis of early left ventricular heart failure. Specific to this type of heart failure, what statement by the client would the nurse expect?

I have trouble breathing when I walk rapidly

The nurse has provided instructions to a client receiving enalapril maleate for hypertension. Which statement by the client indicates a need for further instruction?

I need to notify the primary health care provider if a sore throat occurs

A client in shock develops a central venous pressure (CVP) of 2 mm Hg. Which prescribed intervention should the nurse implement first?

Increase the rate of IV fluids

A client who is in the progressive stage of hypovolemic shock has all of the following signs, symptoms, or changes. Which ones does the nurse attribute to ongoing compensatory mechanisms? SATA

Increasing pallor. Increasing thirst. Increasing heart rate. Increasing respiratory rate. Decreasing systolic BP. Decreasing urine output

Potassium chloride intravenously is prescribed for a client with hypokalemia. Which actions should the nurse take to plan for preparation and administration of the potassium? Select all that apply.

Obtain an IV infusion pump. Monitor urine output during administration. Monitor the IV site for signs of infiltration or phlebitis. Ensure the medication is diluted in the appropriate volume of fluid. Ensure that the bag is labeled so that it reads the volume of potassium in the solution.

A patient is 36 hours status post a myocardial infarction. The patient is starting to complain of chest pain when they lay flat or cough. You note on auscultation of the heart a grating, harsh sound. What complication is this patient mostly likely suffering from?

Pericarditis

A client is receiving furosemide to help treat heart failure. Which laboratory result will cause the nurse to notify the primary healthcare provider?

Potassium 3.0

The nurse is asked to assist in preparing a heparin sodium infusion for a client with a diagnosis of thrombophlebitis. Which items should the nurse have available for this procedure? Select all that apply.

Protamine sulfate. Intravenous tubing. Intravenous infusion controller. Intravenous insertion equipment

The nurse expects that a client with mitral stenosis would demonstrate symptoms associated with congestion in the:

Pulmonary circulation

When caring for a patient with mitral valve stenosis, it is most important that the nurse assess for

Shortness of breath on exertion

A 21-year-old female is seen in the Emergency Department for vomiting and diarrhea for 3 days. Her BP is 94/64 and her EKG rhythm shows that she is sinus tachycardia. The best action for the nurse to take initially is to:

Start IV and bolus normal saline per protocol

A patient is diagnosed with an abdominal aortic aneurysm (AAA). A patient with this diagnosis would describe the pain as:

Steady with a gnawing quality, unaffected by movement

A client receiving thrombolytic therapy with a continuous infusion of alteplase suddenly becomes extremely anxious and reports itching. The nurse hears stridor and notes generalized urticaria and hypotension. Which interventions are a priority? Select all that apply.

Stop the infusion. Administer diphenhydramine. Call for RRT

There are five clients in the emergency unit. Which client conditions require immediate treatment? Select all that apply.

Unstable vital signs. Severe abdominal pain. Chest pain with diaphoresis

An older adult with peripheral vascular disease has stopped smoking, and the client's children want to make the home environment safe. What should the home healthcare nurse emphasize when providing instructions?

Use measures that can prevent thermal injuries

A client is receiving digoxin (Lanoxin) daily. The nurse suspects digoxin toxicity after collecting data noting which signs and symptoms? Select all that apply.

Visual disturbances. Nausea and Vomiting. Serum digoxin level of 2.3

Which teaching point does the nurse include for a client with pad?

Walk to the point of leg pain, then rest, resuming when pain stops

Which person should the nurse identify as having the highest risk for abdominal aortic aneurysm?

a 70-year-old male, with high cholesterol and hypertension

What is the first intervention for a client experiencing MI?

administer oxygen

Your patient has returned from a peripheral artery bypass for the treatment of peripheral arterial disease. The nurse will make it PRIORITY to?

assess and grade lower extremity pulses bilaterally

The nurse is caring for a client diagnosed with and anterior myocardial infarction 2 days ago. Upon assessment, the nurse identifies a systolic murmur at the apex. What should the nurse do first?

assess for changes in vital signs

The nurse teaches a client who has recently been diagnosed with hypertension about following a low-calorie, low-fat, low-sodium diet. Which menu selection would best meet the client's needs?

baked chicken, an apple, and a slice of white bread

The patient who has recently been experiencing runs of ventricular tachycardia suddenly loses consciousness. The patient is defibrillated, and the rate returns as the following. What should the nurse do first? v-fib

begin compressions

the nurse observes the cardiac rhythm for a client who is being admitted with a myocardial infarction. What should the nurse do first? v-tach

check for a pulse

The nurse is monitoring a client during IV nitroglycerin infusion. Which assessment finding will cause the nurse to take action?

chest pain

The nurse in the outpatient clinic is reviewing phone messages. Which client should the nurse call back first?

client with a hisotry of mitral valve regurgitation who reports fatigure

Which of the following are signs of a rupturing AAA? Select all that apply.

decreased hct. low back pain. decreased BP.