Cardiac- NU 325- Med Surg
What is the term for the ability of the cardiac muscle to shorten in response to an electrical impulse?
contractility
A client is prescribed quinine for treatment of moderate depression of depolarization. Which sign indicates the drugs' effectiveness in the client's treatment?
decrease in cardiac contractility
Several hours after being admitted to the unit, an intravenous lidocaine drip is started for a client diagnosed with acute myocardial infarction. The nurse understands which outcome is the purpose of this medication?
decrease the myocardial irritability
The most important reason for a nurse to encourage a client with peripheral vascular disease to initiate a walking program is that this form of exercise:
decrease venous congestion
During assessment of a client admitted for cardiomyopathy, the nurse notes the following symptoms: dyspnea on exertion, fatigue, fluid retention, and nausea. The initial appropriate nursing diagnosis is which of the following?
decreased cardiac output
The nurse is monitoring a client receiving treatment for hypertension. Which blood pressure reading indicates to the nurse that the treatment is successful?
118/78
The nurse is gathering data from a client recently admitted to the hospital. The nurse asks the client about experiencing orthopnea. What question would the nurse ask to obtain this information?
"Are you only able to breathe when you are sitting upright?"
The nurse teaches a client receiving an antihypertensive medication prior to discharge. The nurse determines that further teaching is necessary when the client makes which statement?
"I can stop taking the medication when my blood pressure goes down."
A client is diagnosed with angina, and the nurse instructs the client about care at home. The nurse determines that teaching is effective if the client makes which statement?
"If I have chest pain, I should stop my activity and take a nitroglycerin tablet"
The nurse is caring for a client newly diagnosed with hypertension. Which statement by the client indicates the need for further teaching?
"If I take my blood pressure and it is normal, I don't have to take my blood pressure pills."
The client asks the nurse what urine output has to do with cardiac function. What is the best response by the nurse?
"Poor urine output may indicate inadequate blood flow to the kidneys."
The office nurse prepares a client for a resting electrocardiogram. Which statement by the client indicates teaching is successful?
"The more still I can lie, the better the results will be."
The nurse instructs a client in the outpatient clinic about a cardiac stress test. Which statement by the nurse is best?
"The stress test will determine the amount of stress that you heart can tolerate"
A monitor technician on the telemetry unit asks a charge nurse why every client whose monitor shows atrial fibrillation is receiving warfarin. Which response by the charge nurse is best?
"Warfarin prevents clot formation in the atria of clients with atrial fibrillation."
The nurse performs blood pressure screenings at a community center. The nurse knows which blood pressure reading indicates stage 1 hypertension?
130-139/ 80-89
What levels are considered hypertension stage 2?
140/90+
What is the body's normal cardiac index?
2.5-4L
When the nurse performs CPR on an adult, which is the correct ratio of compressions to breaths?
30 compressions to 2 breaths
What is the body's normal cardiac output?
4-6L
What BP is considered hypertensive crisis?
>180/>120
The nurse provides discharge teaching for a client with a diagnosis of angina. It is most important for the client to report which occurrence?
A change in the character of pain
A patient is seen in the emergency department (ED) with heart failure secondary to dilated cardiomyopathy. What key diagnostic test does the nurse assess to determine the severity of the patient's heart failure?
B-type natriuretic peptide (BNP)
The nurse is in the mall and observes a client slump to the floor. The nurse assesses the client and notes no pulse. The nurse calls for assistance to others in the mall and requests which piece of equipment?
An automatic external defibrillator
Which term refers to chest pain brought on by physical or emotional stress and relieved by rest or medication?
Angina Pectoris
A nurse is preparing a client for cardiac catheterization. The nurse knows that which nursing intervention must be provided when the client returns to the room after the procedure?
Assess the puncture site frequently for hematoma formation or bleeding
Which medication is the drug of choice for sinus bradycardia?
Atropine
One week following a myocardial infarction, a client reports experiencing fatigue to the nurse. The nurse notes the client is slightly short of breath and the pulse rate is 110 bpm. Which action by the nurse is best?
Check for any edema or weight gain
A middle-aged client presents to the ED reporting severe chest discomfort. Which finding is most indicative of a possible myocardial infarction (MI)?
Chest discomfort not relieved by rest or nitroglycerin
A client had a percutaneous transluminal coronary angioplasty (PTCA). What medication will the nurse administer to prevent thrombus formation in the stent?
Clopidogrel
A client arrives at the emergency department reporting severe pain in the left leg that is not relieved by rest or medication. On physical examination, the nurse is most likely to access which symptom?
Cold, mottled leg
The nurse is working on a medical/ surgical unit and enters a client's room. The client is unresponsive, pulseless, apneic. The nurse calls for help and begins to administer cardiopulmonary resuscitation to the adult client. Which is the most important action for the nurse to take?
Compress the chest at a rate of at least 100 compressions per minute
The nurse understands that when performing CPR, which is the meaning of CAB?
Compressions, airway, breathing
The nurse is caring for a ventilated client after coronary artery bypass graft surgery. What are the criterions for extubation for the client?
adequate cough and gag reflexes, acceptable arterial blood gas values, breathing without assistance of the ventilator
The nurse expects which laboratory test results to be elevated for a client following an acute myocardial infarction?
Creatine kinase, troponin, myoglobin
The nurse provides care for a client diagnosed with angina. The nurse understands NTG is used in the treatment of angina pectoris for which reason?
Decreases preload
A nurse is caring for a client who experienced an MI. The client is ordered to receive metoprolol. The nurse understands that this medication has which therapeutic effect?
Decreases resting heart rate
The nurse understands the primary purpose of promoting rest for a client following a MI includes which rationale?
Decreases the workload on the heart
The nurse is observing the monitor of a patient with a first-degree atrioventricular (AV) block. What is the nurse aware characterizes this block?
Delayed conduction, producing a prolonged PR interval
The nurse in the college student health service is planning a series of brief presentations on reducing health risks. One of the topics will be toxic shock syndrome (TSS). It is most important for the nurse to target which group in marketing this program?
Females on the campus
Which is a modifiable risk factor for coronary artery disease (CAD)?
Hyperlipidemia
A patient seen in the clinic has been diagnosed with stage A heart failure (according to the staging classification of the American College of Cardiology [ACC]). What education will the nurse provide to this patient?
Information about ACE inhibitors and risk factor reduction
A nurse is educating about lifestyle modifications for a group of clients with newly diagnosed hypertension. While discussing dietary changes, which point would the nurse emphasize?
It takes 2 to 3 months for the taste buds to adapt to decreased salt intake.
The nurse provides care for a client receiving methyldopa. The nurse instructs the client about common adverse effects of methyldopa. Which information does the nurse include?
Loss of libido
________ may be given to constrict vessels and decrease stroke volume.
Neosynepherine
_____ may be given to dilate vessels in order to increase stroke volume.
Nitrates
A nurse in the emergency department is caring for a client with acute heart failure. Which laboratory value is most important for the nurse to check before administering medications to treat heart failure?
Potassium
A triage team is assessing a client to determine if reported chest pain is a manifestation of angina pectoris or an MI. The nurse knows that a primary distinction of angina pain is?
Relieved by rest and nitroglycerin
The nurse uses which term for the normal pacemaker of the heart?
SA (Sinoatrial) node
The cardiac nurse instructs a client receiving a pacemaker on how the usual cardiac conduction cycle flows. Which structure does the nurse identify as the natural pacemaker of the heart?
Sinoatrial Node (SA)
Cardiac output/ index can be measured by what type of catheter?
Swan Ganz
The nurse is educating an 80-year-old client diagnosed with heart failure about the medication regimen. Which instruction would the nurse give this client about the use of oral diuretics?
Take the diuretic in the morning to avoid interfering with sleep.
The assess the pulse during adult cardiopulmonary resuscitation (CPR), which site should the nurse assess?
The carotid artery
The nurse provides care for a client on complete bedrest. Which nursing intervention is most effective for preventing thrombophlebitis?
administer low molecular weight heparin as prescribed, instruct the client to flex and point the toes every two hours, encourage the client to drink fluids while on bedrest
The nurse provides care for a client who is prescribed propranolol. What information found in the client's history causes the nurse to hold the medication and contact the health care provider?
The client has had asthma since childhood
Following abdominal surgery, which factor predisposes a client to deep vein thrombosis?
The client will be immobile during and shortly after surgery
The nurse supervises the graduate nurse caring for the client who had a femoropopliteal bypass graft in the right leg 12 hours ago. The nurse intervenes if the graduate nurse performs which intervention?
The graduate nurse places the client in a chair for 30 minutes, the graduate nurse obtains a doppler evaluation of the client's right leg every 2 hours
A nurse is caring for a client with acute pulmonary edema. To immediately promote oxygenation and relieve dyspnea, what actions should the nurse perform?
administer oxygen, place the client in an upright position
The client has had biomarkers tested after reporting chest pain. Which diagnostic marker of myocardial infarction remains elevated for as long as 2 weeks?
Troponin
The physician writes orders for a patient to receive an angiotensin II receptor blocker for treatment of heart failure. What medication does the nurse administer?
Valsartan (Diovan)
The nurse is assisting the client to manage the cardiovascular risk factors of hyperlipidemia and hypertension. The client asks the nurse what type of a diet would be best to follow. What is the best response by the nurse?
a diet low in sodium, fat, and cholesterol
The nurse is explaining the cause of angina pain to a client. What will the nurse say most directly caused the pain?
a lack of oxygen in the heart muscle cells
The nurse is discussing cardiac hemodynamics with a nursing student. The nurse explains preload to the student and then asks the student what nursing interventions might cause increased preload. Which response by the student indicates understanding?
application of anti embolic stockings
The nurse understands which factor is the most important to maintain adequate circulation?
blood volume
A nurse is caring for a client in the cardiovascular intensive care unit following a coronary artery bypass graft. Which clinical finding requires immediate intervention by the nurse?
central venous pressure reading of 1
Which nursing assessment is most important immediately following cardiac catheterization?
check the extremities for pulses
The nurse is caring for a client who has just returned from the cardiac catheterization laboratory following a coronary angioplasty. What is the nurse's priority assessment?
check the temperature, color, and capillary refill of the affected extremity
The cardiac nurse is caring for a client who has been diagnosed with dilated cardiomyopathy (DCM). Echocardiography is likely to reveal what pathophysiological finding?
decreased ejection fraction
The nurse witnesses a client experiencing ventricular fibrillation. What is the nurse's priority action?
defibrillation
What are factors that could decrease preload?
dehydration, diuresis, loss of blood
A patient has been diagnosed with congestive heart failure (CHF). The health care provider has ordered a medication to enhance contractility. The nurse would expect which medication to be prescribed for the patient?
digoxin
The nurse is reviewing the echocardiography results of a client who has just been diagnosed with dilated cardiomyopathy (DCM). What changes in heart structure is this client experiencing?
dilated ventricles without hypertrophy of the ventricles
The nurse is admitting a client with a diagnosis of left ventricular hypertrophy. The client reports dyspnea on exertion, as well as fatigue. Which diagnostic tool would be most helpful in diagnosing this type of myopathy?
echocardiogram
A client comes to the emergency department reporting chest pain. An electrocardiogram (ECG) reveals myocardial ischemia and an anterior-wall myocardial infarction (MI). Which ECG characteristic does the nurse expect to see?
elevated ST segment
A client returns for a follow-up visit to the cardiologist 4 days after a trip to the ED for sudden shortness of breath and abdominal pain. The nurse realizes the client had a myocardial infarction because the results from the blood work drawn in the hospital shows:
elevated troponin levels
The nurse is caring for a client with coronary artery disease. What is the nurse's priority goal for the client?
enhance myocardial oxygenation
You are monitoring the results of laboratory tests performed on a client admitted to the cardiac ICU with a diagnosis of myocardial infarction. Which test would you expect to show elevated levels?
enzymes
A client's Holter monitor strip reveals a heart rate with normal conduction but with a rate consistently above 105 beats/minute. What other conditions can cause this response in a healthy heart?
fever, shock, strenuous activity
The nurse provides care for a client 12 hours after aortofemoral bypass. It is most important for the nurse to place the client in which position?
full supine
Which type of cardiomyopathy is associated with syncope?
hypertrophic
The nurse provides care for a client receiving both digoxin and hydrochlorothiazide. The nurse understands a major adverse effect of hydrochlorothiazide includes which finding?
hypokalemia
The nurse reviews a client's lab results and notes a serum calcium level of 7.9 mg/dL. It is most appropriate for the nurse to monitor the client for what condition?
impaired myocardial contractility
The nurse is creating a plan of care for a client with cardiomyopathy. Which goal would be a priority for the client?
improved cardiac output
The nurse provides medication teaching to a client diagnosed with heart failure. The nurse explains that digoxin helps the heart pump more efficiently by which action?
increases the strength of the heart's contractions, slows the rate of conduction through the AV node
The nurse is caring for an older adult client who has come to the clinic for a yearly physical. When assessing the client, the nurse notes the blood pressure (BP) is 140/93. The nurse knows that in older clients what happens that may elevate the systolic BP?
loss of arterial elasticity
The nurse is providing care for a client with high cholesterol and triglyceride values. In teaching the client about therapeutic lifestyle changes such as diet and exercise, the nurse realizes that the desired goal for cholesterol levels is which of the following?
low LDL values and high HDL values
What is the hallmark sign for heat failure?
low ejection fraction
The nurse is providing discharge education to a client diagnosed with heart failure. What should the nurse teach this client to do to assess fluid balance in the home setting?
monitor weight daily
The nurse is caring for a client who is having chest pain associated with a myocardial infarction (MI). What medication will the nurse administer intravenously to reduce pain and anxiety?
morphine sulfate
What is important to know about drawing cholesterol level labs?
must fast for 12 hours
The client returns to the clinic for a follow-up appointment following a permanent pacemaker insertion and reports tenderness and throbbing around the incision. The nurse observes mild swelling, erythema, and warmth at the pacemaker insertion site. What does the nurse suspect?
pacemaker site infection
The client is started on warfarin. The nurse instructs the client to regularly obtain blood work to measure which laboratory value?
prothrombin time
A hospitalized client with heart failure puts on the call light and states, "I've become very short of breath, and I've been coughing up this pink frothy sputum." The nurse immediately suspects which of the following complications?
pulmonary edema
A nurse is educating a client with coronary artery disease about nitroglycerin administration. The nurse tells the client that nitroglycerin has what actions?
reduces myocardial oxygen consumption, dilates blood vessels, decreases ischemia, relieves pain
What are factors that could increase preload?
replacing blood, replacing fluids
Which finding indicates that hypertension is progressing to target organ damage?
retinal blood vessel damage
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
The nurse is teaching a client about chronic untreated hypertension. What complication will the nurse explain to the client?
stroke
A patient tells the nurse, "I was straining to have a bowel movement and felt like I was going to faint. I took my pulse and it was so slow." What does the nurse understand occurred with this patient?
the patient had a vagal response
The patient has a heart rate of 72 bpm with a regular rhythm. Where does the nurse determine the impulse arises from?
the sino atrial node
The nurse understands which reason is the cause of primary (essential) hypertension?
unknown
