corazon
A client with stage 1 hypertension appears at the clinic for follow-up. The client's BP is 138/88 mm Hg. The client asks why it is important to treat hypertension. What would be the nurse's best response?
"Hypertension greatly increases your risk of stroke and heart disease."
A client is being discharged following insertion of a permanent pacemaker. The nurse determines that the client requires further instruction on safety precaution after the following statement:
"I can lift the farm gate that weighs 20 pounds once I get home and settled"
A client with a forceful, pounding heartbeat is diagnosed with mitral valve prolapse. Which client statement indicates to the nurse a need for additional teaching?
"I can still drink coffee and tea."
A nurse is performing discharge teaching with a client who has an implantable cardioverter defibrillator (ICD) placed. Which client statement indicates effective teaching?
"I'll keep a log of each time my ICD discharges."
A client is unconscious on arrival to the emergency department. The nurse in the emergency department identifies that the client has a permanent pacemaker due to which characteristic?
"Spike" on the rhythm strip
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 nursing student asks the nurse to describe the difference between sinus rhythm and sinus bradycardia on the electrocardiogram strip. What is the nurse's best reply?
"The only difference is the heart rate."
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."
The nurse is caring for a client who is being discharged after insertion of a permanent pacemaker. The client, an avid tennis player, is scheduled to play in a tournament in 1 week. What is the best advice the nurse can give related to this activity?
"You will need to cancel this activity; you must restrict arm movement above your head for 2 weeks."
The nurse is working with a client with a new onset of atrial fibrillation during a three-month follow-up visit. The healthcare provider is planning a cardioversion, and the client asks the nurse why there is a wait for the treatment. What is the best response by the nurse?
"Your atrial chambers may contain blood clots now, so you must take an anticoagulant for a few weeks before the cardioversion."
When assessing a client who reports recent chest pain, the nurse obtains a thorough history. Which client statement most strongly suggests angina pectoris?
"the pain occurred while I was mowing the lawn"
What will the nurse assess is related to the pathophysiology of mitral stenosis? Select all that apply.
- fatigue - low-pitched murmur - shortness of breath with activity - history of endocarditis
The nurse assesses a client with a heart rate of 120 beats per minute. What are the known causes of sinus tachycardia?
- hypovolemia - acute blood loss, - anemia, - shock, - hypovolemia, - fever - exercise
The nurse is educating a patient diagnosed with angina pectoris about the difference between the pain of angina and a myocardial infarction (MI). How should the nurse describe the pain experienced during an MI? (Select all that apply.)
- it is viselike and radiates to the shoulders and arms - it is substernal in location - it is sudden in onset and prolonged in duration
A client is diagnosed with cardiac tamponade. Which is/are the classic clinical manifestation(s) of cardiac tamponade? Select all that apply.
- jugular vein distension - muffled heart tones - hypotension This answer is correct because the classic clinical manifestations of cardiac tamponade are considered hypotension, jugular vein distention (JVD), and muffled heart tones.
After the MI, we want to _________
- prevent clots (heparin IV) - Heart rest (Nitro IV drip, beta blockers, CCB)
A client being treated for pericarditis begins to have symptoms that indicate potential cardiac tamponade. Which symptoms will the registered nurse report that supports this concern? Select all that apply.
- tachypnea - restlessness - loss of consciousness The classic clinical manifestations of cardiac tamponade are hypotension, jugular vein distention (JVD), and muffled heart tones. Other symptoms that occur include tachypnea, tachycardia, restlessness, shortness of breath, weakness, anxiety, chest pain, loss of consciousness as cardiac output decreases.
The nurse is working on a telemetry unit. When the nurse is interpreting a client's heart rhythm, the nurse counts each large block on graph paper as how many seconds?
0.2
A client is experiencing an irregular heartbeat. The client asks the nurse how a heartbeat occurs. The nurse explains the conduction system of the heart beginning with the sinoatrial node (SA node). Place the conduction sequence of the heart in order beginning with the SA node. Use all options.
1. Atrial cell stimulation 2. AV node 3. Bundle of His 4. Bundle branches 5. Purkinje fibers
When administering heparin anticoagulant therapy, the nurse needs to make certain that the activated partial thromboplastin time (aPTT) is within the therapeutic range of:
1.5 to 2.5 times the baseline control.
The nurse is reviewing the results of a total cholesterol level for a client who has been taking simvastatin. What results display the effectiveness of the medication?
160-190 mg/dL
The nurse analyzes the strip below and determines that the interpretation is:
3rd degree (complete) heart block
PTT therapeutic range
46-70
"What percentage of the arterial lumen must be obstructed before intermittent claudication is experienced?"
50
dysrhythmia
Abnormal heart rhythm
The nurse is assessing a client admitted to the telemetry unit from the Emergency Department with complaints of increasing shortness of breath, and is coughing pink-tinged frothy sputum. During the history assessment, the nurse documents a history of left-sided heart failure. The nurse recognizes the presenting signs and symptoms of which health problem?
Acute pulmonary edema
A nurse is reevaluating a client receiving IV fibrinolytic therapy. Which finding requires immediate intervention by the nurse?
Altered LOC
The nurse is providing education to a client with a history of rheumatic heart. Information includes risk factors for bacterial endocarditis. The nurse asks through teach-back if the client knows the importance of taking which of the following drugs prior to scheduled invasive procedures?
Amoxicillin bacterial endocarditis can occur in Pts with rheumatic heart disease. Must take prophylactic abx prior to invasive procedures
Which of the following tests is helpful in determining the diagnosis of heart failure?
Application of oxygen Nitroglycerin tablets Calcium channel blockers
What would you name as the most common cause of peripheral arterial problems in the older adult?
Atherosclerosis
The nurse is working with a client who has just been diagnosed with an aneurysm. What advice should the nurse provide to this client?
Avoid straining during bowel movements and coughing.
What key diagnostic test does the nurse assess to determine the severity of the patient's heart failure?
B-type natriuretic peptide (BNP)
Any PAIN after morphine is _______
BAD! More pain = more tissue death
A client is diagnosed with mitral regurgitation. What does the nurse consider with the mechanics of cardiac hemodynamics?
Blood flows backward from the left ventricle into the left atrium during systole.
A client is recovering from surgical repair of a dissecting aortic aneurysm. Which assessment findings indicate possible bleeding or recurring dissection?
Blood pressure of 82/40 mm Hg and heart rate of 125 beats/minute
The nurse received report from the cardiac catheterization team following a percutaneous coronary intervention (PCI) procedure. During the assessment, the nurse notices a blood-soaked dressing and bleeding from the femoral artery access site. What action should the nurse perform first?
Call for help and apply pressure to the site immediately.
After an Mi, the heart has damage especially in the left ventricle. What complications arise from this?
Cardiogenic shock dysrhythmias heart failure
which food should HF client avoid?
Chips, fried chicken & fries, canned beans
The nurse is caring for a client with a damaged tricuspid valve. The nurse knows that the tricuspid valve is held in place by which of the following?
Chordae tendineae
The nurse is assigned five clients on the medical floor of the hospital. The hospital's infection control committee is creating a proactive program to identify clients at risk for hospital acquired infective endocarditis. Which of the five clients would be most at risk for hospital-acquired infective endocarditis?
Clients with kidney failure and receiving in-hospital dialysis.
A nurse is caring for a client who has been admitted to have a cardioverter defibrillator implanted. The nurse knows that implanted cardioverter defibrillators are used in which clients?
Clients with recurrent life-threatening tachydysrhythmias
A client had a percutaneous transluminal coronary angioplasty (PTCA). What medication will the nurse administer to prevent thrombus formation in the stent?
Clopidogrel
Which medication is given to clients who are diagnosed with angina but are allergic to aspirin?
Clopidogrel
A client is hospitalized for repair of an abdominal aortic aneurysm. The nurse must be alert for signs and symptoms of aneurysm rupture and thus looks for which of the following?
Constant, intense back pain and falling blood pressure
A client is admitted for observation following complaints of intermittent chest pain while mowing the grass. The pain persisted for an hour following the activity. All cardiac labs, electrocardiogram, and radiologic studies were normal and the client was provided nitroglycerin for a new diagnosis of angina pectoris. Discharge education includes information that angina is most often attributable to what cause?
Coronary arteriosclerosis
The nurse is caring for a client who was admitted to the telemetry unit with a diagnosis of "rule/out acute MI." The client's chest pain began 3 hours earlier. Which laboratory test would be most helpful in confirming the diagnosis of a current MI?
Creatine kinase-myoglobin (CK-MB) level
The nurse is assessing a patient with a probable diagnosis of first-degree AV block. The nurse is aware that this dysrhythmia is evident on an ECG strip by what indication?
Delayed conduction, producing a prolonged PR interval
As the clinic nurse caring for a client with varicose veins, what is an appropriate nursing action for this client?
Demonstrate how to apply and remove elastic support stockings.
The nurse is preparing a client for upcoming electrophysiology (EP) studies and possible ablation for treatment of atrial tachycardia. What information will the nurse include in the teaching?
During the procedure, the dysrhythmia will be reproduced under controlled conditions.
A client with aortic regurgitation is admitted to the hospital. Which assessment findings would indicate left ventricular failure?
Dyspnea, orthopnea, paroxysmal nocturnal dyspnea (PND) Signs and symptoms of progressive left ventricular failure include breathing difficulties, such as orthopnea and PND. Distended jugular veins, pedal edema, and nausea are signs and symptoms of right-sided heart failure.
Which is the conduit for the pumping action of the heart?
Electrical impulses
A client with venous insufficiency asks the nurse what they can do to decrease their risk of complications. What advice should the nurse provide to clients with venous insufficiency?
Elevate the legs periodically for at least 15 to 20 minutes.
How should the nurse position a patient who has leg ulcers that are venous in origin?
Elevate the patient's lower extremities.
A nurse caring for a client with peripheral arterial insufficiency determined the nursing diagnosis of altered peripheral arterial insufficiency. Which intervention will be most appropriate for the client?
Encourage the client to engage in a moderate amount of exercise.
Which statement is accurate regarding Raynaud disease?
Episodes may be triggered by unusual sensitivity to cold.
A client is having preoperative tests for a pending cholecystectomy. The preoperative electrocardiogram (ECG) reveals sinus bradycardia, heart rate of 55 bpm, and a PR interval of 0.26 second as indicated on the ECG below: The rhythm confirms the finding of:
First degree heart block
A client with chronic HF took cold medicine for her flu. She presents with new productive cough with pink frothy sputum and worsening crackles. Which action should the nurse take first? A. Assess lung sounds B. Give Bumetanide IV push C. Notify the HCP
Give Bumetanide IV push -ide makes body dried. she has extreme HF so she has heavy fluids.
what fruit blocks statin drugs?
Grapefruit juice blocks statin drugs!
Which of the following is the hallmark symptom for peripheral arterial disease (PAD) in the lower extremity?
Intermittent claudication
A client is receiving enoxaparin and warfarin therapy for a venous thromboembolism (VTE). Which laboratory value indicates that anticoagulation is adequate and enoxaparin can be discontinued?
International normalized ratio (INR) is 2.5.
Two nursing students are reading EKG strips. One of the students asks the instructor what the P-R interval represents. The correct response should be which of the following?
It shows the time needed for the SA node impulse to depolarize the atria and travel through the AV node."
A client is diagnosed with peripheral arterial disease. Review of the client's chart shows an ankle-brachial index (ABI) on the right of 0.45. This indicates that the right foot has which of the following?
Moderate to severe arterial insufficiency
Aortic dissection may be mistaken for which of the following disease processes?
Myocardial infarction (MI)
For worsening HF, the doctor wants to give IV maintenance fluid. What does the nurse do?
No, do not give fluids for worsening HF.
Patient with HF is transferred onto new unit. What does the nurse do?
Nurse must reassess heart & lung sounds. check for worsening crackles in the lungs.
A client has had oral anticoagulation ordered. What should the nurse monitor for when the client is taking oral anticoagulation?
PT (Prothrombin Time) and INR (international normalized ratio)
A client has been diagnosed with peripheral arterial occlusive disease. Which of the following instructions is appropriate for the nurse to give the client for promoting circulation to the extremities?
Participate in a regular walking program.
A healthy adult client is seeing a health care provider for an annual physical examination. While the nurse is taking the client's vital signs, the client states, "Occasionally, my heart skips a beat." The nurse believes that the client is experiencing what condition?
Premature atrial contraction
The nurse is caring for a client following a coronary artery bypass graft (CABG). The nurse notes persistent oozing of bloody drainage from various puncture sites. The nurse anticipates that the physician will order which medication to neutralize the unfractionated heparin the client received?
Protamine sulfate
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
A client with systemic lupus erythematosus (SLE) complains that his hands become pale, blue, and painful when exposed to the cold. What disease should the nurse cite as an explanation for these signs and symptoms?
Raynaud's disease
It is important for a nurse to be aware of the normal hemodynamics of blood flow to recognize and understand pathology when it occurs. The nurse should know that incomplete closure of the tricuspid valve results in a backward flow of blood from the:
Right ventricle to the right atrium.
The nurse is assessing heart sounds in a patient with heart failure. An abnormal heart sound is detected early in diastole. How would the nurse document this?
S3
Which is the correct sequence of events for the electrical impulses that travel through the heart to facilitate a ventricular contraction?
Sinoatrial node, atrial contraction, atrioventricular node, bundle of His, purkinje fibers, ventricular contraction.
What does sodium do to the body?
Sodium swells the body. - nothing from a package. no packaged foods, chips, no salad dressings. and nothing OTC
A client arrived at the Emergency Room complaining of heaviness in the chest for the past hour. The nurse placed the client on a heart monitor and immediately alerted the physician of the following electrocardiogram (ECG) reading: The nurse interprets the finding as abnormal according to the following ECG characteristics:
St segment elevation is present ST elevation is noted on this ECG strip which, added to the client complaint of heaviness in the chest, indicates a STEMI and occurs when one or more cardiac arteries are blocked. The blockage will halt supply of oxygen rich blood to the affected area in the heart, which may cause permanent injury and even death.
Diabetics on Metformin getting a Cath lab. when do you stop it?
Stop Metformin 48hrs before/after to prevent lactic acidosis and nephropathy
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? Choose all that apply. T wave P wave QRT wave S-Q segment P-R interval
T wave P wave P-R interval
During a blood clot, you give ________----
TPA (aminolase) or Streptokinase (huge bleeding risk 8hr window)
Your client is going to have a stress test. What radionuclide would most likely be used to diagnose ischemic heart disease during this test?
Thallium-201
A nurse and physician are preparing to visit a hospitalized client with peripheral arterial disease. As you approach the client's room, the physician asks if the client has reported any intermittent claudication. The client has reported this symptom. The nurse explains to the physician which of the following details?
The client can walk about 50 feet before getting pain in the right lower leg.
The nurse performs an admission assessment for an older client admitted to the telemetry floor. The client's history reveals type 2 diabetes, mitral valve prolapse, and hypertension. Which assessment information is an important indication of risk for heart failure (HF)? Select all that apply
The client is an African American man. The client's age is greater than 65. The client's BMI is 32.
The client is admitted for a scheduled cardiac catheterization. On the morning of the procedure, while assessing the client's morning laboratory values, the nurse notes a blood urea nitrogen (BUN) of 34 mg/dL and a creatinine of 4.2 mg/dL. What priority reason will the nurse notify the healthcare provider?
The client is at risk for renal failure due to the contrast agent that will be given during the procedure.
A nurse notices frequent artifacts on the ECG monitor for a client whose leads are connected by cable to a console at the bedside. The nurse examines the client to determine the cause. Which of the following items is unlikely to be responsible for the artifact?
Tightly secured cable connections.
The nurse is caring for a client who has hypomagnesaemia and hypokalemia. While watching the telemetry monitor, the nurse notices a twisting of the QRS complexes and immediately informs the health care provider that the monitor reveals which abnormality.
Torsade de pointes
what is the #1 indicator of MI?
Troponin
What symptoms should the nurse assess for in a client with lymphedema as a result of impaired nutrition to the tissue?
Ulcers and infection in the edematous area
The nurse is caring for a client diagnosed with peripheral arterial occlusive disease (PAD). What assessment finding is most consistent with this diagnosis?
Unequal peripheral pulses between extremities
What would cause sinus bradycardia?
Vagal stimulation, hypothyroidism, digoxin
A client in the ICU received advanced cardiac life support after his monitor revealed the following rhythm, which the nurse identified as:
Ventricular fibrillation ventricular fibrillation is a rapid, disorganized ventricular rhythm that causes ineffective quivering of the ventricles. CPR must be initiated immediately. The question indicates that CPR is in progress and rhythm is identified as ventricular fibrillation. The priority is to administer a shock immediately
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
What do we wanna do with cardiogenic shock?
We want to increase the BP with Epi, dopamine, norepi
Is the contrast from the dye harmful?
Yes harmful to kidneys. Thick dye, kidneys die
Temporary pacemakers are used until __________________
a permanent pacemaker can be implanted
A nurse caring for a client on telemetry interprets the electrocardiogram (ECG) as having a bundle branch block based on the following characteristics:
a wide QRS segment
The client is prescribed nadolol for hypertension. What is the reason the nurse will teach the client not to stop taking the medication abruptly?
abrupt stop can cause a myocardial infarction
The nurse is caring for a client admitted for acute pericarditis. Which nursing diagnosis should take priority during the first 24 hours of nursing care?
acute pain related to inflammation of the pericardium because pericarditis is the inflammation of the membranous sac that surrounds the heart. Pericarditis causes severe pain with rapid onset that worsens with breathing, coughing, and/or changing positions. Such pain prevents the ability to help respiratory efforts. It worsens as excessive accumulation of fluid in the pericardial sac occurs. The result is decreased stroke volume and compression of the heart.
The nurse is caring for a client who is displaying a third-degree AV block on the EKG monitor. What is the priority nursing intervention for the client?
alerting the healthcare provider of the third-degree heart block
Which of the following medication classifications is more likely to be expected when the nurse is caring for a client with atrial fibrillation?
anticoagulant
What is protamine sulfate?
antidote for heparin toxicity
The ___________ is the main artery of the body. It supplies oxygenated blood to the circulatory system from the heart.
aorta
A nurse is caring for a client who returned from surgical popliteal bypass graft procedure. A priority assessment during the first 24 hours will include:
assess pulse of every extremity every 15min, followed by agency policy
A fixed-rate pacemaker is _________________________.
asynchronous and permanent
The ______________ is either of the two upper chambers of the cardiac muscle that receive blood from the veins and force it into the ventricles.
atria
The nurse cares for a client with a dysrhythmia and understands that the P wave on an electrocardiogram (ECG) represents which phase of the cardiac cycle?
atrial depolarization
the P wave on an electrocardiogram (ECG) represents which phase of the cardiac cycle?
atrial depolarization
A client presents to the emergency department via ambulance with a heart rate of 210 beats/minute and a sawtooth waveform pattern per cardiac monitor. The nurse is most correct to alert the medical team of the presence of a client with which disorder?
atrial flutter
A client's electrocardiogram (ECG) tracing reveals a atrial rate between 250 and 400, with saw-toothed P waves. The nurse correctly identifies this dysrhythmia as
atrial flutter
The nurse admits a client to the cardiac floor for a scheduled intervention. The initial electrocardiogram depicts the following: the rhythm is:
atrial flutter
A client has confirmed second degree type II AV block (Mobitz II) and heart rate of 45 bpm. The nurse expects the following treatment for the condition: Select all that apply.
atropine for bradycardia temporary pacemaker
The nurse is caring for a client with second-degree atrioventricular block, Type I with symptomatic bradycardia. What is the most likely medication the nurse will administer?
atropine sulfate
The nurse is removing a client's femoral sheath after cardiac catheterization. What medication will the nurse have available?
atropine sulfate
Which describes a valve used in replacement surgery that is made from the client's own heart valve?
autograft
A client tells the nurse "my heart is skipping beats again; I'm having palpitations." After completing a physical assessment, the nurse concludes the client is experiencing occasional premature atrial complexes (PACs). The nurse should instruct the client to
avoid caffeinated beverages
The nurse is caring for a client with Raynaud's disease. What are important instructions for a client who is diagnosed with this disease to prevent an attack?
avoid situations that contribute to ischemic episodes
TPA and streptokinase is a bleeding risk. What should the nurse be wary of?
be wary of NO injections (IV, SQ, IM, ABG) Not given through Central lines (can't apply pressure) only give via peripheral lines
The nurse is caring for a client when the below rhythm is seen on the ECG monitor. The client becomes short of breath and begins sweating. Which interventions and in which order does the nurse follow for treatment of this?
bearing down, adenosine, synch cardioverter
The nurse is caring for a client with a new prosthetic cardiac valve and is preparing discharge teaching. During discharge teaching, the nurse should provide education on the importance of antibiotic prophylaxis prior to which of the following?
before any dental procedures Clients receiving prosthetic cardiac valves are at a higher risk of having bacterial (infective) endocarditis. Prophylactic antibiotics are recommended prior to dental procedures to help prevent infective endocarditis
The licensed practical nurse is monitoring the waveform pattern on the cardiac monitor of the client admitted following a myocardial infarction. The nurse notes that every other beat includes a premature ventricular contraction (PVC). The nurse notes which of the following in the permanent record?
bigeminy
A client with suspected lymphoma is scheduled for lymphangiography. The nurse should inform the client that this procedure may cause which harmless temporary change?
bluish urine
Which is not a likely origination point for cardiac arrhythmias?
bundle of His
Diltiazem (Cardizem) is categorized as which type of drug?
calcium-channel blocker sometimes causes nausea
Can't palpate pedal pulse after surgery WYD?
call doctor pulses = perfusion
A patient in severe pulmonary edema is being intubated by the respiratory therapist. What priority action by the nurse will assist in the confirmation of tube placement in the proper position in the trachea?
call for a chest x-ray
What classification of drugs are used to treat aortic regurgitation?
cardiac glycosides
A client arrives at the emergency room following a stab wound to the chest. Which emergent complication will the nurse carefully monitor the client for in the emergency department?
cardiac tamponade This answer is correct because causes of cardiac tamponade include trauma (stab wound) to the chest, infection of the pericardial sac, reaction to certain medications, chest radiation, cancer, and autoimmune diseases. A stab wound to the chest is a high risk condition that can cause cardiac tamponade so the nurse should monitor the client carefully for this. Cardiac tamponade is a serious medical emergency in which blood or other fluids fill the pericardial space (the sac that surrounds the heart). This extra fluid places increased pressure on the heart to the extent that the ventricles cannot fill and contract.
A client has had a pneumothorax and needs a chest tube placement. After the chest tube is placed, what should the nurse immediately monitor for associated with a rare, but serious complication?
cariogenic shock This answer is correct because a serious, but rare complication that can occur immediately following a chest tube placement is cardiac tamponade. The client with cardiac tamponade will exhibit symptoms of cardiogenic shock. Symptoms associated with cardiogenic shock include hypotension, tachypnea, weak but a sudden, rapid heartbeat, paleness, shortness of breath, and loss of consciousness. The nurse should monitor the client closely for these symptoms.
A nurse performing triage on a client suspects the client of having endocarditis. Which symptom(s) support this suspicion? Select all that apply.
chest discomfort night sweats aching muscles and joints fever & chills Symptoms of bacterial (infective) endocarditis include chest discomfort with breathing, night sweats, fever, chills, and aching joints and muscles.
The nurse is preparing an individualized education plan for a client who has a history of smoking and is two days post-cardiac surgery. Which information best addresses client education as an intervention for the nursing diagnosis of ineffective airway clearance related to pulmonary secretions?
client teaching and demonstration of deep breathing and coughing exercises
The nurse is assigned five clients on the medical floor of the hospital. The hospital's infection control committee is creating a proactive program to identify clients at risk for hospital acquired infective endocarditis. Which of the five clients would be most at risk for hospital-acquired infective endocarditis?
client with kidney failure and receiving in-hospital dialysis This answer is correct because infective endocarditis in clients receiving hemodialysis is significantly more common and causes greater morbidity and mortality than in other populations. This is due to the risk of bacteria, particularly staph, strep, and enterococcus bacteria, that can enter the bloodstream during repeated vascular access during the dialysis.
The nurse knows that a pacemaker is the treatment of choice for what cardiac arrhythmia?
complete heart block
The nurse is performing a skin assessment for a client and observes a blue tinge in the buccal mucosa and tongue. What condition does the nurse correlate this finding with?
congenital heart disease
The term for a diagnostic test that involves injection of a contrast media into the venous system through a dorsal vein in the foot is
contrast phlebography
A client is admitted for treatment of Prinzmetal angina. When developing this client's care plan, the nurse should keep in mind that this type of angina is a result of what trigger?
coronary artery spasm
The nurse is to administer morphine sulfate to a client with chest pain. What initial nursing action is required prior to administration?
count the respiratory rate for bradypnea
Which signs and symptoms indicate that a client is experiencing left-sided heart failure? Select all that apply. Ascites Crackles Pitting Edema Frothy Pink Sputum Jugular vein distention
crackles frothy pink sputum Other manifestations of left-sided heart failure include frothy pink sputum, dyspnea, and orthopnea.
A client asks the nurse if systolic heart failure will affect any other body function. What body system response correlates with systolic heart failure (HF)?
decrease in renal perfusion
A client admitted with an exacerbation of congestive heart failure (CHF) will have the goals to:
decrease preload, decrease afterload, increase cardiac output This answer is correct because goals for clients with CHF include reduction of preload and afterload and increasing cardiac output.
The nurse is administering a calcium channel blocker to a patient who has symptomatic sinus tachycardia at a rate of 132 bpm. What is the anticipated action of the drug for this patient?
decreases the sinoatrial node automaticity
The nurse witnesses a client experiencing ventricular fibrillation. What is the nurse's priority action?
defibrillation
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
Clients with restrictive or constrictive cardiomyopathy have increased sensitivity to which medication?
digoxin
The nurse is caring for a hospitalized client with admitting diagnosis of right-sided heart failure (HF). What assessment finding is most consistent with the client's diagnosis?
distended neck veins
Which is a cerebrovascular manifestation of heart failure?
dizziness
A patient who had a colon resection 3 days ago is complaining of discomfort in the left calf. How should the nurse assess Homan's sign to determine if the patient may have a thrombus formation in the leg?
dorsiflex the foot while the leg is elevated to check for calf pain
A nurse is caring for a client with venous disease in the lower extremities and is ordered radiologic testing. The nurse educates the client on which exam will likely be ordered for lower venous disease?
duplex ultrasonography
the ST segment on an electrocardiogram (ECG) represents which phase of the cardiac cycle?
early ventricular repolarization, and lasts from the end of the QRS complex to the beginning of the T wave
The nurse is caring for a client with heart failure. What procedure should the nurse prepare the client for in order to determine the ejection fraction to measure the efficiency of the heart as a pump?
echocardiogram
Which diagnostic study is usually performed to confirm the diagnosis of heart failure?
echocardiogram
A client with an atrial dysrhythmia has come to the clinic for a follow-up appointment and to talk with the health care provider about options to stop this dysrhythmia. What procedure could be used to treat this client?
elective electrical cardioversion
Which test does the nurse anticipate for the client who requires monitoring for both the electrical and mechanical functions of the heart?
electrocardiogram
With PVD, you should
elevate legs
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 bacterial infection or illness is most associated with_______
endocarditis
The inner layer is composed of a thin, smooth layer of endothelial cells. Folds of endocardium form the heart valves
endocardium
The nurse is caring for a client with coronary artery disease. What is the nurse's priority goal for the client?
enhance myocardial oxygenation
Which area of the heart is located at the third intercostal (IC) space to the left of the sternum?
erb point
Which area of the heart that is located at the third intercostal space to the left of the sternum?
erb point
A client with left sided heart failure asks the nurse why it is so difficult for him to breathe while lying flat. What is the nurse's best response?
explain that with his condition, blood is backing up into the lungs and that it may help to sleep while propped on pillows
A nurse is instructing a client about using antiembolism stockings. Antiembolism stockings help prevent deep vein thrombosis (DVT) by:
forcing blood into the deep venous system.
The emergency department (ED) nurse is assessing a client who arrived with severe retrosternal chest pain described as burning and sharp which worsens on inspiration. The health care provider diagnoses the client with acute pericarditis. Which finding is most consistent with this diagnosis?
friction rub pericarditis is the inflammation of the membranous sac that surrounds the heart. The finding most consistent with pericarditis is friction rub, a scratching, grating sound similar to leather rubbing against leather.
The nurse is teaching a client about medications prescribed for severe volume overload from heart failure. What diuretic is the first-line treatment for clients diagnosed with heart failure?
furosemide (loop diuretic)
rheumatic endocarditis occurs most often in children after _______?
group A beta hemolytic streptococcal pharyngitis
With PAD you should
hang legs
How does the nurse know that the treatment is successful in HF?
hear clearer lung sounds and decreased HR
The nurse is administering oral metoprolol. Where are the receptor sites mainly located?
heart
A 43-year-old male came into the emergency department where you practice nursing and was diagnosed with atrial fibrillation. It's now 48 hours since his admittance and the dysrhythmia persists. Which of the following medications will the client's healthcare provider most likely order?
heparin
Which type of graft is used when a heart valve replacement is made of tissue from an animal heart valve?
heterograft
In which type of cardiomyopathy does the heart muscle actually increase in size and mass weight, especially along the septum?
hypertrophic
The nurse identifies which of the following as a potential cause of premature ventricular complexes (PVCs)?
hypokalemia PVCs can be caused by cardiac ischemia or infarction, increased workload on the heart (e.g., exercise, fever, hypervolemia, heart failure, tachycardia), digitalis toxicity, acidosis, or electrolyte imbalances, especially hypokalemia.
Which of the following is inconsistent as a condition related to metabolic syndrome?
hypotension
When do we use cardioversion?
if we can COUNT a pulse *synchronize*
Angiographs or Angioplastys are _________
images taken via x-rays to visualize the blockages pasty means balloon or stent placement
The nurse enters the client's room and finds the client pulseless and unresponsive. What would be the treatment of choice for this client?
immediate defibrillation
The nurse is caring for a client with a telemetry heart monitor, and notices flat electrocardiographic complexes and occasional sinus rhythm. The monitor alarms sound when cardiac complexes become absent, and then alarms cease when sinus rhythm occurs. Which is the priority action by the nurse?
immediately go to the client's hospital room and assess telemetry lead placement.
Low calcium is an indicator for
impaired myocardial contractibility
When o you see V fib/V tach?
in 90% of recovering MI patients
When the nurse notes that, after cardiac surgery, the client demonstrates low urine output (less than 25 mL/h) with high specific gravity (greater than 1.025), the nurse suspects which condition?
inadequate fluid volume
what does a Troponin level over 0.5 indicate?
indicates an MI (trauma) pt will also have hyperkalemia due to K+ leaking out along with troponin
The nurse is caring for a post-surgical client. During the assessment, the client complains of sudden onset of pain to the right lower leg. The right lower leg is swollen, reddened, and warm to touch. What is the most appropriate action by the nurse?
inform HCP that client has s/s of venous thrombosis
Creatinine over 1.3 means
injured kidney (contrast nephropathy)
The nurse is caring for a client with severe left ventricular dysfunction and understands the client is at risk for sudden cardiac death. The nurse anticipates which medical intervention?
insertion of an implantable cardioverter defibrillator clients who have reduced left ventricular ejection fraction (LVEF) and dysfunction (especially if they experienced MI) are at increased risk of sudden cardiac death (SCD) related to lethal arrhythmias. Implantable cardioverter defibrillator (ICD) provides significant survival benefit since it monitors the heart rhythm, detects irregular heart rhythms, and delivers a shock, if needed.
The nurse is caring for a client who requires insertion of an automatic internal cardioverter-defibrillator and is preparing information for home management and safety. Which information by the nurse is most important for client instruction?
instruction on use of medic-alert device
The nurse is assessing a client who reports pain to the left lower extremity, especially while ambulating. The discomfort is relieved with rest. Assessment findings confirm left lower leg mottling and hairlessness. Which health problem will the nurse most likely include in the planning of the client's care?
intermittent claudication
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
Ventricular fibrillation is
irregular with undulating waves and no QRS complex
Each chamber of the heart has a particular role in maintaining cellular oxygenation. Which chamber is responsible for pumping blood to all the cells and tissues of the body?
left ventricle
Each chamber of the heart has a particular role in maintaining cellular oxygenation. Which chamber is responsible for pumping blood to all the cells and tissues of the body?
left ventricle Left ventricular failure would likely result in impairment to all other organ systems.
increased pulmonary artery diastolic pressure suggests:
left-sided heart failure
Hallmark of systolic heart failure
low ejection fraction (EF)
The nurse expects to see which of the following characteristics on an ECG strip for a patient who has third-degree AV block?
more P waves than QRS complexes
A client develops cardiogenic pulmonary edema and is extremely apprehensive. What medication can the nurse administer with a health care provider's order that will relieve anxiety and slow respiratory rate?
morphine sulfate
A female patient is being seen in the ER complaining of fatigue and shoulder blade discomfort. She is also short of breath. Based on these symptoms, what will the nurse suspect?
myocardial infarction
The nurse is admitting a client with an elevated creatine kinase-MB isoenzyme (CK-MB). What is the cause for the elevated isoenzyme?
myocardial necrosis
The middle layer, consists of muscle tissue and is the force behind the heart's pumping action
myocardium
the client with mitral valve prolapse probably had ______
no health symptoms
Can heparin dissolve clots?
no, only clot busters like TPA can dissolve clots
The nurse analyzes a 6-second electrocardiogram (ECG) tracing. The P waves and QRS complexes are regular. The PR interval is 0.18 seconds long, and the QRS complexes are 0.08 seconds long. The heart rate is calculated at 70 bpm. The nurse correctly identifies this rhythm as
normal sinus rhythm
A client with coronary artery disease (CAD) requires education on risk factors that can be controlled or modified. Which of the risk factors will the nurse indicate that are controllable or modifiable?
obesity, inactivity, diet, smoking
What does the instructor tell the class safeguards the heart from infectious microorganisms?
parietal pericardium
The nurse expects which priority intervention to occur when a cardiac tamponade occurs?
pericardiocentesis This answer is correct because immediate pericardiocentesis (removal of the excessive fluid in the pericardium) is the treatment for cardiac tamponade since there is then no cardiac output until the pressure of the fluid is removed. Cardiac tamponade is a serious medical emergency in which blood or other fluids fill the pericardial space (the sac that surrounds the heart). This extra fluid places increased pressure on the heart to the extent that the ventricles cannot fill and contract.
A viral infection or illness is most associated with __________
pericarditis
A nurse auscultates the lungs and heart sound of a client and charts the finding of a pleural friction rub. The nurse reports this new finding immediately, understanding which condition is most associated with this finding?
pericarditis a very common finding with pericarditis is a pleural friction rub. A pleural friction rub has a scratching, grating sound similar to leather rubbing against leather.
a saclike structure that surrounds and supports the heart.
pericardium
A patient complains of a "stabbing pain and a burning sensation" in his left foot. The nurse notices that the foot is a lighter color than the rest of the skin. The artery that the nurse suspects is occluded would be the:
posterior tibial
A patient in the recovery room after cardiac surgery begins to have extremity paresthesia, peaked T waves, and mental confusion. What type of electrolyte imbalance does the nurse suspect this patient is having?
potassium
The nurse is preparing to administer furosemide to a client with severe heart failure. What lab study should be of most concern for this client while taking furosemide?
potassium level of 3.1 Severe heart failure usually requires a loop diuretic such as furosemide (Lasix). These drugs increase sodium and therefore water excretion, but they also increase potassium excretion. If a client becomes hypokalemic, digitalis toxicity is more likely. The BNP does not demonstrate a severe heart failure. Sodium level of 135 is within normal range, as is the hemoglobin level.
The nurse is caring for a client with congestive heart failure. The client's blood pressure has been trending down with the most recent result being 78/48. The nurse will take action to improve the blood pressure in order to prevent:
pre-renal failure hypotension and congestive heart failure prevent adequate renal perfusion and are thus considered pre-renal etiologies for renal injury.
The nurse places the client on a monitor and interprets the findings after analyzing the following electrocardiogram (ECG): Based on the nurse's interpretation, the ECG monitor reveals:
premature ventricular contractions PVCs the rhythm shown in the ECG strip is sinus rhythm with a distinct P wave that initiates a normal QRS followed by a premature QRS complex that is wider and results from increased irritability within the ventricles. They may be unifocal or may occur in frequent patterns. Potassium levels should be evaluated since hypokalemia may cause PVCs. The person with a PVC feels as though their heart skipped a beat.
infective endocarditis usually develops in people with ______?
prosthetic heart valves or structural cardiac defects; also occurs in patients who are IV drug abusers, debilitating diseases, indwelling catheters, or prolonged IV therapy
What is the antidote for heparin?
protamine sulfate
The ____________ is a structure that carries oxygen-poor blood from the right ventricle of the heart to the lungs for oxygenation.
pulmonary artery
Which structure sends blood to the lungs for oxygenation to occur?
pulmonary artery
Which structure receives blood from the lungs that is oxygen rich?
pulmonary vein
The clinic nurse is assessing a client's pulse before outpatient diagnostic testing. What should the nurse document when assessing the client's pulse?
rate, quality, and rhythm
A client reports a cough, fatigue, and a low-grade fever. Which medical history of a client should the nurse report immediately since it is most commonly associated with pericarditis?
recent influenza infection a medical history of recent viral illnesses, such as influenza, Epstein-Barr, mumps, varicella, and rubella, are associated with the condition. The most common cause is an idiopathic etiology.
cariogenic shock
results when an inefficient heart cannot sustain adequate circulation S/S Low BP cool pale skin low urine output
A nurse is obtaining a history from a new client in the cardiovascular clinic. When investigating for childhood diseases and disorders associated with structural heart disease, which finding should the nurse consider significant?
rheumatic fever
Central venous pressure is measured in which heart chamber?
right atrium
A client has jugular venous distention (JVD), hepatomegaly, and peripheral edema. The client is exhibiting signs of:
right sided heart failure
During an admission assessment, a client informs the nurse of a history of having a certain type of heart block. Previous records were analyzed by the nurse and the client was found to have the following ECG the previous year. interpret as:
second degree AV type I (Wenckebach)
An operating room nurse is caring for a client who is having a pacemaker implanted. The health care provider has requested a demand mode pacemaker for this client. What is this type of pacemaker?
self-activated
The nurse is caring for a client with abdominal aortic aneurysm (AAA). Which assessment finding is most likely to indicate a dissection of the aneurysm?
severe back pain
When the nurse observes that the client's heart rate increases during inspiration and decreases during expiration, the nurse reports that the client is demonstrating
sinus arrhythmia.
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
Part of the plan of care for a client who recently received mechanical valve prosthesis is discharge education for home management. Which information will the nurse determine to have the most priority?
strategies for infection prevention This answer is correct because bacterial endocarditis is a condition which can occur if a person has received a mechanical valve prosthesis. To help reduce this risk, the client should be taught infection prevention (handwashing, avoidance of sick individuals and taking prophylactic antibiotics prior to any invasive procedure, including dental procedures).
The nurse is caring for a young adult client following a balloon valvuloplasty of the aortic valve. During the post-procedure assessment, the nurse monitors for which complications related to valvuloplasty? Select all that apply. sudden cardiac arrhythmia emboli sudden mental status change redness near the radial vein access site stroke
sudden cardiac arrhythmia emboli sudden mental status change stroke
After CATH lab patient must lie
supine for several hours & no blood thinners within 6hr window (no warfarin, aspirin)
A client arrives at the emergency department stating they "...may be having a heart attack". Which clinical manifestation is an important finding to report to the healthcare provider to potentially rule out a myocardial infarction and support the potential diagnosis of acute pericarditis?
temperature of 100.1F a fever is a common symptom of acute pericarditis whereas a myocardial infarction may produce a low grade fever later due to the inflammatory process associated with myocardial death. Tachycardia, chest pain, and shortness of breath are associated with both pericarditis and myocardial infarction (MI).
Which is the location where ventricular systole begins?
the QRS
Which of the following is the most common site for a dissecting aneurysm?
the aorta (thoracic cavity)
The outer layer is composed of fibrous and loose connective tissue.
the epicardium
what is afterload?
the force the heart must work against to pump. this is reduced by administration of vasodilators
The nurse is scheduling a client for a cardiac catheterization. The client has type 2 diabetes and takes metformin. Which action will the nurse take prior to scheduling the procedure?
the nurse will instruct the client to hold the metformin for 24hrs before and 48hrs after the procedure. This is due to the risk of lactic acidosis associated with the combination of anesthesia and/or contrast medium with metformin. The contrast medium may affect kidney function, and metformin in the system may increase risk of lactic acidosis.
Classification II of heart failure is indicated by
the patient being comfortable at rest, but experiencing fatigue, palpitation, or dyspnea during ordinary physical activity.
The nurse is caring for a client who is scheduled for a percutaneous transluminal coronary angioplasty (PTCA). Which information by the nurse best explains the procedure?
the procedure involves opening a blocked artery with an inflatable balloon located on the end of a catheter
The client has just been diagnosed with a arrhythmia. The client asks the nurse to explain normal sinus rhythm. What would the nurse explain is the characteristic of normal sinus rhythm?
the sinoatrial (SA) node initiates the impulse
A nursing student understands that a client with which arrhythmia will be the most likely to need an immediate pacemaker?
third degree heart block
In the treatment of coronary artery disease (CAD), medications are often ordered to control blood pressure in the client. Which of the following is a primary purpose of using beta-adrenergic blockers in the nursing management of CAD?
to decrease the workload of the heart
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
When a client who has been diagnosed with angina pectoris reports experiencing chest pain more frequently, even at rest, that the period of pain is longer, and that it takes less stress for the pain to occur, the nurse recognizes that the client is describing which type of angina?
unstable
What is atropine?
used in management of patients with bradycardia. increases the heart rate and improves the atrioventricular conduction by blocking the parasympathetic influences on the heart.
Ventricular tachycardia is
usually regular and fast, with wide QRS complexes.
What is preload?
venous return to the right side of the heart. this is reduced by administration of diuretics
The nurse is caring for a client with an open lower extremity leg ulcer. The wound margins are irregular, the wound bed is red, and is draining moderate amounts of thick exudate. The nurse documents which type of ulcer?
venous ulcer
the QRS complex on an electrocardiogram (ECG) represents which phase of the cardiac cycle?
ventricular depolarization
the T wave on an electrocardiogram (ECG) represents which phase of the cardiac cycle?
ventricular repolarization
a low K+ can cause
ventricular tachycardia or fibrillation.
Patient with HF is constipated. what would nurse recommend?
walking, more fiber, stool softeners. NO EXTRA WATER
When do we defibrillate?
when we DONT have a pulse *dont synchronize* * early defibrillation BEFORE CPR ("we choose D-fib for V-fib")
