Health and Illness Exam 1 - Cardiac

hypertensive crisis

>180 and/or >120

Which assessment finding is consistent with a client of right-sided heart failure? - collapsed neck veins - distended abdomen - dependent edema - decreased appetite - cool extremities

- distended abdomen - dependent edema - decreased appetite

which assessment finding would the nurse expect when a client is diagnosed with left-sided CHF? - dyspnea - crackles - frequent cough - peripheral edema - jugular distention

- dyspnea - crackles - frequent cough

Which signs of hypokalemia would the nurse monitor in the postop surgical client with a NG tube attached to continuous low suction? - irritability - dysrhythmias - muscle weakness - abdominal cramps - acidosis

- dysrhythmias - muscle weakness

What manifestation in a client with heart failure indicates digoxin toxicity? -Nausea -Yellow vision -Irregular pulse -Increased urine output -Increased urine output -Heart rate of 64 bpm

-Nausea -Yellow vision -Irregular pulse

Modifiable risk factors for HTN

-Smoking -Obesity -excessive alcohol consumption -Diabetes mellitus -Lack of physical exercise -insulin resistance -low potassium, calcium, and mag intake -stress -High LDL -Low LDL

Which statement accurately describes mitral valve prolapse?

Buckling of the valve into the left atrium during ventricular systole

Risk factors for hypertension

Family history Age-related changes in blood pressure Race Insulin resistance and metabolic abnormalities Circadian variations Lifestyle factors

primary hypertension

High blood pressure, the cause of which is unknown; also known as essential hypertension

Hypertensive crisis treatment

IV vasodilators, adrenergic inhibitors, and calcium channel blockers

Which cardiac valve disorder causes a sudden onset of cardiovascular collapse?

Acute aortic regurgitation

What ethnicity has the highest prevalence of HTN?

African Americans

Which drug would the nurse expect to be prescribed for a patient with a mechanical heart valve?

Anticoagulants

Which statement by a patient after a mechanical valve replacement, indicates to the nurse that further instruction is needed?

The biggest risk I have during invasive health procedures is bleeding because of my anticoagulants

The reversal agent for warfarin is?

Vitamin K

Which action would the nurse implement first for a client whose serum potassium level has increased to 5.8 mEq/L? a. Assess vital signs b. call the laboratory to repeat the test c. inform the cardiac arrest team to place them on alert d. perform and EKG

a. Assess vital signs

A patient with newly discovered high BP has an average reading of 158/98 mm Hg after 3 months of exercise and diet modifications. Which management strategy will be a priority for this patient? a. Drug therapy will be needed because the BP is still not at goal. b. BP monitoring should continue for 3 months to confirm a diagnosis of hypertension. c. Lifestyle changes are less important since they were not effective, and drugs will be started. d. More changes in the patient's lifestyle are needed for a longer time before starting drug therapy.

a. Drug therapy will be needed because the BP is still not at goal.

which prescribed action would the nurse question when caring for a client who had heart failure, with a BP 102/70, pulse 106, and bilateral lung crackles? a. infuse normal saline at 100 mL/h b. given furosemide 40 mg IV now c. administer potassium chloride 10 mEq orally now d. titrate oxygen by mask to keep oxygen saturation 93% or higher

a. infuse normal saline at 100 mL/h

which action would the nurse take next when a client with a history of heart failure on daily weights has a 4-pound weight gain since the previous day? a. perform a head-to-toe assessment b. place the client on restricted fluid intake c. discuss a restricted sodium diet with the client d. document the findings in the health care record

a. perform a head-to-toe assessment

which outcome would the nurse use to determine the effectiveness of sublingual nitroglycerin? a. relief of anginal pain b. improved cardiac output c. decreased blood pressure d. ease in respiratory effort

a. relief of anginal pain

Which intervention is the priority nursing care for a client in the coronary care unit who develops "viselike" chest pain radiating to the neck with a BP of 124/64, an irregular apical pulse of 64 beats per minute, and diaphoresis who is prescribed morphine sulfate 4mg IV push stat and cardiac monitoring? a. relief of pain b. client teaching c. cardiac monitoring d. maintenance of bed rest

a. relief of pain

Which description would the nurse expect the client to use to characterize the pain when admitted to the coronary care unit with a diagnosis of ST segment elevation MI? a. severe, intense chest pain b. burning sensation of short duration c. sharp, stabbing chest pain with breathing d. squeezing chest pain, relieved by nitroglycerin

a. severe, intense chest pain

which lab test is important for the nurse to monitor when a client is admitted with acute coronary syndrome? a. troponin b. myoglobin c. homocysteine d. creatine kinase

a. troponin

which laboratory test is important for the nurse to monitor when a client is admitted with acute coronary syndrome? a. troponin b. myoglobin c. homocysteine d. creatine kinase

a. troponin

which agent will be used if an antidote is needed for a client taking warfarin? a. vitamin K b. fibrinogen c. prothrombin c. protamine sulfate

a. vitamin K

when the nurse is auscultation a client's heart, where would S1 be the loudest? a. base of the heart b. apex of the heart c. left lateral border d. right lateral border

b. apex of the heart

Which adverse effect would a nurse monitor for when caring for a client with hypertension who is prescribed metoprolol? a. hirsutism b. bradycardia c. restlessness angina

b. bradycardia

While obtaining subjective assessment data from a patient with hypertension, the nurse recognizes that a modifiable risk factor for the development of hypertension is a. A low-calcium diet. b. Excess alcohol intake. c. A family history of hypertension. d. Consumption of a high-protein diet.

b. excess alcohol intake

which nursing action has the highest priority when providing care for a client who has had an acute MI a. prevent N&V b. monitor for cardiac dysrhythmias c. use prescribed medication to lower fever d. teach about the phases of cardiac rehabilitation

b. monitor for cardiac dysrhythmias

which nursing action has the highest priority when providing care for a client who has had an acute MI? a. prevent N&V b. monitor for cardiac dysrhythmias c. used prescribed medication to lower fever d. teach about the phases of cardiac rehabilitation

b. monitor for cardiac dysrhythmias

which autoimmune disease can result in damage to the heart? a. b. rheumatic fever c. d.

b. rheumatic fever

which topic would be included in discharge teaching for a 22 year old client who has had mitral valve replacement with a mechanical valve? a. daily aspirin use b. care of leg incision c. anticoagulation therapy d. low fat and cholesterol diet

c. anticoagulation therapy

Which information about a client who is being discharged 3 days after having an STEMI and coronary artery stent placement indicated that a home health referral may be needed at discharge? a. ST segments have not yet returned to baseline b. troponin T and Troponin I levels are still elevated c. client reports frequently forgetting to take medication d. pulse increases from 65 beats/minute to 75 beats/minute with exercise

c. client reports frequently forgetting to take medication

which action will the nurse taken in a client hospitalized for uncontrolled hypertension and chest pain on a daily diuretic for 2 days whose potassium level this morning is 2.7? a. send another blood sample to the lab to retest the serum potassium level b. notify the HCP that the potassium level is above normal c. notify the HCP that the potassium level is below normal d. no action is required because the potassium level is within normal limits

c. notify the HCP that the potassium level is below normal

after consistently obtaining a blood pressure of 140/76 for a client, which stage of hypertension will the nurse document? a. normal b. elevated c. stage 1 c. stage 2

c. stage 2

which medication would a nurse conclude is the cause of a decreased heart rate in a client receiving a cardiac glycoside, a diuretic, an ACE inhibitor, and a vasodilator? a. diuretic b. vasodilator c. ACE inhibitor d. cardiac glycoside

d. cardiac glycoside

the nurse provides education for a client who has received a prescription for spironolactone. The information includes a correlation between potassium intake and the medication, and a list of fluids and their potassium content. The nurse concludes that the teaching is effective when the client plans to consume which type of juice? a. prune juice b. orange juice c. tomato juice d. cranberry juice

d. cranberry juice

which concern when caring for a client prescribed furosemide 40 mg every day in conjunction with digoxin would prompt the nurse to ask the HCP about potassium supplements? a. digoxin causes significant potassium depletion b. the liver destroys potassium as digoxin is detoxified c. lasix requires adequate serum potassium to promote diuresis d. digoxin toxicity occurs rapidly in the presence of hypokalemia

d. digoxin toxicity occurs rapidly in the presence of hypokalemia

which concern when caring for a client prescribed furosemide 40mg every day in conjunction with digoxin would prompt the nurse to ask the health care provider about potassium supplements? a. digoxin causes significant potassium depletion b. the liver destroys potassium as digoxin is detoxified c. lasix requires adequate serum potassium to promote diuresis d. digoxin toxicity occurs rapidly in the presence of hypokalemia

d. digoxin toxicity occurs rapidly in the presence of hypokalemia

which type of shock would the nurse monitor for in a client with a ruptured abdominal aortic aneurysm? a. obstructive b. neurogenic c. cardiogenic d. hypovolemic

d. hypovolemic

In teaching a patient with hypertension about controlling the illness, the nurse recognizes that a. All patients with elevated BP need drug therapy. b. Obese persons must achieve a normal weight to lower BP. c. It is not necessary to limit salt in the diet if taking a diuretic. d. Lifestyle modifications are needed for all persons with elevated BP.

d. lifestyle modifications are needed for all persons with elevated BP

secondary hypertension

high blood pressure caused by the effects of another disease that can be identified and corrected

Most important modifiable risk factor for CAD

hypertension

Patients with mechanical heart valves require anticoagulation for ____?

indefinitely

Before early middle age, HTN is more common in

men

causes for coronary artery disease

plaque builds up on inside of artery -hypertension -diabetes -smoking -hyperlipidemia -hypercholesterolemia

Most effective IV drug for a hypertensive crisis

sodium nitroprusside

Which explanation would the nurse given about the purpose of the procedure when a client with angina is schedule to have a cardiac catheterization? a. to obtain the pressures in the heart chambers b. to determine the existence of congenital heart disease c. to visualize the disease process in the coronary arteries d. to measure the oxygen content of various heart chambers

to visualize the disease process in the coronary arteries

After age 64 hypertension is more common in

women

What specific labs are ordered for patients with mechanical heart valves?

PT/INR

Parameters for Stage 1 HTN

SBP: 130-139 and DBP: 80-89

Parameters for Stage 2 HTN

SBP: > 140 DBP: > 90

Modifiable risk factors for CAD

Smoking, inactivity, hypertension, diabetes mellitus, obesity, excessive alcohol consumption, cholesterol management and stress.

Are patient with aortic stenosis - S.A.D?

Syncope, angina, dyspnea