heart failure prepU

The nurse is assigned to care for a patient with heart failure. What classification of medication does the nurse anticipate administering that will improve symptoms as well as increase survival? Bile acid sequestrants Diuretic Calcium channel blocker ACE inhibitor

ACE inhibitor

After receiving the shift report, a registered nurse in the cardiac step-down unit must prioritize her client care assignment. The nurse has an ancillary staff member available to help her care for her clients. Which of these clients should the registered nurse assess first? The client admitted during the previous shift with new-onset controlled atrial fibrillation, who has her call light on. The client with heart failure who is having some difficulty breathing. The coronary bypass client asking for pain medication for "11 of 10" pain in her donor site. The anxious client who was diagnosed with an acute myocardial infarction (MI) 2 days ago, and was transferred from the coronary care unit today.

The client with heart failure who is having some difficulty breathing.

A client receiving a loop diuretic should be encouraged to eat which foods? Select all that apply. dried fruit banana peppers angel food cake orange juice

dried fruit banana orange juice

A client with left-sided heart failure is in danger of impaired renal perfusion. How would the nurse assess this client for impaired renal perfusion? Assess for elevated blood potassium levels. Assess for elevated blood urea nitrogen levels. Assess for reduced urine output. Assess for reduced blood sodium levels.

Assess for elevated blood urea nitrogen levels.

The client is to receive digoxin 0.25 mg. Available are 0.125-mg scored tablets. How many tablets should the nurse administer? 1.5 tablets 2 tablets 0.5 tablet 1 tablet

2 tablets

A nurse is caring for a client with heart failure. The nurse knows that the client has left-sided heart failure when he makes which statement? "My feet are bigger than normal." "I sleep on three pillows each night." "I don't have the same appetite I used to." "My pants don't fit around my waist."

"I sleep on three pillows each night."

A client is receiving furosemide (Lasix), a loop diuretic, to prevent fluid overload. The order is for 50 mg intraveneous now. The pharmacy supplies Lasix 80 mg per 2 mL. How many mL will the nurse give the client? Enter the correct number ONLY.

1.25

A nurse is caring for a client with end-stage heart failure who is awaiting a heart transplant. The client tells the nurse that he thinks he's going to die before a donor heart is found. He also tells the nurse that he hasn't been attending a church but wants to talk with a priest. What action should the nurse take? Contact her priest to see if he will see the client. Contact the clergy member who is assigned to the transplant team. Reassure the client that he has nothing to worry about because donors are usually found in time. Tell the client that it doesn't matter if he attends a church or not.

Contact the clergy member who is assigned to the transplant team.

A client has a significant history of congestive heart failure. What should the nurse specifically assess during the client's semiannual cardiology examination? Select all that apply. Examine the client's joints for crepitus. Examine the client's eyes for excess tears. Monitor the client for signs of lethargy or confusion. Examine the client's neck for distended veins.

Examine the client's neck for distended veins. Monitor the client for signs of lethargy or confusion.

The nurse is assigned to a client in the ICU. During the initial assessment, the nurse notes jugular vein distention and recognizes that the plan of care will follow which disorder? Abdominal aortic aneurysm Myocardial infarction (MI) Heart failure Pneumothorax

Heart failure

A nurse is caring for a client with a new prescription of digoxin. Which client statement would require further teaching about digoxin? Select all that apply. "If I forget a dose, I will catch-up by doubling the next dose." "I understand that I will need annual blood work to check therapeutic levels." "I will take the digoxin with my antacids at night." "I will notify my doctor if experiencing increased fatigue or muscle weakness." "I will take my pulse before each dose of digoxin." "I will take the digoxin at 9 a.m. daily."

I will take digoxin with my antacids at night. If I forget a dose, I will catch-up by doubling the next dose I understand that I will need annual blood work to check therapeutic levels

You are talking about heart failure to a local community group. What would you explain is the major cause of right-sided heart failure? Pulmonary hypertension Left-sided heart failure Venous insufficiency COPD

Left-sided heart failure

A nurse administers furosemide to treat a client with heart failure. Which adverse effect must the nurse watch for most carefully? High serum sodium level Increase in blood pressure Increase in blood volume Low serum potassium level

Low serum potassium level

Which of the following clinical manifestations are consistent with right-sided heart failure (HF)? Pulmonary interstitial edema Pulmonary congestion Left ventricular insufficiency Positive hepatojugular reflux

Positive hepatojugular reflux

A visiting nurse is teaching a client with heart failure about taking his medications. The client requires six different medications that are taken at four different times per day. The client is confused about when to take each medication. How should the nurse intervene? Ask the physician if the client can take fewer pills each day. Ask the client's family to take turns coming to the house at each administration time to assist the client with his medications. Come to the client's house each morning to prepare the daily allotment of medications. Teach a family member to fill a medication compliance aid once per week so the client can independently take his medications.

Teach a family member to fill a medication compliance aid once per week so the client can independently take his medications.

A nurse is assessing a client with heart failure. The breath sounds commonly auscultated in clients with heart failure are: tracheal. coarse crackles. fine crackles. friction rubs.

fine crackles.

A client is experiencing an acute myocardial infarction (MI) and I.V. morphine is ordered. The nurse knows that morphine is given because it: raises the blood pressure, lowers myocardial oxygen demand, and eliminates pain. eliminates pain, reduces cardiac workload, and increases myocardial contractility. increases venous return, lowers resistance, and reduces cardiac workload. lowers resistance, reduces cardiac workload, and decreases myocardial oxygen demand.

lowers resistance, reduces cardiac workload, and decreases myocardial oxygen demand.

A client with heart failure will take oral furosemide at home. To help the client evaluate the effectiveness of furosemide therapy, the nurse should teach the client to: have a serum potassium level drawn weekly. weigh daily. take blood pressure daily. keep a daily record of urine output.

weigh daily

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. The student correctly answers which of the following? Application of antiembolytic stockings Maintenance of the client's legs in a dependent position Fluid restriction Administration of a vasodilating drug (as ordered by a physician)

Application of antiembolytic stockings

A client is returning from the operating room after inguinal hernia repair. The nurse notes that he has fluid volume excess from the operation and is at risk for left-sided heart failure. Which sign or symptom indicates left-sided heart failure? Right upper quadrant pain Jugular vein distention Bibasilar crackles Dependent edema

Bibasilar crackles

The nurse is assessing a client admitted with a myocardial infarction with the following assessment: dyspnea, heart rate of 140 bpm, and crackles in the posterior chest. The nurse would interpret these findings as which of the following? Acute renal failure Cardiogenic shock associated with heart block A hypoglycemic reaction Development of congestive heart failure

Development of congestive heart failure

The nurse is caring for a client with heart failure that has developed pulmonary edema. The client has become very anxious. What medication would the nurse expect to be ordered to assist this client's breathing and anxiety? Morphine sulfate Lasix Calcium channel blockers Intropin

IDK...i put morphine

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 Calcium White blood cell (WBC) count Platelet count

Potassium

A patient taking an ACE inhibitor has developed a dry, hacking cough. Because of this side effect, the patient no longer wants to take that medication. What medication that has similar hemodynamic effects does the nurse anticipate the physician ordering? Isosorbide dinitrate (Dilatrate) Metoprolol (Lopressor) Valsartan (Diovan) Furosemide (Lasix)

Valsartan (Diovan)

A nurse is caring for a cardiac client who requires various cardiac medications. When the nurse helps the client out of bed for breakfast, the client becomes dizzy and asks to lie down. The nurse helps the client lie down, puts up the side rails, and obtains the client's blood pressure, which is 84/50 mm Hg. It's time for the nurse to administer the client's medications: nitroglycerin, metoprolol, and furosemide. Which action by the nurse is best? Administer the medications immediately. Encourage the client to sit up and eat breakfast. Administer the nitroglycerin and metoprolol and withhold the furosemide. Withhold the medications and notify the physician

Withhold the medications and notify the physician.

The nurse is admitting an older adult to the hospital. The echocardiogram report revealed left ventricular enlargement. The nurse notes 2+ pitting edema in the ankles when getting the client into bed. Based on this finding, what should the nurse do first? Insert a Foley catheter. Draw blood for laboratory studies. Weigh the client. Assess respiratory status.

Assess respiratory status.

A client has been diagnosed with right-sided heart failure. The nurse should assess the client further for: Intermittent claudication. Crackles. Dyspnea. Dependent edema.

Dependent edema.

The nurse observes a client with an onset of heart failure having rapid, shallow breathing at a rate of 32 breaths/minute. What blood gas analysis does the nurse anticipate finding initially? Respiratory alkalosis Metabolic alkalosis Respiratory acidosis Metabolic acidosis

Respiratory alkalosis

The client with heart failure asks the nurse about the reason for taking enalapril maleate. The nurse should tell the client: "This drug helps your heart beat more forcefully." "This drug will slow your heart rate down." "This drug will constrict your blood vessels and keep your blood pressure from getting too low." "This drug will dilate your blood vessels and lower your blood pressure."

This drug will dilate your blood vessels and lower your blood pressure."

A client is awaiting the availability of a heart for transplant. What option may be available to the client as a bridge to transplant? Pacemaker Implanted cardioverter-defibrillator (ICD) Intra-aortic balloon pump (IABP) Ventricular assist device (VAD)

Ventricular assist device (VAD)

While auscultating the heart sounds of a client with heart failure, the nurse hears an extra heart sound immediately after the second heart sound (S2). The nurse should document this as: a first heart sound (S1). a third heart sound (S3). a murmur. a fourth heart sound (S4).

a third heart sound (S3).

A client with left-sided heart failure complains of increasing shortness of breath and is agitated and coughing up pink-tinged, foamy sputum. The nurse should recognize these findings as signs and symptoms of: right-sided heart failure. acute pulmonary edema. cardiogenic shock. pneumonia.

acute pulmonary edema.

A client with heart failure is receiving furosemide, 40 mg I.V. The physician orders [40 mEq (40 mmol/L)] of potassium chloride in 100 ml of dextrose 5% in water to infuse over 4 hours. The client's most recent serum potassium level is [3.0 mEq/L (3.0 mmol/L)]. At what infusion rate should the nurse set the I.V. pump? 50 ml/hour 10 ml/hour 100 ml/hour 25 ml/hour

25 ml/hour

The treatment for heart failure is directed toward all of the following except: Increasing preload and afterload. Increasing cardiac output by strengthening muscle contraction or decreasing peripheral resistance. Decreasing the oxygen needs of the heart. Reducing the amount of circulating blood volume.

Increasing preload and afterload.

A client is in the early stage of heart failure. During this time, which compensatory mechanism occurs? Decreased renal blood flow causes the renin-angiotensin-aldosterone system to increase aldosterone secretion. Low blood pressure triggers the baroreceptors to decrease sympathetic nervous system stimulation. Low blood pressure triggers the baroreceptors to increase sympathetic nervous system stimulation. Decreased renal blood flow causes the renin-angiotensin-aldosterone system to reduce secretion of aldosterone and antidiuretic hormone.

Low blood pressure triggers the baroreceptors to increase sympathetic nervous system stimulation.

A client is taking spironolactone. Which change in the diet should the nurse teach the client to make when taking this drug? Avoid eating foods high in potassium. Maintain a fluid intake of 3,000 mL/day. Restrict sodium intake. Incorporate iron-rich foods into the diet.

Avoid eating foods high in potassium.

A community health nurse is participating in a healthy-living workshop that has been sponsored by a local seniors' center. The discussion has turned to the problem of heart failure, and the nurse is emphasizing preventative measures. When teaching older adults to decrease their future risks of developing heart failure, the nurse should emphasize what action? Close blood pressure monitoring and vigilant adherence to hypertension therapy Effective stress management A low-fat, high-protein diet Physical exercise and the importance of getting 30 to 60 minutes of activity each day

Close blood pressure monitoring and vigilant adherence to hypertension therapy

A nurse is awaiting the arrival of a client from the emergency department with a diagnosis of anterior wall myocardial infarction. In caring for this client, the nurse would be alert for which signs and symptoms of left-sided heart failure? Select all that apply. Crackles Tachycardia Hepatomegaly Right upper quadrant pain Jugular vein distention Dyspnea

tachycardia crackles dyspnea

Which is the hallmark of heart failure? Pulmonary congestion Limited ADLs Low ejection fraction (EF) Basilar crackles

Low ejection fraction (EF)

A patient is admitted to the intensive care unit (ICU) with left-sided heart failure. What clinical manifestations does the nurse anticipate finding when performing an assessment? (Select all that apply.) Jugular vein distention Ascites Pulmonary crackles Dyspnea Cough

Pulmonary crackles dyspnea cough

A client with chronic heart failure is receiving digoxin, 0.25 mg by mouth daily, and furosemide, 20 mg by mouth twice daily. The nurse instructs the client to notify the physician if nausea, vomiting, diarrhea, or abdominal cramps occur because these signs and symptoms may signal digoxin toxicity. Digoxin toxicity may also cause: nocturia and sleep disturbances. dry mouth and urine retention. taste and smell alterations. visual disturbances.

visual disturbances.

A client with stage IV heart failure has a living will indicating that he does not want to be placed on a ventilator. A nurse is caring for this client when he begins experiencing severe dyspnea. The nurse should: administer oxygen, morphine, and a bronchodilator for client comfort. ask the client's family to consent to ventilator placement. administer oxygen and hope the client will change his mind. call for respiratory therapy to intubate the client.

administer oxygen, morphine, and a bronchodilator for client comfort

The nurse is teaching a client with heart failure how to avoid complications and future hospitalizations. The nurse is confident that the client has understood the teaching when the client identifies which potential complications? Select all that apply. becoming increasingly short of breath at rest having to sleep sitting up in a reclining chair high intake of sodium for breakfast weight gain of 2 lb (0.9 kg) or more in 1 day weight loss of 2 lb (0.9 kg) in 1 day

becoming increasingly short of breath at rest weight gain of 2 lb (0.9 kg) or more in 1 day having to sleep sitting up in a reclining chair

The nurse has completed an assessment on a client with a decreased cardiac output. Which findings should receive the highest priority? weight gain of 1 kg in 3 days, BP 130/80 mm Hg, mild dyspnea with exercise BP 110/62 mm Hg, atrial fibrillation with HR 82 bpm, bilateral basilar crackles SpO2 92% on 2 L nasal cannula, respirations 20 breaths/min, 1+ edema of lower extremities confusion, urine output 15 mL over the last 2 hours, orthopnea

confusion, urine output 15 mL over the last 2 hours, orthopnea

The nurse is planning the care of a patient with HF. The nurse should identify what overall goals of this patient's care? Extend survival. Improve functional status Limit physical activity. Relieve patient symptoms. Prevent endocarditis.

Relieve patient symptoms. Extend survival. Improve functional status

The nurse is planning care for a client who is diagnosed with peripheral vascular disease (PVD) and has a history of heart failure. The nurse should develop a plan of care that is based on the fact that the client may have a low tolerance for exercise related to: increased blood flow. increased blood viscosity. decreased pain. decreased blood flow.

decreased blood flow

An 80-year-old client is admitted with nausea and vomiting. The client has a history of heart failure and is being treated with digoxin. The client has been nauseated for a week and began vomiting 2 days ago. Laboratory values indicate hypokalemia. Because of these clinical findings, the nurse should assess the client carefully for: exacerbation of heart failure. metabolic acidosis. digoxin toxicity. chronic renal failure.

digoxin toxicity.

A client has been diagnosed with right-sided heart failure based on symptomology. The cardiologist will confirm this suspicion through diagnostics. Which diagnostics are used to reveal right ventricular enlargement? Select all that apply. pulmonary arteriography chest radiograph echocardiography electrocardiogram

electrocardiogram echocardiography chest radiograph

The nurse monitors the serum electrolyte levels of a client who is taking digoxin. Which electrolyte imbalance is a common cause of digoxin toxicity? hypocalcemia hypokalemia hypomagnesemia hyponatremia

hypokalemia

The nurse's discharge teaching plan for the client with heart failure should emphasize the importance of: maintaining a high-fiber diet. walking 2 miles (3.2 km) every day. remaining sedentary for most of the day. obtaining daily weights at the same time each day.

obtaining daily weights at the same time each day.