LWW Cardio 2020
A nurse is caring for a child with transposition of the great arteries. Which associated defect should the nurse expect to see in this client?
patent foramen ovale
A client comes to the emergency department reporting chest pain. Upon further evaluation, the nurse suspects unstable angina. Which disease process should the nurse reinforce teaching this client about because it is directly related to unstable angina?
"Children who have chronic health issues may experience developmental delays." Explanation: Chronic illnesses can impact a child's growth and development both emotionally and cognitively. The child with a cardiac disorder may experiences delays as a result of hypoxic episodes or repeated hospitalizations.
The nurse is reinforcing teaching with a client how to take nitroglycerin to treat angina pectoris. Which statements indicate that the client understands the potential side effects of nitroglycerine? Select all that apply.
"I may experience a pounding headache." "I may feel dizzy." "I may feel flushed." Explanation: Headache, hypotension, dizziness, and flushing are classic adverse effects of nitroglycerin, a vasodilator.
Propranolol has been prescribed for a teen who has been diagnosed with hypertension. When discussing the medication with the teen, which statement indicates the need for further instruction?
"I should take this medication daily on an empty stomach." Explanation: Propranolol is used in the management of hypertension. The medication is taken daily. It is recommended that it be taken at the same time each day. The drug is administered with food.
A teenager with heart failure who has been prescribed digoxin asks the nurse, "What will this drug do for my heart?" What is the best response by the nurse?
"It will decrease the workload of the heart." Explanation: Digoxin is a cardiac glycoside. It decreases the workload of the heart and improves myocardial function.
A client is being discharged from the hospital with a permanent cardiac pacemaker that is set at 72 beats/minute. The nurse should instruct the client to report which pulse rate immediately to the physician?
64 BPM A demand pacemaker guarantees approximately 72 beats/minute. Whenever a client's rate falls below this mark, the pacemaker initiates a beat. A rate about 72 beats/minute is normal and indicates that the client's heart is initiating the beats. A rate below 72 beats/minute should be reported because it means that the pacemaker isn't functioning at the preset rate.
A nurse is caring for a client who has been administered digoxin 0.125 mg by mouth daily. The client develops sinus bradycardia with a heart rate of 50 beats/minute. His vital signs are stable. Which of the following actions should the nurse take first?
Because bradycardia is an adverse effect of digoxin, the nurse should notify the physician and follow his orders.
A client with a history of atrial arrhythmia is receiving propranolol, 10 mg by mouth three times per day. The nurse knows that propranolol inhibits the action of sympathomimetics at beta1-receptor sites. Where are these sites mainly located?
Beta1-receptor sites are mainly located in the heart.
A client is in hemorrhagic shock. What data best reflects the effectiveness of fluid replacement therapy?
Blood pressure
When measuring the radial pulse of a client with known aortic insufficiency, the nurse detects a "water-hammer" or Corrigan's pulse. What are the characteristics of this pulse?
Bounding, with a rapid rise and fall
A client with a forceful, pounding heartbeat is diagnosed with mitral valve prolapse. This client should be instructed to avoid which of the following?
Caffeine is a stimulant, which can exacerbate palpitations, and should be avoided by a client with symptomatic mitral valve prolapse.
The telemetry monitor technician notifies the nurse that a client has sinus bradycardia with a heart rate of 42 beats/minute. What should the nurse do first?
Check the client's level of consciousness, obtain vital signs, and assess the client for symptoms. The first priority is to gather data by assessing the client's level of consciousness, obtaining vital signs, and determining the presence or absence of symptoms. C
The 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, the nurse should consider which finding significant?
Childhood diseases and disorders associated with structural heart disease include rheumatic fever and severe streptococcal.
A child with tetralogy of Fallot has clubbing of the fingers and toes. The nurse understands that this finding is related to which condition?
Chronic hypoxia causes clubbing of the fingers and toes when untreated.
A client diagnosed with acute arterial occlusive disease is scheduled to undergo an atherectomy. What is the priority nursing intervention for this client immediately after the procedure?
Closely monitor catheter site for bleeding. Explanation: Atherectomy is a surgical treatment used for acute arterial occlusive disease. After the procedure, the client should be monitored frequently for bleeding at the catheter site, and vital signs should be taken every 15 minutes times four, and then every hour for the first few hours.
A client is evaluated for hypertension. The physician prescribes atenolol, 50 mg by mouth daily. Atenolol should have which therapeutic effect on the client?
Decreased cardiac output and systolic and diastolic blood pressure
A pregnant client is suspected of experiencing worsening mitral valve prolapse. Which diagnostic test should the nurse prepare the client for?
Echocardiography is less invasive than x-rays and other methods; it provides the information needed to determine cardiovascular disease,
A nurse obtaining data from a client observes jugular vein distention (JVD). Which condition does the nurse suspect this client to have?
Elevated venous pressure, exhibited as JVD, indicates the heart's failure to pump. J
A client is admitted to the health care facility for treatment of an abdominal aortic aneurysm. When planning this client's care, the nurse formulates interventions with which goal in mind?
For a client with an aneurysm, nursing interventions focus on stabilizing the heart rate and blood pressure, to avoid aneurysm rupture. Easing anxiety also is important because anxiety and increased stimulation may speed the heart rate and boost blood pressure, precipitating aneurysm
The nurse administers furosemide to treat a client with heart failure. Which adverse effect must the nurse watch for most carefully?
Furosemide is a potassium-wasting diuretic. The nurse must monitor the serum potassium level and assess for signs of low potassium.
Which statement by the client best indicates an understanding on how to prevent complications while taking warfarin?
I should use a soft toothbrush."
The nurse is caring for a child with symptomatic aortic stenosis. Which instruction should be provided to the child and parents.
In a child with symptomatic aortic stenosis, exercise should be restricted due to low cardiac output and left ventricular failure.
Atropine is being administered to a child with sinus bradycardia. Which statement is most accurate about the administration of this medication?
It increases heart rate.
The nurse is caring for a child undergoing cardiac surgery? Which home care instruction is most appropriate?
Maintain the prescribed medication regimen until the health care provider makes a change. Explanation: Drugs such as digoxin and furosemide shouldn't be stopped abruptly. T
A nurse is giving discharge instructions to the parents of a child with Kawasaki disease. Which statement by the parents shows an understanding of the treatment plan?
My child should use a soft-bristled toothbrush." Explanation: Because of the anticoagulant effects of aspirin therapy, a soft-bristled toothbrush will prevent bleeding of the gums.
A nurse places electrodes on a collapsed individual who was visiting a hospitalized family member. The monitor displays the waveform depicted in the image. Which intervention should the nurse do first?
Observe the client's airway, breathing, and circulation. Explanation: The rhythm the client is experiencing is ventricular tachycardia (VT). The nurse must first assess the airway, breathing, and circulation and the level of consciousness to establish the client's stability and obtain further help from nursing staff.
A nurse is caring for several clients on a medical floor. Which client does the nurse identify to have the greatest chance of developing cardiogenic shock?
Of all clients with an acute MI, 15% suffer cardiogenic shock secondary to the myocardial damage and decreased function.
A client is admitted for treatment of Prinzmetal angina. When developing the plan of care, the nurse keeps in mind that this type of angina is triggered by:
Prinzmetal angina results from coronary artery spasm.
A postoperative client is receiving heparin after developing thrombophlebitis. The nurse monitors the client carefully for adverse effects of heparin, especially bleeding. If the client starts to exhibit signs of excessive bleeding, the nurse should expect to administer an antidote that's specific to heparin. Which agent fits this description?
Protamine sulfate
A client who had an anterior wall myocardial infarction (MI) would have a greater risk for exhibiting crackles in the lungs related to which disorder?
left-sided heart failure
A client is being discharged home with a diagnosis of hypertrophic cardiomyopathy (HCM). Which statement by the client best demonstrates an understanding of this disease process?
Since this is a hereditary disorder, my family members should probably be evaluated for similar symptoms."
The nurse is caring for a client with acute pulmonary edema. To immediately promote oxygenation and relieve dyspnea, the nurse should:
The high Fowler's position will initially promote oxygenation in the client and relieve shortness of breath.
The nurse is performing an electrocardiogram (ECG) for a client with chest pain. To achieve the best results, in which position will the nurse place the client?
The most appropriate position for a client undergoing an ECG is lying flat,
Which potential side effects should the nurse include when assisting in discharge teaching of a male client who was started on atenolol?
causes and treatments for erectile dysfunction Explanation: Erectile dysfunction is a potential adverse effect of beta blockers.
A child with tetralogy of Fallot has clubbing of the fingers and toes. The nurse understands that this finding is related to which condition?
chronic hypoxia Explanation: Chronic hypoxia causes clubbing of the fingers and toes when untreated. Hypoxia varies with the degree of pulmonary stenosis.
The nurse is caring for a client with a ventricular septal repair receiving dopamine postoperatively. Which response indicates a therapeutic effect of the medication?
increased cardiac output
The nurse is obtaining data from a new client in the cardiovascular clinic. When asking about childhood diseases and disorders associated with structural heart disease, the nurse should consider which finding significant?
rheumatic fever
A client with a deep vein thrombosis (DVT) is admitted to the hospital for treatment. Which medication will the nurse administer orally to prevent further thrombus formation?
warfarin
