Term 3 Cardio
A client is receiving heparin sodium intravenously at 1500 units/hour. The concentration in the bag is 25,000 units/500 milliliters. The nurse determines that how many milliliters will infuse during the nurse's 8-hour shift? Record you answer using a whole number. ____mL
240 mL
A client with angina pectoris is scheduled for a stress echocardiogram. What should the nurse tell the client that an echocardiogram is?
A noninvasive approach to assess cardiovascular status
A client is brought to the emergency department with chest pain. The client asks why an electrocardiogram (ECG) has been prescribed. The nurse explains that the ECG will do what?
Aid in detecting in heart damage
The nurse providing post-procedure care to a client who had a cardiac catheterization through the femoral artery discovers a large amount of blood under the client's buttocks. After donning gloves, which action should the nurse take first?
Assess the catheterization site
A client with heart failure is digitalized (given a loading dose of digoxin) and placed on a maintenance dose of digoxin 0.25 mg by mouth daily. What responses does the nurse expect the client to exhibit when a therapeutic effect of digoxin is achieved?
Diuresis and decreased pulse rate
A client's diet is modified to eliminate foods that act as cardiac stimulants. Which foods will the nurse instruct the client to avoid? Select all that apply.
Iced Tea Hot Cocoa Chocolate Pudding
Which serum laboratory values in a client with urinary problems may indicate the risk of developing muscle weakness and cardiac arrhythmias?
Potassium of 7.02 mEq/L (7.02 mmol/L)
A client's monitor shows a PQRST wave for each beat and indicates a rate of 120 beats/minute. The rhythm is regular. What does the nurse conclude that the client is experiencing?
Sinus tachycardia
A nurse is providing dietary instruction to a client with cardiovascular disease. Which dietary selection by the client indicates that the nurse needs to follow up?
Whole milk with oatmeal
The nurse is providing teaching to a client who is scheduled for cardiac catheterization via the femoral approach. The teaching includes that the client will be what?
In the supine position with the affected leg extended for several hours postprocedure
The nurse provides medication discharge instructions to a client who received a prescription for digoxin (Lanoxin) following the client's myocardial infarction. The nurse concludes that the teaching was effective when the client says what?
"I should check my radial pulse rate daily"
A client with cirrhosis of the liver has a prolonged prothrombin time and a low platelet count. A regular diet is prescribed. What should the nurse instruct the client to do considering the client's condition?
Report signs of bleeding no matter how slight
A client with cardiovascular disorder reports exhaustion and activity intolerance. What does the nurse document in the assessment report?
Fatigue
What is the most important information the nurse and the rapid response team must keep in mind when caring for a client who had a cardiac arrest?
How long the client was anoxic
The healthcare provider prescribes atenolol for a client with angina. What potential side effect will the nurse mention when instructing the client about this medication?
Hypotension
What are the clinical manifestations of myocardial infarction in women? Select all that apply.
Indigestion Unusual Fatigue Sleep Disturbances
After a deep vein thrombosis developed in a postpartum client, an intravenous (IV) infusion of heparin therapy was instituted 2 days ago. The client's activated partial thromboplastin time (aPTT) is now 98 seconds. What should the nurse do next?
Interrupt the infusion and notify the primary healthcare provider of the aPTT result
The nurse is caring for a client who is experiencing signs and symptoms of a cardiac dysrhythmia who is scheduled to wear a holter monitor for 24 hours. During the test, what should the client be instructed to do?
Keep a diary of activities
When developing a plan of care for a client who had a cardiac catheterization via a femoral insertion site, what should the nurse include?
Maintaining a supine position for a minimum of 4 hours
A client is admitted to the emergency department with chest pain and shortness of breath. An electrocardiogram indicates that the client is experiencing a myocardial infarction. An emergency cardiac catheterization is scheduled. What information should the nurse include in the pre-procedure teaching?
Mild sedation is maintained during the procedure
A nurse is auscultating a client's heart sounds. Which valves close when the first heart sounds are produced?
Mitral and tricuspid
A nurse is providing postprocedure care to a client who had a cardiac catheterization via a brachial artery. For the first hours after the procedure, what is the priority nursing intervention?
Monitor the vital signs every 15 minutes
A 3-year-old child is scheduled for cardiac catheterization. What is the priority nursing care after this procedure?
Monitoring the site for bleeding
Which electrolyte concentration has the potential to precipitate dysrhythmias and cardiac arrest in a client?
Serum Potassium of 7.2 mEq/L (7.2 mmol/L)
A pregnant client who has a history of cardiac disease asks how she can relieve her occasional heartburn. The nurse should instruct the client to avoid antacids containing which ingredient?
Sodium
A client with a history of a pulmonary embolus is to receive 3 mg of warfarin (Coumadin) daily. The client has blood drawn twice weekly to ascertain that the international normalized ratio (INR) stays within a therapeutic range. The nurse provides dietary teaching. Which food selected by the client indicates that further teaching is necessary?
Spinach salad
A client is hospitalized for heat failure is receiving digoxin (Lanoxin) and will continue taking the drug after discharge. What should be included in the plan of care for the next few days?
Taking the apical pulse before drug administration and teaching the client how to count the pulse
A client with a long history of cardiovascular problems, including angina and hypertension, is scheduled to have a cardiac catheterization. During the preprocedure teaching, what does the nurse explain to the client as the major purpose for catheterization?
To visualize the disease process in the coronary arteries
Which modifiable risk factors for coronary artery disease (CAD) should the nurse include in a teaching session for a Native American patient? Select all that apply.
Tobacco Hypertension Diabetes Mellitus (DM)
A client is admitted to the hospital with the diagnosis of myocardial infarction. The nurse should monitor this client for which signs and symptoms associated with heart failure? Select all that apply.
Unusual Fatigue Dependent Edema Nocturnal Dyspnea
A client is taking warfarin (Coumadin). The nurse recalls that the antidote for this medication is what?
Vitamin K
A nurse is monitoring a child for toxicity precipitated by digoxin. For what sign of digoxin toxicity will the nurse assess the child?
Vomiting
A nurse is conducting cholesterol screening for a manufacturing corporation during a health fair. A 50-year-old man who is 6 feet tall and weighs 293 pounds puts out his cigarette and asks the nurse how to modify his risk factors for coronary artery disease. On which risk factors should the nurse help the client focus? Select all that apply.
Weight Smoking
Discharge teaching for a client with hypercholesterolemia includes nutritional instruction for a diet low in saturated fat. Which items included by the client on a list of foods to avoid supports the nurse's conclusion that teaching has been effective?
Whole milk and hard cheeses
A patient with a partial occlusion of the left common carotid artery is to be discharged while still receiving warfarin (Coumadin). Which clinical adverse effect should the nurse identify as a reason for the client to seek medical consultation?
Presence of blood in urine
A nurse begins to develop a plan of care with a client who has left ventricular heart failure that resulted from a myocardial infarction (MI). What should be the primary focus of the plan during the acute phase of recovery?
Promoting physical and emotional rest
A home care nurse makes an initial visit to a 60-year-old female client with heart failure. The client lives with her daughter who is addicted to drugs and a single parent of seven children. When the nurse enters the home, the client is feeding a 6-month-old granddaughter and preparing dinner for the rest of the family. A 14-year-old grandson, disabled and in a wheelchair, states his mother is sleeping. What should the nurse do?
Question the client to determine whether there is a private place to take a health history and perform an examination
The nurse providing postprocedure care to a client who had a cardiac catheterization through the femoral artery discovers a large amount of blood under the client's buttocks. After donning gloves, which action should the nurse take first?
Assess the catheterization site
A healthcare provider prescribes an antidysrhythmic to be administered intravenously (IV) at 1000 mcg/min. The directions from the pharmacy state that 500 mg of the drug should be added to 500 mL of D5W. At what rate should the nurse set the volume control device to administer the medication correctly? Record your answer using a whole number. ____ mL/hr
60 mL/h
A nurse is teaching a client who had a myocardial infarction about the prescribed 1500-calorie, 2-gram-sodium, weight-reducing diet. Which low-sodium, low-calorie nutrients should the nurse recommend that the client include in the diet? Select all that apply.
Baked Chicken Mashed Potatoes
Four days after the client's total hip arthroplasty, the nurse is preparing to transfer the client to the rehabilitation center. Before admission the client took warfarin sodium (Coumadin) daily for a history of pulmonary embolus. While hospitalized, the client received subcutaneous heparin two times a day. The nurse does not see any anticoagulant therapy listed on the client's transfer prescriptions. What should the nurse do?
Contact the health care provider to determine what anticoagulant therapy should be prescribed for this client
A client with a history of angina is scheduled for a cardiac catheterization. Catheter entry will be through the femoral artery. What should the nurse tell the client to expect?
Experience a feeling of warmth during the procedure
A client with a history of heart failure on daily weights has a 2-pound (0.9 kilogram) weight gain and pitting edema in lower extremities bilaterally. Which action would the nurse take next?
Perform a head-to-toe assessment, including vital signs
A nurse teaches a client about warfarin (Coumadin). Which information is essential for the nurse to include in the education plan?
Periodic blood testing is necessary
A client's echocardiogram report indicates decreased cardiac output. Which nursing intervention is most appropriate for this client?
Restricting activity to avoid fatigue
One week after admission to the cardiac care unit, a client displays an outburst off anger and tells the nurse to get out of the room. Which is the most appropriate nursing action?
Return when the client has calmed down
A healthcare provider prescribes morphine for a client who had a myocardial infarction. What clinical response will be reduced if the client experiences the intended therapeutic effect of morphine?
Workload of the heart
A client with heart disease has been reading on the internet about anatomy and physiology of the heart and tells the nurse, "I'm so confused." The nurse reinforces the pattern of circulation in the body. Which client statement indicates an understanding?
"Blood enters the right atrium via the superior and inferior vena cava, flows to the right ventricle and then into the lungs, returns from the lungs to the left atrium and left ventricle, and exits out the aorta."
A client with a history of hypertension has a blood pressure of 180/102 mm Hg. When the nurse asks whether the client has been taking any medications, the client replies, "I took the blood pressure pills the healthcare provider prescribed for a few weeks, but I didn't feel any different, so I decided I'd only take them when I feel sick." What is the best initial response by the nurse?
"It is important to take your medications daily to achieve optimal results."
The nurse provides medication discharge instructions to a client who received a prescription for digoxin following the client's myocardial infarction. Which statement by the client leads the nurse to conclude that the teaching was effective?
"It will be important to check my radial pulse rate daily"
A client who is suspected of having had a silent myocardial infarction has an electrocardiogram (ECG) prescribed by the primary healthcare provider. While the nurse prepares the client for the procedure, the client asks, "Why was this test prescribed?" Which is the best reply by the nurse?
"This test will reflect any heart damage"
A client has a prescription for an antibiotic in an intravenous (IV) piggyback of 50 mL of D5W to run for 30 minutes. the microdrip tubing has a drop factor of 60 gtt/mL. at what rate should the nurse set the IV infusion? Record your answer using a whole number. ____________ gtts/min
100 gtt/minute
A nurse is working in the intensive care unit. Which client will the nurse be prepared to assist with cardioversion?
A client with supraventricular tachycardia
When assessing an 85-year-old client's vital signs, the nurse anticipates a number of changes in cardiac output that result from the aging process. Which finding is consistent with a pathologic condition rather than the aging process?
A pulse rate irregularity
An older adult with cerebral arteriosclerosis is admitted with atrial fibrillation and is started on a continuous heparin infusion. What clinical finding enables the nurse to conclude that the anticoagulant therapy is effective?
An activated partial thromboplastin (aPTT) twice the usual value
A client has a pulse deficit. Which documentation by the nurse supports this finding?
Apical pulse 86 and radial pulse 78 indicating pulse deficit of 8
A client undergoes cardiac catheterization via the femoral artery. What is the most important nursing action after the procedure?
Assess the groin for bleeding
A client who just returned from cardiac catheterization reports to the nurse that the pressure bandage on the right groin is tight. What action should the nurse take?
Assess the pulses distal to the dressing
The nurse should suspect that a client who had a recent myocardial infarction is experiencing denial when the client does what?
Attempts to minimize the illness
A nurse is providing discharge instructions about digoxin. Which response should a nurse include as a reason for a client to withhold the digoxin?
Blurred Vision
A client with a high cholesterol level says to the nurse, "Why can't the doctor just give me a medication to eliminate all the cholesterol in my body so it isn't a problem?" Which factor related to why cholesterol is important in the human body should the nurse include in a response to the client's question?
Cellular membranes
After undergoing a cardiac catheterization, the client complains of tingling sensations in the affected leg. What should the nurse do to determine the cause of the tingling?
Compare femoral, popliteal, and pedal pulses in both legs
A client who is receiving multiple medications for a myocardial infarction complains of severe nausea, and the client's heartbeat is irregular and slow. The nurse understands that these signs and symptoms are toxic effects of which medication?
Digoxin (Lanoxin)
What is the most common warning symptom of myocardial infarction in women?
Fatigue
What is the most common warning system of myocardial infarction in women?
Fatigue
A thallium scan is scheduled for a client who had a myocardial infarction. What should the nurse explain to the client regarding the reason the scan has been prescribed?
That it establishes the viability of myocardial muscle
A nurse is caring for a client who was diagnosed with a myocardial infarction. While caring for the client two days after the event, the nurse identifies that the client's temperature is elevated. The nurse concludes that this increase in temperature is most likely the result of what?
Tissue Necrosis
A client hospitalized with a severe myocardial infarction tells the nurse, "My life is over. I may as well just give up." What is the best response by the nurse?
"You feel your life is over?"
A client has elevated triglycerides and cholesterol. The client appears discouraged and says, "Well, I guess I'd better cut out all the fat and cholesterol in my diet." Which is the nurse's most appropriate response?
"You need some fat to supply the necessary fatty acids, so you mainly just need to cut down on the amount of fat you consume."
A client whose total cholesterol level is found to be 210 mg/dL at a screening session at a health fair asks the nurse what to do in light of this result. How does the nurse respond?
"Your level is elevated slightly and a diet low in saturated fats should be followed"
A nurse is to administer 5000 units of heparin to a prenatal client on prolonged bed res. The label indicates that there are 20,000 units of heparin in each milliliter of solution. How much solution should the nurse give the client? Record your answer using two decimal places and include a leading zero if applicable. ____ mL
0.25 mL
While instructing a community group regarding risk factors for coronary artery disease, the nurse provides a list of risk factors that cannot be modified. What should be included on the list?
Heredity
When obtaining a health history, the nurse is informed that a client has been taking digoxin. What therapeutic effect of digoxin does the nurse expect?
Increased contractile force of the myocardium
A primary health-care provider suggests that a low-income 40-year-old client with cardiovascular disease, hypertension, and cerebrovascular accident access long-term care services. Which system would financially support the client to access the services?
Medicaid