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Flashcards in Cardio Deck (16):
1

A nurse is assessing a client who has a history of DVT and is receiving warfarin. The nurse should identify that thich of the following findings indicates teh medication is effective?

Hemoglobin 14 g/dL

Minimal bruising of extremities

Decreased bp

INR 2.0

INR 2.0

Desired reference range
2.0 to 3.0 for a client who has a DVT and is receiving warfarin

2

A nurse is providing discharge teaching for a client who has a prescription for the transdermal nitroglycerin patch. Which of the following instructions should the nurse include in the teaching?

Apply the new patch to the same site as the previous patch.

Rotating the patch site can help prevent skin irritation.

Place the patch on an area of skin away from skin folds and joints.

The client should apply the patch to an area of skin that is not prone to movement or wrinkling.

Keep the patch on 24 hr per day.

INCORRECT


The client should have a patch-free interval of 10 to 12 hr per day to help prevent tolerance to the medication.

Replace the patch at the onset of angina.

INCORRECT


The nurse should emphasize that nitroglycerin patches offer ongoing prevention of angina attacks. The patches do not treat angina attacks because they do not take effect immediately.

Place the patch on an area of skin away from skin folds and joints.

3

The client should have a patch free interval of ________ to prevent tolerance to the medication.

10 to 12 hours per day

4

The nurse should emphasize that nitroglycerin patches offer ongoing prevention of ________.

angina attacks (do not take effect immediately)

5

A nurse in the emergency department is caring for a client who had an anterior myocardial infarction. The client's history reveals she is 1 week postoperative open cholecystectomy. The nurse should recognize that which of the following interventions is contraindicated?

Administering IV morphine sulfate

Administering oxygen at 2 L/min via nasal cannula

Helping the client to the bedside commode

Assisting with thrombolytic therapy

Assisting with thrombolytic therapy

*** the nurse should recognize the major surgery within the previous 3 weeks is a contraindication for thrombolytic therapy.

6

Using a bedside commode is less stressful than using _____, and most clients are allowed to use a commode following a MI.

a bedpan

7

A nurse is caring for a client who is being treated for heart failure and has prescriptions for digoxin and furosemide. The nurse should plan to monitor for which of the following as an adverse effect of these medications?

SOB
lightheadedness
dry cough
metallic taste

lightheadedness

***Furosemide can cause a substantial drop in blood pressure, resulting in lightheadedness.

8

A nurse is admitting a client who has a leg ulcer and a history of diabetes mellitus. The nurse should use which of the following focused assessments to help differentiate between an arterial ulcer and a venous stasis ulcer?

Explore the client's family history of peripheral vascular disease

Note the presence or absence of pain at the ulcer site.

Inquire about the presence or absence of claudication.

Ask if the client has had a recent infection.

Inquire about the presence or absence of claudication

***Knowing if the client is experiencing claudication helps differentiate venous from arterial ulcers. Clients who have arterial ulcers experience claudication, but those who have venous ulcers do not.

9

A nurse is caring for a client who has endocarditis. Which of the following findings should the nurse recognize as a potential complication?

Ventricular depolarization

Guillain-Barre syndrome

Myelodyslastic syndrome

Valvular disease

Valvular disease

**** Valvular disease or damage often occurs as a result of inflammation or infection of the endocardium.

10

A nurse is watching a client's ECG monitor and notes that the client's rhythm has changed from a normal sinus rhythm to supraventricular tachycardia. The client is conscious with a heart rate of 200 to 210/min and has a faint radial pulse. The nurse should anticipate assisting with which of the following interventions?

Delivery of a precordial thump

Vagal stimulation

Administration of atropine IV

Defibrillation

Vagal stimulation

Vagal stimulation can help the client's heart return to a normal sinus rhythm temporarily.

11

A nurse is preparing a client for coronary angiography. The nurse should report which of the following findings to the provider prior to the procedure?

•Hemoglobin 14.4 g/dL

History of peripheral arterial disease

Urine output 200 mL/4 hr

Previous allergic reaction to shellfish

Previous allergic reaction to shellfish

The contrast medium used is iodine-based. Clients who have a history of allergic reaction to shellfish often react to iodine and might need a steroid or antihistamine.

12

A nurse is caring for a client in the first 8 hr following coronary artery bypass graft (CABG) surgery. Which of the following client findings should the nurse report to the provider?

•Mediastinal drainage 100 mL/hr

Blood pressure 160/80 mm Hg

Temperature 37.1° C (98.8° F)

Potassium 3.8 mEq/L

Blood pressure 160/80 mm Hg

The nurse should report an elevated blood pressure following a CABG procedure because increased vascular pressure can cause bleeding at the incision sites.

13

A nurse is providing discharge teaching for a client who has heart failure. The nurse should instruct the client to report which of the following findings immediately to the provider?


•Weight gain of 0.9 kg (2 lb) in 24 hr

Increase of 10 mm Hg in systolic blood pressure

Dyspnea with exertion

Dizziness when rising quickly

Weight gain of 2 lb in 24 hour

When using the urgent vs. nonurgent approach to client care, the nurse should determine that the priority finding is a weight gain of 0.5 to 0.9 kg (1 to 2 lb) in 1 day. This weight gain is an indication of fluid retention resulting from worsening heart failure. The client should report this finding immediately.

14

A nurse is assessing a client who has left-sided heart failure. Which of the following manifestations should the nurse expect to find?

Increased abdominal girth

Weak peripheral pulses

Jugular venous neck distention

Dependent edema

Weak peripheral pulses

CORRECT


Weak peripheral pulses are related to decreased cardiac output resulting from left-sided heart failure.

15

A nurse is caring for a client who has a history of angina and is scheduled for a stress test at 1100. Which of the following statements by the client requires the nurse to contact the provider for possible rescheduling?

•"I'm still hungry after the bowl of cereal I ate at 7 a.m."

"I didn't take my heart pills this morning because the doctor told me not to."

"I have had chest pain a couple of times since I saw my doctor in the office last week."

"I smoked a cigarette this morning to calm my nerves about having this procedure."

Smoking prior to the test can change the outcome and places the client at additional risk, so the test should be rescheduled.
...


"I smoked a cigarette this morning to calm my nerves about having this procedure."

CORRECT


Smoking prior to the test can change the outcome and places the client at additional risk, so the test should be rescheduled.
...

16

A nurse is caring for a client in the first hour following an aortic aneurysm repair. Which of the following findings can indicate shock and should be reported to the provider?

•Serosanguineous drainage on dressing

Severe pain with coughing

Urine output of 20 mL/hr

Increase in temperature from 36.8° C (98.2° F) to 37.5° C (99.5° F)

Urine output of 20 mL/hr

CORRECT


Urine output less than 30 mL/hr can indicate shock because it reflects decreased blood flow to the kidneys, possibly from graft rupture and hemorrhage.