CARDIAC - RHYTHMS - SYMPTOMS

Question 1

A _____ or _____ is indicative of a low potassium level.

Answer 1

flattened T wave or the development of U waves

Question 2

The client has a digoxin level within the therapeutic range of 0.5 to 0.8 ng/mL. _____ are a few of the dysrhythmias occurring with toxic digoxin levels.

Answer 2

AV BLOCK - V-FIB - V-TACH

Question 3

The client who has low hemoglobin will manifest _____ on the ECG rhythm because of the compensatory mechanism that provides oxygen to vital organs. The ECG pattern anticipated with low hemoglobin is tachycardia.

Answer 3

TACHYCARDIA

Question 4

The client who has hypocalcemia can have a prolonged S-T interval and a prolonged Q-T interval, but not a flattened T wave.

Answer 4

PROLONGED S-T INTERVAL & PROLONGED Q-T INTERVAL

Question 5

ASSESSMENT FINDING OF UNSTABLE ANGINA?

Answer 5

1. will have chest pain even while resting because of insufficient blood flow to the coronary arteries and decreased oxygen supply. Chest pain at rest is a condition called variant (Prinzmetal’s) angina, caused by an artery spasm.
2. will have minimal, if any, relief of chest pain from nitroglycerin. This is due to the reduced blood flow in a coronary artery due to atherosclerotic plaque and thrombus formation causing partial arterial obstruction.
3. will report chest pain or discomfort with exertion, which can limit the client’s activity. This is due to the reduced blood flow in a coronary artery due to atherosclerotic plaque and thrombus formation causing partial arterial obstruction.
4. will have chest pain lasting longer than 15 min. This is due to the reduced blood flow in a coronary artery due to atherosclerotic plaque and thrombus formation causing partial arterial obstruction, or from an artery spasm.

Question 6

A nurse is assessing a client who has fluid volume overload from a cardiovascular disorder. Which of the following manifestations should the nurse expect? (Select all that apply.)

Answer 6

1. Jugular vein distension - increase in venous pressure due to excessive circulating blood volume results in neck vein distension.
2. Moist crackles - is an indicator of pulmonary edema that can quickly lead to death.
3. Increased heart rate - Fluid volume excess, or hypervolemia, is an expansion of fluid volume in the extracellular fluid compartment. This results in increased heart rate and bounding pulses.

Question 7

____ is common in clients who are experiencing dehydration, not fluid volume excess.

Answer 7

FEVER

Question 8

_____ occurs when bacteria invades the endothelial surface of the heart. It is usually seen in clients who have prosthetic heart valves or pacemakers.

Answer 8

Infective endocarditis

Question 9

A nurse is monitoring a client who had a myocardial infarction. For which of the following complications should the nurse monitor in the first 24 hr?

Answer 9

After a myocardial infarction, the electrical conduction system of the heart can be irritable and prone to dysrhythmias. Ischemic tissue caused by the infarction can also interfere with the normal conduction patterns of the heart’s electrical system.

Question 10

_____ can occur 10 days to 2 months following a myocardial infarction. It is an inflammation of the pericardial sac that surrounds the heart and is usually a result of infection, connective tissue disorders, or trauma.

Answer 10

Pericarditis

Question 11

_____occur if the client develops heart failure following a myocardial infarction. They are found more commonly with valvular disorders, atrial fibrillation, or from a deep-vein thrombosis.

Answer 11

Pulmonary emboli

Question 12

Assessment findings - abd aortic aneurysm

Answer 12

1. The nurse should assess for mid or lower abdominal pain to the left of the midline because of the enlarged artery mass.
2. The nurse should auscultate for a bruit heard over the location of the mass.
3. Pitting edema is a manifestation of heart failure. This is not an assessment the nurse should find with an abdominal aortic aneurysm.
4. Abdominal aortic aneurysm involves a widening, stretching, or ballooning of the aorta. Back and abdominal pain indicate that the aneurysm is extending downward and pressing on lumbar spinal nerve roots, causing pain.

Question 13

Assessment findings - late-stage heart failure fluid overload

Answer 13

1. A weight gain of 1 kg (2.2 lb) in 1 day alerts the nurse that the client is retaining fluid and is at risk of fluid volume overload. This is an indication that the client’s heart failure is worsening.
2. Pitting edema, a visible finger indentation after application of pressure, alerts the nurse that the client has retained fluid and demonstrates that there is fluid in the client’s tissues. Pitting edema is rated on a scale of mild (+1) to severe (+3). Pitting edema of +3 is an indication that the client has developed fluid volume overload and the heart failure is worsening.
3. Client report of nocturnal cough
   The client who is in the early stages of heart failure might report a cough that is irritating, occurs at night, and is nonproductive.
4. BNP levels increase as the result of the ventricular hypertrophy that occurs in heart failure. A BNP level above 100 pg/mL is indicative of heart failure. Levels continue to increase with the severity of the heart failure.