Cardiovascular Disorders Flashcards
A client returns from a left heart catheterization. The right groin was used for catheter access. To evaluate distal blood flow, the nurse should palpate the pulse on this client at which location?
a. anterior to the right tibia
b. dorsal surface of the right foot
c. posterior to the right knee
d. right midinguinal area
B
The nurse is caring for a client diagnosed with an anterior myocardial infarction (MI) 2 days ago. Upon assessment, the nurse identifies a
systolic murmur at the apex. What should the nurse do first?
a. Assess for changes in vital signs.
b. Draw blood for an arterial blood gas test.
c. Evaluate heart sounds with the client leaning forward.
d. Obtain a 12-lead electrocardiogram (ECG).
ANS: 1
The nurse should first obtain vital signs because changes in the vital signs will reflect the severity of the sudden drop in cardiac output: a decrease in blood pressure, an increase in the heart rate, and
an increase in the respiration rate. Infarction of the papillary muscles is a potential complication of an MI, causing ineffective closure of the
mitral valve during systole. Mitral regurgitation results when the left ventricle contracts and blood flows backward into the left atrium,
which is heard at the fifth intercostal space at the left midclavicular line. The murmur worsens during expiration and in the supine or leftside
position and can best be heard when the client is in these
positions, not with the client leaning forward. A 12-lead ECG views the electrical activity of the heart; an echocardiogram views valve function.
A client with acute chest pain is receiving IV morphine sulfate. Which effect(s) of morphine would be expected? Select all that apply.
a. reduces myocardial oxygen consumption
b. promotes reduction in respiratory rate
c. prevents ventricular remodeling
d. reduces blood pressure and heart rate
e. reduces anxiety and fear
ANS: A, D, E
Morphine sulfate acts as an analgesic and sedative. It
also reduces myocardial oxygen consumption, blood pressure, and heart rate. Morphine also reduces anxiety and fear because of its
sedative effects and by slowing the heart rate. It can depress
respirations; however, such an effect may lead to hypoxia, which should be avoided in the treatment of chest pain. Angiotensinconverting
enzyme inhibitor drugs, not morphine, may help prevent
ventricular remodeling.
The nurse notices that a client’s heart rate decreases from 63 bpm to 50 bpm on the monitor. What should the nurse do first?
a. Administer atropine 0.5 mg via intravenous (IV) push.
b. Auscultate for abnormal heart sounds.
c. Prepare for transcutaneous pacing.
d. Take the client’s blood pressure.
ANW: D
The nurse should first assess the client’s tolerance to the drop in heart rate by checking the blood pressure and level of consciousness and determining if atropine is needed. If the client is symptomatic, atropine and transcutaneous pacing are interventions for symptomatic
bradycardia. Once the client is stable, further physical assessments can be done.
The nurse is preparing a client for a cardiac angiogram. What action(s) should the nurse take? Select all that apply.
a. Determine if the client has an allergy to liquid contrast
material.
b. Inform the client that an intravenous infusion will be started before the procedure.
c. Remind the client to have nothing to eat or drink 8 hours
before the procedure.
d. Instruct the client to remain still during the procedure.
e. Explain that the client will receive a fast-acting acting
anesthetic.
ANS: A,B,C,D
When preparing the client for a cardiac angiogram,
the nurse should determine if the client has an allergy to the liquid contrast medium used in the procedure. Contrast dyes contain iodine, and the administration of a dye could lead to an anaphylactic response in clients who are allergic to the dye. An intravenous infusion will be
started before the procedure to administer the contrast dye. The client should not eat or drink for 8 hours prior to the procedure. The client
may experience a flushing sensation, but this is a normal response and does not indicate a life-threatening reaction. The client may receive light sedation, but not an anesthetic as the client must be awake to follow instructions. The client should be instructed to remain still during the procedure.
