CHAPTER 32 quiz Flashcards
A 55-year-old man with aortic valve stenosis is being admitted for valve replacement surgery which assessment findings should the nurse expect answer systolic murmur
Systolic murmur
a 74-year-old woman who has a history of heart failure and chronic obstructive lung disease which which diagnostic study with the nurse expect to be elevated if the cause of death was cardiac related
BNP
The nurse is a 62-year-old woman underground radiation for breast cancer how should the nurse patient to auscultate for signs of acute pericarditis
Sitting and leaning forward
Repairing to teaching group of women in the community about heart disease what should the nurse include in the teaching plan
Women are more likely to have non-cardiac symptoms of heart disease
A 64-year-old patient with a history of myocardial infarction is scheduled for a transesophageal echo cardio gram to visualize a suspected clot in the left atrium what information should the nurse include when teaching the patient about this diagnostic study
The intravenous sedation may be administered to help the patient relax the rationale is intravenous sedation is administered to help the patient relax and ease the insertion of the tube into the esophagus
The most tedious a 28-year-old man newly diagnosed with hypertension about lifestyle modifications to reduce his blood pressure which statement by the patient acquires intervention by the
I can lower my blood pressure by switching to smokeless tobacco the rationale is nicotine contained and tobacco products smoking and chew cause vasoconstriction and increase blood pressure
The nurse supervisor is an unlicensed assistant who is taking the blood pressure of a 58-year-old female patient admitted with heart failure the patient is obese the nurse should intervene what is absurd absurd observed
That uap deflates the blood pressure cuff at 8 to 10 per second the rationale be deflated to her second the arm should you supported at the level of the heart but pressure minute
44-year-old man is diagnosed with hypertension and receives a prescription for lotensin benazapril after the nurse teaches him about the medication which statement by the patient indicates his correct understanding
If I develop a dry cough while taking this medication I should notify my doctor
A 67-year-old woman with a history of her disease and prior myocardial infarction emergency department with a blood pressure of 238/148 and started on IV nitroprusside(nitropress) what should the nurse deerine as an appropriate goa for the first hour oftreatment
mean arterial pressure no lower than 133 mmhg
the nurse admits a 73 y/o m pt with dementia for tx of uncontrolled htn the nurse will closely monitor for hypokalemia if the pt recvs which med
bumetadine (bumex) a loop diuretic..hypokalemia is common a/e of this rx…the opposite affect for spironolacone and amiloride
the rn prepared a d/c teaching plan for a 44 y/o m pt who has recently been diagnoses withcoronoary artery dz. which risk factor sbould the nurse plan to fcus on dring theteaching session
elevated serum levels. dislipidemia is one of the four major modfiable risk factors for coronary artery dz CAD.
The nurse instructs a 68-year-old woman With hypercholesterolemia about lowering the nurse to turn further teaching is necessary if the patient makes makes which statement
I will take garlic instead of my prescription medication to reduce my cholesterol the rationale current evidence does not support using garlic in the treatment of elevated cholesterol strong evidence supports the use of omega-3 fatty acid’s duction of tryglyceride lvls
A 52 patient has received Activase for an st elevation or STEMI to determine the effectiveness of this medication the nurse should assess the pt for the
presence of chest pain
74 y/o man witha hisotry o f prostate cancer and htn is admitted to the ER with substernal chest pain which will the urse complete before administering sublingal nitroglycerin
obtain a 12 lead ecg
hich patient is at greatest risk for sudden cardiac death?
A 52-year-old African American man with left ventricular failure
The home care nurse visits a 73-year-old Hispanic woman with chronic heart failure. Which clinical manifestations, if assessed by the nurse, would indicate acute decompensated heart failure (pulmonary edema)?
evere dyspnea and blood-streaked, frothy sputum
54-year-old male patient who had bladder surgery 2 days ago develops acute decompensated heart failure (ADHF) with severe dyspnea. Which action by the nurse would be indicated first?
Assist the patient to a sitting position with arms on the overbed table.
A70-year-old woman with chronic heart failure and atrial fibrillation asks the nurse why warfarin (Coumadin) has been prescribed for her to continue at home. Which response by the nurse is accurate?
“The medication prevents blood clots from forming in your heart.”
The nurse prepares to administer digoxin (Lanoxin) 0.125 mg to an 82-year-old man admitted with influenza and a history of chronic heart failure. What should the nurse assess before giving the medication?
Serum potassium level
At a clinic visit, the nurse provides dietary teaching for a 56-year-old woman who was recently hospitalized with an exacerbation of chronic heart failure. The nurse determines that teaching is successful if the patient makes which statement?
“I will limit the amount of milk and cheese in my diet.”
A 38-year-old teacher who reported dizziness and shortness of breath while supervising recess is admitted with a dysrhythmia. Which medication, if ordered, requires the nurse to carefully monitor the patient for asystole?
Adenosine (Adenocard).....Rationale IV adenosine (Adenocard) is the first drug of choice to convert supraventricular tachycardia to a normal sinus rhythm. Adenosine is administered IV rapidly (over 1 or 2 seconds) followed by a rapid, normal saline flush. The nurse should monitor the patient's ECG continuously because a brief period of asystole after adenosine administration is common and expected. Atropine sulfate increases heart rate, whereas lanoxin and metoprolol slow the heart rate.
he nurse is monitoring the ECGs of several patients on a cardiac telemetry unit. The patients are directly visible to the nurse, and all of the patients are observed to be sitting up and talking with visitors. Which patient’s rhythm would require the nurse to take immediate action?
52-year-old man with premature ventricular contractions (PVCs) at a rate of 12 per minute……
Cardioversion is attempted for a 64-year-old man with atrial flutter and a rapid ventricular response. After the nurse delivers 50 joules by synchronized cardioversion, the patient develops ventricular fibrillation. Which action should the nurse take immediately?
Turn the synchronizer switch to the “off” position and recharge the device.
The nurse performs discharge teaching for a 74-year-old woman with an implantable cardioverter-defibrillator. Which statement by the patient indicates to the nurse that further teaching is needed?
“I can expect redness and swelling of the incision site for a few days.”
