PrepU Perfusion Flashcards
When reviewing beta1-selective adrenergic blocking agents, which medication is found to be most often prescribed for clients diagnosed with hypertension?
Atenolol: More widely used than other drugs of this class for HTN
A distressed client who is 33 weeks’ pregnant calls the nurse. The client is crying and says, “Something is wrong with me. I cannot sleep, my shoes do not fit, my rings do not fit, even my face is swollen. I have heartburn all day, and now I have a headache and keep seeing spots and flashes of light.” Based on this information, which instruction should the nurse give this client?
A. You need to come to labor and delivery to be evaluated
B. You need to come into the office tomorrow to have your blood pressure checked
C. You need to be on bed rest for the next 48 hours
D. Monitor fetal activity and let us know if it decreases
A: Ct. is demonstrating s/s of preeclampsia and needs to be evaluated at the labor and delivery unit ASAP. Given the headache and vision changes, waiting 24 hours to evaluate the BP is too long. Bed rest and home monitoring of fetal activity are inappropriate given the S/S.
Which is a key indicator of HF?
A. creatinine levels
B. BUN
C. Brain natriuretic peptide (BNP)
D. CBC
C. BNP is key diagnostic indicator of HF. High levels of BNP are a sign of high cardiac filling pressure and can aid in diagnosis.
Which measurement of waist circumference would lead the nurse to suspect a female client is at an increased risk for CVD and DM?
> 35 = increased risk for DM, HTN, HLD, CVD
The nurse is assessing a client with a cardiac condition who reports fatigue and nocturia. The nurse should recognize what implication of this statement?
A. A conduction problem
B. Adequate compensation
C. Coronary Artery Disease
D. HF
With HF, increased renal perfusion during periods of rest or recumbency may cause nocturia. This does not signal CAD, a conduction problem, or adequate compensation.
Which valve does contraction of the R. atrium send blood through?
tricuspid valve
A ct. recovering from a stoke reports of pain. The nurse suspects this ct. is most likely experiencing which type of pain?
A. nociceptive
B. neuropathic
C. idiopathic
D. visceral
B: neuropathic pain can occur from CNS brain injury caused by a stroke. Nociceptive pain is caused by tissue damage. Somatic pain is another term used for nociceptive pain. Idiopathic pain has no identified cause.
The nurse is performing a respiratory assessment of a ct. who has been experiencing episodes of hypoxia. The nurse is aware that this example of impaired gas exchange is primarily dependent upon what?
An inadequate ventilation-perfusion ratio is was adequate gas exchange is dependent on.
A pregnant client in in the third trimester, lying supine on the examination suddenly grows very short of breath and dizzy. Concerned, the ct. asks me what is happening. What should I respond?
Blood is trapped in the vena cava in a supine position
What is a cardiac catheterization used for?
Usually done to assess how blocked or open a ct.’s coronary arteries are.
A ct. comes to the dermatology clinic requesting removal of a port-wine stain on their right cheek. Which procedure is especially useful in treating cutaneous vascular lesions such as port-wine stains?
Laser tx
For both outpatients and inpatients scheduled for a diagnostic procedure of the cardiovascular system, the nurse performs a thorough initial assessment to establish accurate baseline data. Which data is necessary to collect if the client is experiencing chest pain?
A. BP in the left are
B. HR
C. Description of pain
D. RR
C: HX of location frequency, and duration. Description, including radiation, precipitation, and relief. I would weight the ct. and measure vital signs. May measure BP in both arms and compare findings. Assess apical and radial pulses, noting rate, quality, and rhythm. Check peripheral pulses in lower extremities.
What does decreased pulse pressure reflect?
A. Reduced stroke volume
B. elevated stroke volume
A: decreased pulse pressure reflected reduced stroke volume and ejection velocity or obstruction to the blood flow during systole. Increase pulse pressure would indicated reduced distensibility of the arteries, along with bradycardia…
In which stage of a pressure injury to be considered a partial-thickness wound?
II
- I = area of erythema that does not blanch with pressure
- III = pressure injury extends into SC tissue
- IV = extends to underlying muscle and bone.
The surgical client is at risk for injury related to positioning. Which of the following clinical manifestations exhibited by the ct. would indicate the goal was met of avoiding injury?
A. Vitals all WNL for the client
B. Absence of itching
C. Peripheral pulses palpable
C. Surgical cts are at risk for pressure ulcers and damage to nerves and blood vessels as a result of awkward positioning required for surgical procedures. Palpable peripheral pulses indicate integrity of blood vessels
A ct. is admitted with weakness, expressive aphasia, and right hemianopia. The brain MRI reveals an infarct. The nurse understands these symptoms to be suggestive of which of the following findings?
Left-sided cerebrovascular accident (CVA). When the infarct is on the left side of the brain, the symptoms are likely to be on the right and the speech is more likely to be involved. If the MRI reveals an infarct, trans ischemic attack (TIA) is no longer the diagnosis.
A school-age child is admitted to the ER with a possible concussion following a collision when playing football. After the collision , the parents state the child was “knocked out” for a few minutes before recognizing their surroundings. What is the priority assessment when the nurse first sees the client?
A. Head circumference
B. Evaluation of all cranial nerves
C. Assessment of vital signs and respiratory status
D. Start an IV for rehydration
Assessment of vital signs and respiratory status: assessment after a head injury includes immediate evaluation of airway, breathing, and circulation. Therefor, assessment of vital signs and respiratory status is a priority for the ct. Head circumference is only beneficial in children less than 2 y.o. and/or with open fontanels. Eval. of all cranial nerves does not take priority over cardiopulmonary assessment. Assessment comes before intervention in the nursing process and more assessment is needed for the client before the need for an IV line is determined.
S/S of compensatory stage of shock:
-normal BP
-tachycardia
-decreased urinary output
-confusion
-respiratory alkalosis
I am asked to describe the difference between sinus rhythm and sinus bradycardia on an ECG strip:
All characteristics of sinus bradycardia are the same as those of normal sinus rhythm except for the rate, which will be below 60 in sinus bradycardia. P waves will be shaped differently in other dysrhythmias. QRS is the same voltage for sinus rhythms. P-R interval is prolonged in atrioventricular blocks.
When assessing a client for possible varicose veins, which of the following would the nurse do?
A. Obtain the ankle-brachial index
B. Raise the client’s legs
C. Have the client stand for the exam
D. Dorsiflex the foot
C. Varicose veins may not be visible when ct. is supine and not as pronounced when the ct. is sitting.
Most common cause of shock?
Hypovolemia
Which nursing intervention should a nurse perform to reduce cardiac workload in a ct. diagnosed with myocarditis?
A. Raise the head of the bead
B. Administer prescribed antipyretic
C Maintain the client on bed rest
D. Administer supplemental oxygen as needed
C: Bed rest can reduce cardiac workload and promote healing. Also helps decrease myocardial damage and complications of myocarditis.
-Nurse should administer supplemental oxygen to relieve tachycardia that may develop from hypoxemia
-Ct. has a fever, nurse should admin. antipyretic and minimize layers of bed linen, promoting air circulation and evaporation of perspiration, and offering oral fluids.
-Elevation of the head promotes maximal breathing potential
The PT notifies the nurse that a ct. with coronary artery disease (CAD) experienced a significant increase in HR during physical therapy. The nurse recognizes that an increase in HR in a ct. with CAD may result in which outcome?
A. Myocardial ischemia
B. Formation of a pulmonary embolism
A: unlike other arteries, coronary arteries are perfused during diastole. An increased HR shortens diastole and can decrease myocardial perfusion. Ct.s particularly those with CAD, can develop myocardial ischemia.
