Quiz # 3 Cardiology Flashcards
A nurse is caring for a client with infective endocarditis. Which of the following manifestations is the priority for the nurse to monitor for?
A. anorexia
B. dyspnea
C. fever
D. malaise
D. Dyspnea
-When using the airway, breathing, circulation (ABC) approach to client care, the nurse determines the priority manifestation to monitor for is dyspnea. Dyspnea can be an indication of left-sided heart failure, or a pulmonary infarction due to embolization
A nurse is caring for a client who is scheduled for an exercise stress test. Which of the following comments made by the client should indicate to the nurse that the client requires further teaching?
A. “I’ll skip my coffee the morning of my test.”
B. “I’ll take my heart medications the morning of my test.”
C. “I’ll get 8 hours of sleep the night before the test.”
D. “I will not smoke prior to my test.”
B. “Ill take my heart meds the morning of the test”
Informing the provider of any medications they are taking, as some medications may need to be withheld or adjusted before the test, such as beta blockers, calcium channel blockers, nitrates, or antiarrhythmics. These medications can affect the heart rate and blood pressure and interfere with the interpretation of the test results.
A nurse is preparing a client who is scheduled for an echocardiogram the following day. Which of the following instructions should the nurse include about the test?
A. “It might cause slight discomfort in the chest area.”
B. “It takes about 5 or 10 minutes.”
C. “It requires lying quietly on one side.”
D. “It is best to have no food or beverages the day of the test.”
C. “It requires lying quietly on one side.”
Question: A nurse is assisting with the care of a client who is postoperative following a cardiac catheterization via the femoral artery. Which of the following actions should the nurse take? (Select all that apply.)
(Select all that apply.)
A. Check peripheral pulses in the affected extremity.
B. Place the client in high Fowler’s position.
C. Measure the client’s vital signs every 8 hr
D. Keep the client’s hip and leg extended.
E. Have the client remain in bed up to 6 hr
A. Check peripheral pulses in the affected extremity.
D. Keep the client’s hip and leg extended.
E. Have the client remain in bed up to 6 hr
The nurse obtains a health history from a 65-year-old patient with a prosthetic mitral valve who has symptoms of infective endocarditis (IE). Which question by the nurse is most appropriate?
a. “Do you have a history of a heart attack?”
b. “Is there a family history of endocarditis?”
c. “Have you had any recent immunizations?”
d. “Have you had dental work done recently?”
d. “Have you had dental work done recently?”
(infect)ive = infection)
Dental procedures place the patient with a prosthetic mitral valve at risk for infective endocarditis (IE). Myocardial infarction (MI), immunizations, and a family history of endocarditis are not risk factors for IE.
The nurse has identified a nursing diagnosis of acute pain related to inflammatory process for a patient with acute pericarditis. An appropriate intervention by the nurse for this problem is to
a. teach the pt to take deep, slow breaths to control the pain.
b. force fluids to 3000 mL/day to decrease fever and inflammation.
c. provide a fresh ice bag every hour for the pt to place on the chest.
d. place the patient in Fowler’s position, leaning forward on the overbed table.
d. place the patient in Fowler’s position, leaning forward on the overbed table.
Sitting upright and leaning forward frequently will decrease the pain associated with pericarditis. Forcing fluids will not decrease the inflammation or pain. Taking deep breaths will tend to increase pericardial pain. Ice does not decrease this type of inflammation and pain.
A pt recovering from heart surgery develops pericarditis and complains of level 6 (0 to 10scale) chest pain with deep breathing. Which prescribed PRN medication will be the most
appropriate for the nurse to give?
a. Fentanyl 1 mg IV
b. IV morphine sulfate 4 mg
c. Oral ibuprofen (Motrin) 600 mg
d. Oral acetaminophen (Tylenol) 650 mg
c. Oral ibuprofen (Motrin) 600 mg
The pain associated with pericarditis is caused by inflammation, so nonsteroidal antiinflammatory drugs (e.g., ibuprofen) are most effective. Opioid analgesics and acetaminophen are not very effective for the pain associated with pericarditis
Which assessment finding obtained by the nurse when assessing a patient with acute pericarditis should be reported immediately to the health care provider?
a. Pulsus paradoxus 8 mm Hg
b. Blood pressure (BP) of 168/94 mm Hg
c. Jugular venous distention (JVD) to jaw level
d. Level 6 (0 to 10 scale) chest pain with a deep breath
c. Jugular venous distention (JVD) to jaw level
The JVD indicates that the pt may have developed cardiac tamponade and may need
rapid intervention to maintain adequate cardiac output. Hypertension would not be associated
with complications of pericarditis, and the BP is not high enough to indicate that there is any
immediate need to call the health care provider. A pulsus paradoxus of 8 mm Hg is normal. Level 6/10 chest pain should be treated but is not unusual with pericarditis
Patient bathroom trip vital signs within normal range
Allow them continued bathroom privileges
Patient states cabg procedure is a cure. How should pt respond ATI question
“CABG procedure is not a cure. But will relieve symptoms”
A patient is considering options to manage his/her coronary artery disease. The nurse explains a coronary artery bypass graft (CABG) procedure will:
a. Cure the patients coronary artery disease
b. Replace the leaking valve in the heart
c. Connect grafts to aorta to improve blood flow.
d. Place a permanent pacemaker on the heart
c. Connect grafts to aorta to improve blood flow.
Patient history leading to restrictive cardiomyopathy
History of cocaine use??
The nurse knows that the most common cardiomyopathy that occurs in middle aged makes presenting with ventricular contraction impairment, dilated heart chambers secondary to exposure to toxins, metabolic conditions, alcohol and cocaine use is called
A. Dilated cardiomyopathy
B. Hypertrophic cardiomyopathy
C. Restrictive cardiomyopathy
D. Menopausal cardiomyopathy
A. Dilated cardiomyopathy
A 14 year old child was recently diagnosed with hypertrophic cardiomyopathy. During a follow-up appointment, the mother asks the nurse, “How will this affect my child’s ability to play football in the fall?” How should the nurse respond?
A) “This shouldn’t affect his ability to play football.”
B) “Children with cardiomyopathy should not play football.”
C) “He could participate in flag football but not tackle football.”
D) “This may actually make him a better, stronger football player.”
B) “Children with cardiomyopathy should not play football.”
Children with cardiomyopathy should not play competitive sports due to the possibility of collapse or increased heart failure. Depending on the child’s clinical status, low-impact activities may be appropriate, but this should be discussed with the child’s physician.
A nurse is completing discharge planning for a client who has bacterial endocarditis. The client will need to receive 12 weeks of antibiotic therapy. Which of the following venous access devices would be appropriate for the client?
A. Surgically placed central catheter
B. Implanted infusion port
C. Peripherally inserted central catheter
D. Arteriovenous fistula
C. Peripherally inserted central catheter
This is a long, thin catheter inserted into a peripheral vein (e.g., in the arm) and advanced until the tip is in a large vein near the heart. It can remain in place for weeks to months, making it suitable for prolonged antibiotic therapy like 12 weeks.
