![]() NCLEX 3. 50. 0: Cardiac . To monitor the effectiveness of the intervention, the nurse should focus primarily on the client’s: 1. The best indicator of its effectiveness is a reduction in or disappearance of ventricular arrhythmias as seen on an ECG. Urine output is an indicator of pump effectiveness; CK and troponin levels monitor myocardial damage. Blood pressure and heart rate measurements are too nonspecific to help determine the effectiveness of parenteral lidocaine. A client is admitted to the emergency department after complaining of acute chest pain radiating down his left arm. ![]() Feeding the Cardiac Patient Heart disease most commonly results in abnormalities of physiology that require special dietary considerations. The American College of. Perfect Diet - Perfect Nutrition Toxic Heavy Metal Poisoning, Contamination, Symptoms, Testing, Chelation, and Detox Protocols. Mercury, Lead, Arsenic, Cadmium. Low-sodium diet might not lower blood pressure Findings from large, 16-year study contradict sodium limits in Dietary Guidelines for Americans. Background It is known that obesity, sodium intake, and alcohol consumption influence blood pressure. In this clinical trial, Dietary Approaches to Stop Hypertension. Which laboratory studies would be indicated? Hemoglobin and hematocrit 2. Serum glucose 3. Creatinine phosphokinase (CPK) 4. Troponin T and troponin I 5. ![]() Myoglobin 6. Blood urea nitrogen (BUN)Correct Answer: 3,4,5 RATIONALES: Levels of CPK, troponin T, and troponin I elevate because of cellular damage. Myoglobin elevation is an early indicator of myocardial damage. Hemoglobin, hematocrit, serum glucose, and BUN levels don’t provide information related to myocardial ischemia. A client is admitted to an acute care facility with pneumonia. When auscultating heart sounds, the nurse notes a fixed split of the second heart sound (S2) — a pathological split that doesn’t vary with respirations. A fixed S2 split is the hallmark of: 1. Background Low-carbohydrate diets have been advocated for weight loss and to prevent obesity, but the long-term safety of these diets has not been determined. REVIEW ARTICLE. Diet and nutritional aspects in systemic lupus erythematosus. Karin Klack I; Eloisa Bonfa II; Eduardo Ferreira Borba Neto III. I Nutritionist of the. A “low-potassium diet” may sound weird, because so often we’re told to increase our intake of potassium. But, recently, I met a woman (I’ll call her Teena. ![]() This split, which is continuous and doesn’t vary with respirations, results from prolonged emptying of the right ventricle. A right bundle- branch block causes a wide S2 split that is louder on inspiration than on expiration; this split results from delayed depolarization of the right ventricle and late pulmonic valve closure. Left bundle- branch block, aortic stenosis, and patent ductus arteriosus cause a paradoxical S2 split. Heard only on expiration, a paradoxical S2 split results from delayed aortic valve closure. A client with an acute myocardial infarction is receiving nitroglycerin (Tridil) by continuous I. V. Which statement by the client indicates that this drug is producing its therapeutic effect? Headache is an adverse effect of nitroglycerin. The drug shouldn’t cause a tingling sensation around the mouth and should lower, not raise, blood pressure. A client with refractory angina is scheduled for a percutaneous transluminal coronary angioplasty (PTCA). The cardiologist orders an infusion of abciximab (Reo. Pro). Before beginning the infusion, the nurse should ensure the client has: 1. Before abciximab is administered, the client should have an up- to- date PTT result available. The drug isn’t contraindicated in clients with a seizure history. Abciximab isn’t an opioid; therefore, an opioid antagonist doesn’t need to be at the bedside. Any client with refractory angina should be on continuous ECG monitoring; however, monitoring isn’t a requirement for administering abciximab. The telemetry unit nurse is caring for a client who was just transferred from the coronary care unit (CCU). The client is anxious because he fears he won’t be monitored as closely as he was in the CCU. How can the nurse allay his fears? ![]() Learn about the causes, symptoms, diagnosis & treatment of Electrolyte Disorders from the Professional Version of the Merck Manuals. Heart failure develops when the heart, via an abnormality of cardiac function (detectable or not), fails to pump blood at a rate commensurate with the requirements of. ![]() Assign the same nurse to the client when possible. Allow the client uninterrupted periods of rest as much as possible. Limit the client’s visitors to coincide with CCU visiting policy. Move the client to a room far from the nurses’ station to reduce his exposure to noise. Correct Answer: 1 RATIONALES: Assigning the same nurse to the client when possible provides continuity of care and stability, thereby reducing his anxiety. The client needs uninterrupted periods of rest; however, providing as much rest as possible may leave the client feeling isolated. Feelings of isolation can increase the client’s anxiety, and having visitors can help distract the client. A room close to nurses’ station would provide this client with a sense of security because the nurses are close by in the event of an emergency. Before administering digoxin (Lanoxin), a nurse reviews information about the drug. ![]() She learns that after digoxin is metabolized, the body eliminates remaining digoxin as unchanged drug by way of the: 1. Therefore, a client with renal dysfunction will require a decreased digoxin dosage. Although some drugs may be eliminated by other routes, digoxin isn’t known to be eliminated by way of the lungs, feces, or skin. The nurse determines that a hockey player hospitalized with bilateral leg fractures is hemodynamically stable and observes the following pattern on the electrocardiogram (ECG) monitor. Which nursing intervention is most appropriate at this time? None; this arrhythmia is benign 2. Administering atropine sulfate, 0. Continuing to monitor for lengthening PR intervals 4. Evaluating the client’s recent serum electrolyte studies. Correct Answer: 1 RATIONALES: This ECG shows sinus arrhythmia with a rate of 7. In this benign arrhythmia, the rhythm is irregular; the impulse originates in the sinoatrial node and travels down the conduction system normally. The P- P interval is irregular; a P wave precedes every QRS complex; and the R- R interval is irregular, increasing with inspiration and decreasing with expiration. Sinus arrhythmia commonly is associated with vagal inhibition caused by respiration. It seldom causes symptoms and doesn’t call for atropine or other treatment. Continuing to monitor for lengthening PR intervals isn’t necessary because the PR interval doesn’t increase with sinus arrhythmia. Because this arrhythmia isn’t caused by an electrolyte imbalance, evaluating serum electrolyte studies isn’t warranted. The nurse would advise the client with an axillofemoral bypass graft to avoid: 1. Prolonged sitting can kink the femoral portion of the graft. Prolonged standing and upper- extremity exercises need not be avoided. The nurse administers basic cardiac life support to a client in cardiac arrest. Which action does the nurse perform? Assessing the patency of the airway 2. Administering I. V. Administering a countershock of 2. Breathing for the client after inserting an endotracheal (ET) tube. Correct Answer: 1 RATIONALES: A nurse certified in basic cardiac life support can assess airway patency. Administering a countershock of 2. ET tube are measures carried out during advanced life support. The nurse is caring for a cardiac client who requires various cardiac medications. When the nurse helps the client out of bed for breakfast, the client becomes dizzy and asks to lie down. The nurse helps the client lie down, puts up the side rails, and obtains the client’s blood pressure, which is 8. Hg. It’s time for the nurse to administer the client’s medications: nitroglycerin, metoprolol (Lopressor), and furosemide (Lasix). Which action is best taken by the nurse? Withhold the medications and notify the physician. Administer the medications immediately. Encourage the client to sit up and eat breakfast. Administer the nitroglycerin and metoprolol and withhold the furosemide. Correct Answer: 1 RATIONALES: The nurse should withhold the three medications and notify the physician. Each of these medications has the potential to lower the client’s blood pressure. Administering them together when the client is already hypotensive may severely lower the client’s blood pressure. The client may continue to experience dizziness when sitting up so breakfast should be held until his blood pressure stabilizes. A client with a permanent pacemaker and a long history of cardiac disease is admitted to the coronary care unit for evaluation for heart failure. The nurse observes the following electrocardiogram (ECG) pattern. What does this pattern indicate? Use of a DDD pacemaker with a rate of 7. Use of a VVI pacemaker with a rate of 7. Use of an AVI pacemaker with a rate of 7. Use of an AAI pacemaker with a rate of 8. Correct Answer: 2 RATIONALES: In the pacemaker identification code, the first letter stands for the heart chamber being paced (atrium, ventricle, or both . This ECG indicates use of a VVI pacemaker, which paces and senses the ventricle and is inhibited by a sensed event (a spontaneous QRS complex). A spike precedes every QRS complex stimulated by the pacemaker. Sensing that the client’s intrinsic rate is below 7. The other options give incorrect rates; also, if the atrium were being paced, a spike would precede each P wave, indicating atrial contraction. During digoxin (Lanoxin) therapy, the nurse should closely monitor the client’s: 1. This is because hypokalemia or hypomagnesemia can predispose the client to digitalis toxicity. Glucose and ketones aren’t usually in the urine except in a client with uncontrolled diabetes, and digoxin isn’t known to affect these levels in the diabetic. CK levels may be elevated if digoxin is administered I. M., but this route of administration isn’t recommended. A client is participating in a cardiac research study in which his physician is directly involved. Which statement by the client indicates a lack of understanding about his rights as a research study participant? The client has the right to withdraw from a study at any time without penalty. All information provided by the client will be kept confidential and used only by members of the study team for scientific purposes. The client must be informed of all risks associated with study participation. A client with chest pain receives nitroglycerin on the way to the acute care facility. Based on an electrocardiogram obtained on admission, the physician suspects a myocardial infarction (MI) and prescribes I. V. A primary goal of nursing care for this client is to recognize life- threatening complications of an MI. The major cause of death after an MI is: 1. Heart failure, in contrast, accounts for 3. MI deaths. Pulmonary embolism, another potential complication of an MI, is less common. The home care nurse visits a client diagnosed with atrial fibrillation who is prescribed warfarin (Coumadin). The nurse teaches the client about warfarin therapy. Which statement by the client indicates the need for further teaching? The client should limit his intake to one to two servings per day.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. Archives
August 2017
Categories |