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answering questions (evaluation). Left-sided heart failure Rationale Sinus bradycardia, rate of 48 beats/min RATIONALE Test-Taking Tip: Identify option components as correct or incorrect. This
may help you identify a wrong answer. Example: If you are being asked to identify a diet that is specific to a certain condition, your knowledge about that condition would help you choose the correct response (e.g., cholecystectomy = low-fat, high-protein, low-calorie diet).
Terms in this set (45)What is the role of digitalis in treating a patient with heart failure? It increases the force of heart contraction, thereby increasing cardiac output. Digitalis increases the force of heart contraction, thereby increasing cardiac output. Diuretics reduce fluid retention in the lungs. Beta-adrenergic blockers are used to slow the heart down if tachycardia is causing heart failure. Venous dilators such as isosorbide dinitrate (Isordil) and nitroglycerin relax and dilate the blood vessels to allow the vessels to accommodate larger percentages of the total blood volume. What are some causes of ventricular tachycardia? Select all that apply. Hypoxia Hypoxia, cocaine use, hypokalemia, and cardiac ischemia are some of the causes of ventricular tachycardia. Fever is not considered a cause of ventricular tachycardia. What is true about heart failure in America? Select all that apply. Cardiac dysrhythmias can contribute to heart failure. Cardiac dysrhythmias can contribute to heart failure, and approximately 1 in 100 people will develop heart failure. African Americans have a higher incidence of heart failure. Half of the patients with heart failure die within 5 years, not 3 years. Heart failure is not defined as an irregular heart rhythm. A patient has pericarditis with effusion in the pericardium. What is the patient at risk for? Cardiac tamponade When a patient has pericarditis with effusion in the pericardium, the patient is at risk for cardiac tamponade. It occurs when fluid restricts the filling and pumping of the heart. Infarction occurs when the heart has a necrotic area caused by decreased blood flow (ischemia). Arrhythmia is a disruption of the normal electrical conduction in the heart. The nurse should provide which teaching point for a patient with heart failure? Checking weight daily It is important to teach the patient to check weight daily (at the same time every day) and record it. Avoiding foods high in calcium will not treat heart failure. Checking the blood pressure (not the heart rate) is important before taking diuretics. The patient would never change his or her own batteries in a pacemaker; a medical professional does this. What are the most common causes of heart failure? Select all that apply. Coronary artery disease What is the role of diuretics in treating
a patient with heart failure? They reduce fluid retention in the lungs and lower extremities. Diuretics reduce fluid retention in the lungs and the lower extremities. Beta-adrenergic blockers are used to slow the heart down if tachycardia is causing heart failure. Digitalis increases the force of heart contraction, thereby increasing cardiac output. Venous dilators such as isosorbide dinitrate (Isordil) and nitroglycerin relax and dilate the blood vessels to allow the vessels to accommodate larger percentages of the total blood volume. Which
medical term best describes a necrotic area of the heart caused by decreased blood flow? Infarction Infarction occurs when the heart has a necrotic area caused by decreased blood flow (ischemia). Arrhythmia is a disruption of the normal electrical conduction in the heart. Cardiac tamponade occurs when fluid restricts the filling and pumping of the heart. The patient is being discharged following a mitral valve replacement and will be prescribed the anticoagulant warfarin. Which food should the nurse instruct him to avoid? Green leafy vegetables Green leafy vegetables contain a significant amount of vitamin K, which would counteract the patient's anticoagulant ( warfarin). Bananas, dairy products, and meat products do not need to be avoided. What is the most common cause of mitral stenosis? Rheumatic fever The most common cause of mitral stenosis is rheumatic fever. The common cold and tuberculosis are not implicated in mitral stenosis. Pericardial friction rub is associated with pericarditis. The nurse teaches good oral hygiene because poor oral hygiene can lead to what serious problem? Infective endocarditis It is important for the nurse to teach good oral hygiene because poor oral hygiene can lead to infective endocarditis. Poor oral hygiene does not lead to heart failure, cardiac tamponade, or premature ventricular contractions. A nurse is assisting with data collection for a patient with pain from pericarditis. Which finding is most typical of a patient with pericarditis? Pain upon inspiration Chest pain is the hallmark symptom of pericarditis. The pain is most severe on inspiration. It is relieved by sitting up and leaning forward. Anginal pain—not pericarditis—is relieved with nitroglycerin. A patient is admitted with right-sided heart failure. Which data will the nurse typically find during data collection? Dependent edema With right-sided heart failure, the patient has increased central venous pressure, jugular venous distention, abdominal engorgement, and dependent edema. Coughs and crackles occur with left-sided heart failure. Weight gain will occur, not weight loss. Which are risk factors for heart failure and congestive heart failure? Select all that apply. Lung disease Lung disease increases pressure in the alveoli, which also contributes to the compromised pumping of blood to the lungs. Atherosclerosis causes increased resistance in the face of compromised pumping action, and the heart may not be able to overcome it. When the heart is not able to pump effectively, blood and intravascular fluids pool in the heart chambers, the lungs, and the lower extremities. Acute myocardial infarction may be the cause of this ineffective pumping state. Too much circulating fluid may exacerbate fluid collection. Incomplete valve closure contributes to pooling because the blood flows out through the valve and back in again. Dehydration refers to a lower-than-normal level of circulating fluid. What are some classic symptoms of pericarditis?
Select all that apply. Fever Fever, pericardial friction rub, and chest pain eased by sitting up and leaning forward are some classic symptoms of pericarditis. Ascites and crackles are seen with various problems, including heart failure. What are some factors that can precipitate heart failure? Select all that apply. Hypothyroidism What are some causes of sinus tachycardia? Select all that
apply. Fever Some causes of sinus tachycardia include fever, stress, and pain or discomfort. Bradycardia can occur if a person uses the vagal maneuver or takes a beta blocker. Which dysrhythmia will definitely result in death
without cardiopulmonary resuscitation (CPR)? Ventricular fibrillation Ventricular fibrillation results in no cardiac output and requires CPR and defibrillation to correct. Although atrial fibrillation, ventricular tachycardia, and premature ventricular contractions can all result in serious consequences or death, ventricular fibrillation is a rhythm that is not compatible with life. The nurse is administering a calcium channel blocker to a patient for treatment of hypertension. Of which effect of this medication on the cardiovascular system should the nurse be aware? It decreases the heart rate. The nurse should be aware that calcium channel blockers decrease heart rate and vasodilate. The nurse should be aware of this effect so that the heart rate can be properly monitored. Calcium channel blockers do not increase cardiac workload or decrease venous return to the lungs. Which drug classes are commonly used to
treat heart failure? Select all that apply. Digitalis Digitalis, loop diuretics, antineoplastic medications, nitrate vasodilators, and angiotensin-converting enzyme inhibitors are drug classes commonly used to treat heart failure. Antineoplastic medications are not used to treat heart failure; these are used for the treatment of cancer and a few other conditions. The nurse discusses the importance of restricting sodium in the diet of a patient with heart failure. Which statement made by the patient indicates that the patient needs further teaching? "I should avoid grilling hamburgers." Cutting out beef or hamburgers made at home is not necessary; however, fast-food hamburgers are to be avoided due to their higher sodium content. Bacon, canned foods, lunchmeats, and processed foods are high in sodium, which promotes fluid retention; these are to be avoided. The patient correctly understands that adding salt to food should be avoided. What makes a person most susceptible to infective endocarditis? Untreated group A Streptococcus Untreated group A Streptococcus makes a person susceptible to infective endocarditis. Antineoplastic therapy, untreated tuberculosis, and premature ventricular contractions do not make a person susceptible to infective endocarditis. After undergoing cardiac catheterization, the patient is informed that he has a 20% ejection fraction. After the physician leaves, the patient asks the nurse, "What does that mean?" The nurse correctly explains using which statement? "The heart is pumping only 20% of the blood within the ventricle during contraction." An ejection fraction of 20% means that the heart is pumping only 20% of the blood within the ventricle during contraction. It does not mean that the heart is pumping and contracting at only 80% of its capability (a normal ejection fraction is 50% to 70%). The ejection fraction does not determine oxygenation levels or predict sudden death. The nurse teaches a patient who has just been prescribed digitalis some important things to monitor, including digitalis toxicity. What are the signs and symptoms of
digitalis toxicity? Select all that apply. Nausea Nausea and visual disturbances are among the signs and symptoms of digitalis toxicity. Fever is associated with infection. Crackles are most often seen with heart failure or pneumonia. Pericardial friction rub is a symptom of pericarditis.
A patient with aortic stenosis is most likely to have which symptoms noted during data collection? Select all that apply. Angina Syncope, angina, and dyspnea are related to the decreased cardiac output that caused the stiffened aortic valve. Narrowing pulse pressures are caused by the left ventricle attempting to compensate for the extra pressure needed to expel blood into the general circulation. Low blood pressure would not be seen for this same reason. A nurse is caring for an older woman with heart failure who is taking several medications. Which factor does the nurse consider when contributing to the plan of care? Monitoring for decreased urine output will be necessary. Decreased urine output can indicate dehydration, which is common with diuretics that are used to treat heart failure. Loop diuretics continue to work even after excess fluid is eliminated. Confusion is not associated with normal aging. With decreased kidney function, it is especially important to look for drug interactions. The nurse is caring for a patient with a diagnosis of heart failure (HF). Which diet is most appropriate for this patient? Low sodium, high fiber A low-sodium, high-fiber diet is the most appropriate because of the patient's need to prevent further fluid accumulation and because fiber helps with bowel elimination. The patient needs a diet low in fats, trans fats, and saturated fats. What are some major teaching instructions for a patient who had a permanent pacemaker inserted yesterday? Select all that apply. Monitor for incision infection. Major teaching instructions for a patient with a permanent pacemaker include monitoring for incision infection, monitoring the heart rate daily and reporting it as instructed, and avoiding lifting the arm and shoulder on the pacemaker side. Use of a cell phone or a cordless phone should be on the ear opposite the pacemaker. Angina pain is not an expected or normal finding after the placement of a pacemaker. Which is the most serious type of arrhythmia? Ventricular fibrillation Ventricular fibrillation is a medical emergency that will result in death if left untreated. It is a state whereby the ventricles are quivering with disorganized electrical and mechanical activity. Atrial fibrillation, although serious, is not as imminently life-threatening as ventricular fibrillation. In atrial fibrillation, electrical activity is disorganized, and the atria quiver at a rate of 350 to 600 per minute rather than contracting in an organized manner. Supraventricular tachycardia is the sudden onset of a rapid heartbeat that originates in the atria. It is characterized by a pulse rate of 150 to 250 bpm. The patient with supraventricular tachycardia may experience palpitations, light-headedness, dyspnea, and angina. Sinus bradycardia is a slow rhythm that originates in the sinoatrial node and that is characterized by a rate of less than 60 bpm. Which teaching points should be included in patient teaching for a patient with an automatic implantable cardioverter/defibrillator? Avoid exposure to microwave towers and transformers. An automatic implantable cardioverter/defibrillator is an implantable device that recognizes a lethal rhythm such as ventricular fibrillation and generates a shock to restore the normal sinus rhythm. The patient should avoid exposure to microwave towers, transformers, and electrical transmitters. The pulse generator is larger than a regular pacemaker. The patient should be instructed to avoid handheld security devices at airports. The patient should avoid all contact with arc-welding equipment. The LPN/LVN is evaluating the patient's electrocardiogram (ECG) rhythm strip and notes the distance between the P waves is the same. Which interpretation by the nurse of this ECG is correct? The heart rate is regular. The same distance between P waves means that the heart rate is regular, but it does not mean that there cannot be other irregularities. The nurse must further evaluate the rhythm strip to determine whether there are any other irregularities. The nurse assesses the edema and jugular venous distention of a patient with heart failure. The nurse realizes that which side of the heart is
failing? Right Edema and jugular venous distention are symptoms of right-sided heart failure, not left-sided failure. No other assessment data indicate left-sided heart failure. What are the signs and symptoms of right-sided heart failure? Select all that apply. Ascites Ascites, dyspnea, hepatomegaly, and 3+ pedal edema are clinical manifestations of of right-sided heart failure. A patient with heart failure would gain, not lose, weight. A patient with pericarditis is admitted to the nursing unit. Which factors should the nursing team consider when planning the care of this patient? Select all that
apply. Pericardial effusion may lead to cardiac
tamponade. Inflammation caused by viruses, bacteria, or trauma decreases the elasticity of the ventricles. Fluid accumulation is known as pericardial effusion; if it is large enough, it causes tamponade, which results in an emergent drop in cardiac output. Cardiac output drops because the ventricles are not able to stretch enough to receive their usual amount of blood, so only a limited amount is expelled. In addition to chest pain, the pericardial rub is a hallmark of the decreased elasticity of the ventricles. A patient is being discharged following insertion of a permanent pacemaker. What should be included in the patient's discharge instructions? Refrain from activities that might cause a direct blow to the pacemaker. There are several discharge teaching points that should be addressed with the patient, including avoiding activities that are likely to cause a direct blow to the pacemaker. The surgical dressing should remain over the insertion site until the follow-up appointment with the provider. The patient may not require afternoon rest periods. It is not necessary to adjust the pacemaker setting for increased activity. The nurse is participating in a care planning session for a patient with atrial fibrillation. The nurse considers which problem to have the highest potential risk of atrial
fibrillation? Clot formation The major risk associated with atrial fibrillation is clot formation. Crackles are associated with fluid in the lungs. Atrial fibrillation is most associated with tachycardia rather than bradycardia. Pericardial friction rub is associated with pericarditis. The nurse is assessing a
newly admitted patient. Which assessment finding should alert the nurse that the patient is developing right-sided heart failure (HF)? Edema in the feet The nurse assesses the patient for the signs and symptoms of advanced systolic heart failure. Which sign(s) or symptom(s) are related to this condition? Select all that
apply. S3 and S4 S3 and S4, dyspnea and crackles or wheezes, and weight gain of 2 lb in 24 hours or 5 lb in 1 week are signs of advanced systolic heart failure. S1 and S2 are normal heart sounds. Pulselessness is not a symptom of advanced systolic heart failure. The nurse is caring for a patient who was diagnosed with aortic valve stenosis. What would indicate that the patient's stenosis is worsening? Peripheral cyanosis Dyspnea, angina, and syncope on exertion are classic symptoms of aortic stenosis. As the condition worsens, the patient experiences extreme fatigue, weakness, and peripheral cyanosis. A patient has cardiomyopathy. Which principle should the nurse consider when planning care for this patient? A poor prognosis exists with cardiomyopathy. A poor prognosis exists with cardiomyopathy. Medication is given to increase, not reduce, contractility. Cardiomyopathy is disease of the heart muscle, not the heart valves. Restrictive cardiomyopathy can progress to right-sided heart failure. Suddenly the monitor shows that a patient is experiencing multiple premature ventricular contractions (PVCs).
The LPN/LVN should expect the RN to administer which drug to correct this problem? Lidocaine Lidocaine is a drug used to treat atrial and ventricular dysrhythmias by slowing the sodium channel, prolonging the time of depolarization, and increasing the refractory period. Atropine, verapamil, and epinephrine would not be the most appropriate choices for this patient. Which diagnostic test result is consistent with a diagnosis of heart failure (HF)? B-type natriuretic peptide level of 760 ng/dL B-type natriuretic peptide is produced and released by the ventricles when the patient has fluid overload as a result of HF; a normal value is less than 100 pg/mL. Hypokalemia may occur in response to diuretic therapy for HF, but it may also occur with other conditions; it is not specific to HF. An ejection fraction of 60% represents a normal value of 50% to 70%. Consolidation on a chest radiograph may indicate pneumonia. The nurse is caring for a patient with heart failure. For which symptoms does the nurse assess? Select all that
apply. Tachycardia Tight-fitting rings or shoes indicate fluid retention and edema. Tachycardia may occur as compensation for or as a result of decreased cardiac output. Dyspnea results when pulmonary venous congestion ensues. Thick, yellow sputum is indicative of infection; patients with acute heart failure have dry cough and, when severe, pink, frothy sputum. Orthopnea (the inability to lie flat) occurs in patients with heart failure. A patient's laboratory values reveal a serum cholesterol of 275 mg/dL, and rosuvastatin is prescribed. The nurse is aware that the nursing care plan should also include diet teaching. Which is
lowest in saturated fats and the most appropriate meal choice for the patient? Salmon and rice Animal products naturally contain cholesterol, but salmon contains the lowest amount of cholesterol compared with steak and a baked potato, broiled lamb chops and a salad, or orange juice and a bagel with cream cheese. A nurse is assisting with data collection for a patient with mitral stenosis. What does the nurse expect to hear when auscultating the heart? A rumbling, diastolic murmur The murmur of mitral stenosis is described as rumbling, and it is heard best during diastole at the apex of the heart. The murmur of mitral regurgitation is blowing and high pitched, and it occurs during systole. The murmur of aortic regurgitation is blowing and high pitched, and it occurs during diastole. There is no such murmur as a systolic, low-pitched non-murmur. Students also viewedEAQ - Chapter 19: Care of Patients With Cardiac Di…22 terms Goleldarie EAQ - Chapter 20: Care of Patients with Coronary A…40 terms Goleldarie Pharm Exam #2 (1/3)64 terms elizabeth_thackstonPlus Ch.34 Cardiac Disorders12 terms Sharmaila_Bush Sets found in the same folderPatho Test 1 - Cardiovascular System68 terms K_Eve_27 Cardiac - NCLEX67 terms aprieto Obstructive Pulmonary NCLEX163 terms devyn_renee_whitt Anemia NCLEX Questions-New50 terms bscarr96
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Which heart sound is diminished or inaudible in a patient with aortic valve stenosis?The aortic component of the second heart sound, A2, is usually diminished or absent, because the aortic valve is calcified and immobile and/or the aortic ejection is prolonged and it is obscured by the prolonged systolic ejection murmur.
Which assessment finding is the most common symptom associated with hypertrophic cardiomyopathy?The most common presenting symptom of hypertrophic cardiomyopathy is dyspnea. Patients also can develop syncope, palpitations, angina, orthopnea, paroxysmal nocturnal dyspnea, dizziness, congestive heart failure, and sudden cardiac death. The latter represents the most devastating presenting symptom.
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Which is a symptom of late stage aortic stenosis select all that apply quizlet
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