Questions and Answers
Which assessment findings in the first few hours after the procedure require immediate action by the nurse? (Select all that apply)
Which findings should alert the nurse to the possibility of atherosclerosis? (Select all that apply)
Which actions should the nurse take when preparing a client for a pharmacologic stress echocardiogram? (Select all that apply)
For which complications of right-sided heart catheterization should the nurse assess? (Select all that apply)
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A nurse assesses a client who had an MI and is hypotensive. Which additional assessment finding should the nurse expect?
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A nurse assesses a client after administering a prescribed beta blocker. Which assessment should the nurse expect to find?
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Which client should the nurse identify as having the greatest risk for cardiovascular disease?
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A nurse assesses an older adult client who has multiple chronic diseases. The client's heart rate is 48 beats/min. Which action should the nurse take first?
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Which statement by the client should alert the nurse to the occurrence of heart failure?
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Which statement by the client should alert the nurse to the presence of edema?
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Which clinical manifestation should the nurse expect in an older adult client experiencing a myocardial infarction?
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Which action should the nurse take after noting that the left pedal pulse is weak post-cardiac angiography?
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Which assessment finding requires immediate intervention after a left-sided cardiac catheterization?
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Which assessment should the nurse complete prior to cardiac catheterization?
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Which action should the nurse take regarding an MRI for a client with a pacemaker?
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Which action should the nurse take first for a client recovering from a myocardial infarction with pulmonary artery pressure readings of 25/12 mm Hg?
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Which intervention should the nurse be prepared to implement while caring for a client with 80% blockage of the right coronary artery?
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Which nutrition-related statement should the nurse include in teaching a client with diabetes at high risk for coronary artery disease?
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How should the nurse respond to a client with advanced cardiac disease who is having trouble sleeping at night?
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How should the nurse respond to a client recovering from a myocardial infarction who states they need to stop eating chili to prevent indigestion pain?
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How should the nurse respond to a client who fears dying before coronary artery bypass graft surgery?
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Which client should the nurse plan to assess first among those presenting with chest discomfort?
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Based on heart tones heard, which action should the nurse take?
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In which location should the nurse auscultate to best hear a cardiac murmur related to aortic regurgitation?
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Which actions should the nurse take prior to cardiac catheterization for a client with a history of renal insufficiency?
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Which assessment findings should alert the nurse to request an electrocardiogram?
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Study Notes
Assessment of Cardiovascular System Key Points
- Hypotension and MI: Clients with hypotension post-myocardial infarction (MI) may show elevated heart rate and respiratory rate due to baroreceptors responding to arterial pressure drops.
- Beta Blockers Effects: They decrease heart rate and blood pressure by blocking beta1-adrenergic receptors, increasing ventricular filling time but may not affect beta2-adrenergic receptor sites.
- Risk Factors for Cardiovascular Disease: American Indians have higher rates of coronary artery disease and hypertension, especially with diabetes mellitus noted as a significant risk factor.
- Bradycardia in Older Adults: Decreased cardiac conduction cells can lead to bradycardia; medication review is essential before taking action like atropine or external pacing.
- Signs of Heart Failure: Early manifestations include dyspnea on exertion, such as getting short of breath when climbing stairs.
- Edema Indicators: Clients may perceive shoe tightness by day's end as a sign of fluid accumulation or edema.
- Older Adult MI Symptoms: Disorientation or confusion may be the predominant sign of MI in older clients, rather than typical pain.
- Post-Angiography Care: Weak pedal pulses after cardiac angiography necessitate assessing color and temperature to identify possible arterial obstruction.
- Neurological Changes Post-Cath: Slurred speech and confusion after left-sided cardiac catheterization signal urgency due to cerebral vascular accident risk.
- Pre-Cath Preparation: Assess for allergies to iodine-based contrast before cardiac catheterization due to potential lifethreatening reactions.
- Pacemaker Considerations: MRI procedures can deactivate a pacemaker; healthcare providers need to be informed before scheduling.
- Pulmonary Artery Pressure Normal Ranges: Normal pressures are 15-26 mm Hg systolic and 5-15 mm Hg diastolic; comparing trends is critical even if single readings are normal.
- AV Node Function: Total occlusion of the right coronary artery (RCA) could cause severe heart block; external pacing availability is crucial.
- Diabetes Nutritional Guidance: Clients should focus on balanced weight loss rich in nutrient-dense foods while avoiding high-fat diets.
- Orthopnea Management: Elevating the head and chest with pillows is recommended for clients experiencing difficulty sleeping due to shortness of breath while lying flat.
- Denial in MI Patients: Clients may deny their condition; effective communication about the illness's implications is necessary.
- Chest Pain Triage: Intense, stabbing chest pain that radiates is most indicative of a myocardial infarction and should be assessed first.
- Atrial Gallop Sound: Atrial gallops (S4 sounds) can be normal in older adults and should be documented without immediate intervention required.
- Aortic Regurgitation: Auscultation for this cardiac murmur is most effective at the second intercostal space just right of the sternum.
- Renal Insufficiency Pre-cath Actions: Assess for iodine allergies, monitor fluids, and check BUN/creatinine levels for renal protection pre-cardiac catheterization.
- Women and MI Symptoms: Women may present with fatigue, indigestion, and shortness of breath rather than classic chest pain during myocardial infarction.
- Post-Cath Monitoring: Signs like hypokalemia, expanding hematomas, and rhythm changes are critical post-catheterization assessment factors.
- Atherosclerosis Screening: A lipid panel indicates atherosclerosis risk with high total cholesterol, triglycerides, and low-density lipoprotein (LDL) levels.
- Stress Echocardiogram Preparation: Actions include continuous monitoring, dietary restrictions pre-procedure, and informing clients about induced exercise by dobutamine.### Pharmacologic Stress Echocardiogram
- Peripheral venous access is essential for clients undergoing a pharmacologic stress echocardiogram.
- Continuous blood pressure and pulse monitoring are required during the procedure.
- Clients must maintain NPO status for 3 to 6 hours prior to the procedure to minimize risks and complications.
- Dobutamine is administered during the procedure; education about its effects and purpose is necessary.
- Beta blockers are typically withheld before the procedure to ensure accurate test results and patient safety.
Right-Sided Heart Catheterization Complications
- Complications to assess for after right-sided heart catheterization include:
- Thrombophlebitis, which can develop from vein irritation or injury during catheter insertion.
- Pulmonary embolism, a serious condition caused by blood clots traveling to the lungs.
- Cardiac tamponade, characterized by fluid accumulation around the heart, posing a risk for both right- and left-sided catheterizations.
- Stroke and myocardial infarction are complications associated specifically with left-sided heart catheterizations and not commonly with right-sided procedures.
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Description
This quiz covers essential points related to the assessment of the cardiovascular system. Topics include the effects of hypotension, beta blockers, risk factors for cardiovascular diseases, and the signs of heart failure. Test your knowledge on key indicators and management strategies in cardiovascular health.
