Podcast
Questions and Answers
Which laboratory test will be most useful in determining whether you should anticipate implementing the acute coronary syndrome (ACS) standard protocol?
Which laboratory test will be most useful in determining whether you should anticipate implementing the acute coronary syndrome (ACS) standard protocol?
Which client finding will require the most immediate action during a treadmill stress test?
Which client finding will require the most immediate action during a treadmill stress test?
Which actions are appropriate to delegate to an experienced LPN/LVN working in the ED? (Select all that apply.)
Which actions are appropriate to delegate to an experienced LPN/LVN working in the ED? (Select all that apply.)
Which topic will you plan on including in the initial teaching plan for a patient with a new diagnosis of stage 1 hypertension?
Which topic will you plan on including in the initial teaching plan for a patient with a new diagnosis of stage 1 hypertension?
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Which finding indicates that you need to contact the health care provider about a change in drug therapy for a hypertensive client taking enalapril?
Which finding indicates that you need to contact the health care provider about a change in drug therapy for a hypertensive client taking enalapril?
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Which interventions will be important to include in the discharge planning for a client with cardiovascular risk factors? (Select all that apply)
Which interventions will be important to include in the discharge planning for a client with cardiovascular risk factors? (Select all that apply)
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Which client is best to assign to a float RN who has come for the day from the general medical-surgical unit?
Which client is best to assign to a float RN who has come for the day from the general medical-surgical unit?
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What finding is most important to communicate to the health care provider considering fibrinolytic therapy for a client with acute MI?
What finding is most important to communicate to the health care provider considering fibrinolytic therapy for a client with acute MI?
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Which nursing activity included in the care plan is best delegated to the LPN/LVN for a client who had an acute MI?
Which nursing activity included in the care plan is best delegated to the LPN/LVN for a client who had an acute MI?
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Which action will you take first for a patient admitted with left anterior chest pain, possible ACS?
Which action will you take first for a patient admitted with left anterior chest pain, possible ACS?
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Which action is most appropriate when an 80-year-old client refuses docusate?
Which action is most appropriate when an 80-year-old client refuses docusate?
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Which finding indicates a need for immediate further action after administering morphine to a client with an acute MI?
Which finding indicates a need for immediate further action after administering morphine to a client with an acute MI?
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Which response is most appropriate for a client needing education about a heart-healthy diet after an MI?
Which response is most appropriate for a client needing education about a heart-healthy diet after an MI?
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Which laboratory value is most important to monitor for a client on captopril and spironolactone?
Which laboratory value is most important to monitor for a client on captopril and spironolactone?
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Which medication should be clarified with the health care provider for a client with unstable angina taking clopidogrel?
Which medication should be clarified with the health care provider for a client with unstable angina taking clopidogrel?
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What is the first action you will take for a client scheduled for transesophageal echocardiography?
What is the first action you will take for a client scheduled for transesophageal echocardiography?
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Which information is of most concern after a client returns from coronary arteriography?
Which information is of most concern after a client returns from coronary arteriography?
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Which task associated with vascular testing is most appropriate to delegate to an experienced UAP?
Which task associated with vascular testing is most appropriate to delegate to an experienced UAP?
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Which client is best for a newly graduated RN preceptor on the cardiac step-down unit?
Which client is best for a newly graduated RN preceptor on the cardiac step-down unit?
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Which client needs immediate intervention in the coronary care unit?
Which client needs immediate intervention in the coronary care unit?
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What is the first action taken when ventricular fibrillation is identified in an unresponsive client?
What is the first action taken when ventricular fibrillation is identified in an unresponsive client?
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Which finding is of most concern during evaluation after the new prescription of carvedilol?
Which finding is of most concern during evaluation after the new prescription of carvedilol?
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Which client will you assess first after the shift change on the coronary step-down unit?
Which client will you assess first after the shift change on the coronary step-down unit?
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Which activity is most appropriate to delegate to an LPN/LVN in a long-term care facility with residents with heart failure?
Which activity is most appropriate to delegate to an LPN/LVN in a long-term care facility with residents with heart failure?
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Which finding during a home visit for a client taking digoxin is most important to communicate to the health care provider?
Which finding during a home visit for a client taking digoxin is most important to communicate to the health care provider?
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In which order will you take the following actions for a client who has developed supraventricular tachycardia?
In which order will you take the following actions for a client who has developed supraventricular tachycardia?
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Which action should you take next for a client with endocarditis reporting severe left foot pain?
Which action should you take next for a client with endocarditis reporting severe left foot pain?
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Which nursing activity included in the resident's care is best for you to delegate to the UAP?
Which nursing activity included in the resident's care is best for you to delegate to the UAP?
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Which finding has the most immediate implications for a client after abdominal aortic aneurysm repair?
Which finding has the most immediate implications for a client after abdominal aortic aneurysm repair?
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Which nursing activity included in the care plan for clients undergoing cardiac surgery must be performed by RN staff members?
Which nursing activity included in the care plan for clients undergoing cardiac surgery must be performed by RN staff members?
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Which medication should you double-check with another licensed nurse for a patient with deep vein thrombosis?
Which medication should you double-check with another licensed nurse for a patient with deep vein thrombosis?
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Which laboratory result will be the most useful to monitor for a client being evaluated for heart failure?
Which laboratory result will be the most useful to monitor for a client being evaluated for heart failure?
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Study Notes
Laboratory Tests in Acute Coronary Syndrome
- Troponin I levels are crucial for diagnosing acute coronary syndrome (ACS).
- Creatine kinase MB and myoglobin levels are less specific for ACS.
Treadmill Stress Test Monitoring
- Chest pain rated 3/10 demands immediate intervention.
- Elevated heart rate and blood pressure provide secondary concerns.
Delegation to LPN/LVN in Emergency Department
- Appropriate tasks include attaching cardiac monitor leads, obtaining 12-lead ECG, and administering aspirin.
- IV push of heparin and administering morphine should not be delegated.
Teaching Plan for Stage 1 Hypertension
- Focus on low-sodium food choices for frequent restaurant goers.
- Discuss adverse effects of medications and alcohol on blood pressure.
Assessing Hypertensive Clients on Enalapril
- A persistent cough indicates a need for medication reassessment.
- Normal blood pressure and frequent urination are less critical.
Discharge Planning for Cardiovascular Risk
- Smoking cessation programs are vital for clients with a family history of myocardial infarctions (MIs).
- Discuss family history's impact on cardiovascular risks.
Appropriate Assignments for Charge Nurses
- Assign clients under stable conditions or requiring routine medication administration to less experienced staff.
Fibrinolytic Therapy Communication
- Continuous chest pain since admission is critical when considering fibrinolytic therapy.
Best Delegated Nursing Activities
- Administering nitroglycerin for chest discomfort is suitable for an LPN/LVN.
- Monitoring vital signs should be done by RN staff.
Emergency Care
- Sublingual nitroglycerin is prioritized in cases of suspected acute coronary syndrome.
- Persisting chest pain after morphine treatment requires immediate attention.
Heart Failure Client Education
- Educate clients on lifestyle changes post-myocardial infarction to prevent denial regarding necessary changes.
Monitoring Potassium Levels
- Potassium levels are critical for clients on captopril and spironolactone to avoid complications.
Clarifying Medication Orders
- Confirm the need for omeprazole if the client is already on clopidogrel due to potential drug interactions.
Pre-Test Preparations
- Clients undergoing transesophageal echocardiography must be placed on NPO status prior to the procedure.
Post-Operative Assessment
- Apical pulse increases to 122 bpm after coronary arteriography raises concern for possible complications.
Delegation of Vascular Testing Tasks
- Measuring ankle and brachial pressures can be delegated to an experienced UAP for ankle-brachial index calculations.
New Graduate Assignments
- More stable clients with less need for complex medical care are suitable for new graduate nurses.
Immediate Interventions in Cardiac Monitoring
- Clients presenting with acute myocardial infarction and significant arrhythmias require urgent assessment.
Cardiac Emergencies
- Immediate action is required for clients in ventricular fibrillation, starting with defibrillation.
Assessing Changes in Heart Failure Clients
- Sinus bradycardia indicates the need for intervention in clients taking beta-blockers.
Prioritizing Client Assessments
- Assess clients who exhibit sudden changes in condition, such as worsening dyspnea and agitation.
Long-Term Care Activity Delegation
- Routine assessments like checking for edema in heart failure residents are suitable for LPNs/LVNs.
Communication of Medication Side Effects
- Report any visual disturbances in clients taking digoxin, as it may indicate toxicity.
Postoperative Action Steps
- Blood pressure readings significantly elevated post-surgery require immediate intervention.
Standardized Care Plan Development
- RNs must develop personalized discharge education plans due to the complexity of care required.
Double-Checking Medications
- High-risk medications like warfarin must be verified with another licensed nurse before administration.
Monitoring Heart Failure Indicators
- B-type natriuretic peptide levels are critical in diagnosing heart failure during evaluations.
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Description
Test your knowledge of critical concepts in emergency medicine with these flashcards focusing on Chapter 7. These cards cover important laboratory tests and their relevance in diagnosing acute coronary syndrome (ACS). Prepare effectively for clinical scenarios in the emergency department.
