Podcast
Questions and Answers
Which findings would prompt the nurse to perform a focused cardiopulmonary assessment?
Select all that apply.
Which findings would prompt the nurse to perform a focused cardiopulmonary assessment? Select all that apply.
Which questions would the nurse include during the patient interview of a focused respiratory health assessment?
Select all that apply
Which questions would the nurse include during the patient interview of a focused respiratory health assessment? Select all that apply
Which peripheral vascular assessment would the nurse perform when admitting a patient with impaired cardiac function?
Which peripheral vascular assessment would the nurse perform when admitting a patient with impaired cardiac function?
Which set of values would the nurse review to determine whether heart muscle injury has occurred?
Which set of values would the nurse review to determine whether heart muscle injury has occurred?
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Which information would the nurse expect to obtain from a chest x-ray prescribed for a patient with a cough and shortness of breath?
Select all that apply.
Which information would the nurse expect to obtain from a chest x-ray prescribed for a patient with a cough and shortness of breath? Select all that apply.
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Which health problem risk would be evaluated by obtaining a lipid panel?
Which health problem risk would be evaluated by obtaining a lipid panel?
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Match the pulmonary function test (PFT) with the measured element.
Match the pulmonary function test (PFT) with the measured element.
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Which cues would the nurse expect to find in a patient with an inability to effectively pump blood to the tissues?
Select all that apply.
Which cues would the nurse expect to find in a patient with an inability to effectively pump blood to the tissues? Select all that apply.
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Which condition would the nurse suspect in a postsurgical patient who is experiencing dyspnea with decreased breath sounds?
Which condition would the nurse suspect in a postsurgical patient who is experiencing dyspnea with decreased breath sounds?
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Which cues would the nurse expect in a patient with hypoxic myocardial tissue?
Select all that apply.
Which cues would the nurse expect in a patient with hypoxic myocardial tissue? Select all that apply.
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Which data would be obtained by the nurse preparing to perform a cough assessment on a patient with a respiratory disorder?
Which data would be obtained by the nurse preparing to perform a cough assessment on a patient with a respiratory disorder?
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Which questions would the nurse include in the patient interview when conducting a focused cardiovascular health assessment?
Which questions would the nurse include in the patient interview when conducting a focused cardiovascular health assessment?
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Which questions would the nurse include as part of a focused respiratory health assessment?
Which questions would the nurse include as part of a focused respiratory health assessment?
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Which information would the nurse be aware of when using cardiac enzyme measurements for assessment of myocardial infarction?
Which information would the nurse be aware of when using cardiac enzyme measurements for assessment of myocardial infarction?
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The complete blood count results for a patient with chronic obstructive pulmonary disease (COPD) show an elevated red blood cell count. Which clinical manifestation would the nurse associate with this finding?
The complete blood count results for a patient with chronic obstructive pulmonary disease (COPD) show an elevated red blood cell count. Which clinical manifestation would the nurse associate with this finding?
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When assessing a patient with low hemoglobin, the nurse looks for symptoms of fluid retention, understanding that the patient may have which condition?
When assessing a patient with low hemoglobin, the nurse looks for symptoms of fluid retention, understanding that the patient may have which condition?
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Which rationale explains why a patient with a recent myocardial infarction would have a basic metabolic panel drawn to monitor serum electrolytes?
Which rationale explains why a patient with a recent myocardial infarction would have a basic metabolic panel drawn to monitor serum electrolytes?
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Which assessment techniques would the nurse include when performing a physical assessment on a patient with an oxygenation problem?
Which assessment techniques would the nurse include when performing a physical assessment on a patient with an oxygenation problem?
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Which major subjective symptom is associated with both chronic obstructive pulmonary disease (COPD) and pneumonia?
Which major subjective symptom is associated with both chronic obstructive pulmonary disease (COPD) and pneumonia?
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Which objective data would the nurse focus on obtaining in a patient with signs of cardiac muscle hypoxia?
Which objective data would the nurse focus on obtaining in a patient with signs of cardiac muscle hypoxia?
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Which postoperative complication can be prevented by regularly performing deep-breathing exercises?
Which postoperative complication can be prevented by regularly performing deep-breathing exercises?
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Study Notes
Focused Cardiopulmonary Assessment Findings
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Findings prompting focused cardiopulmonary assessment:
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Respiratory:
- Dyspnea (difficulty breathing)
- Orthopnea (difficulty breathing when lying flat)
- Tachypnea (rapid breathing)
- Wheezing
- Cough (productive or non-productive)
- Cyanosis
- Chest pain
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Cardiovascular:
- Chest pain
- Irregular heartbeat
- Fatigue
- Edema (swelling)
- Dizziness
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Respiratory:
Focused Respiratory Health Assessment Questions
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Patient Interview Questions:
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History:
- Previous respiratory illnesses
- Smoking history
- Allergies
- Exposure to environmental irritants
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Current Symptoms:
- Onset, duration, and severity of symptoms
- Any associated symptoms
- What relieves or worsens symptoms
- Medications used
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History:
Peripheral Vascular Assessment for Impaired Cardiac Function
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Assessment Techniques:
- Palpation of Peripheral Pulses: Assess for rate, rhythm, and strength (0-4 scale)
- Capillary Refill: Assess for time taken for capillary refill (less than 2 seconds is normal)
- Edema: Assess for presence, location, and severity
- Skin Color and Temperature: Assess for changes (e.g., cyanosis, pallor)
Heart Muscle Injury Assessment
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Serum Markers:
- Troponin I and Troponin T: Highly specific markers of cardiac injury
- Creatine Kinase (CK) and CK-MB: Elevated levels indicate muscle damage
Chest X-Ray Findings for Cough and Shortness of Breath
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Potential Findings:
- Pneumonia: Infiltrates (cloudy areas) in the lungs
- Pulmonary Edema: Fluid build-up in the lungs
- Pleural Effusion: Fluid accumulation in the space between the lungs and chest wall
- Pneumothorax: Air trapped in the space between the lungs and chest wall
Lipid Panel Assessment
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Identifies risk for:
- Cardiovascular disease: High levels of LDL (bad) cholesterol and triglycerides, low levels of HDL (good) cholesterol indicate increased risk
Pulmonary Function Tests (PFTs)
- Spirometry: Measures lung volume and airflow
- Diffusing Capacity (DLCO): Measures how well oxygen moves from the lungs to the blood
- Peak Expiratory Flow (PEF): Measures the maximum speed of air exhaled
- Forced Vital Capacity (FVC): Measures the total amount of air exhaled after taking a deep breath
- Forced Expiratory Volume (FEV1): Measures the amount of air exhaled in the first second of forced expiration
Cues of Ineffective Blood Pumping
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Signs:
- Fatigue
- Weakness
- Dyspnea on exertion
- Edema, especially in the legs and ankles
- Poor capillary refill
- Cool, pale extremities
Postsurgical Dyspnea with Decreased Breath Sounds
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Suspected Condition:
- Atelectasis: Collapse of a part of the lung, often post-surgery due to shallow breathing
Hypoxic Myocardial Tissue Cues
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Signs:
- Chest pain
- Dyspnea
- Tachycardia
- Elevated blood pressure
- ECG changes (ST-segment depression, T-wave inversion)
Cough Assessment Data
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Observations:
- Frequency: How often the patient coughs
- Intensity: How forceful the cough is
- Character: Dry or productive (with sputum)
- Color and consistency: Of any sputum
- Timing: When the cough occurs (e.g., morning, evening)
Focused Cardiovascular Health Assessment Questions
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Patient Interview Questions:
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History:
- Family history of heart disease
- Previous heart problems
- Medications
- Lifestyle habits (diet, exercise, smoking, stress)
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Current Symptoms:
- Onset, duration, and severity of symptoms
- Any associated symptoms
- What relieves or worsens symptoms
-
History:
Focused Respiratory Health Assessment Questions
-
Patient Interview Questions:
-
History:
- Previous respiratory illnesses
- Smoking history
- Allergies
- Exposure to environmental irritants
-
Current Symptoms:
- Onset, duration, and severity of symptoms
- Any associated symptoms
- What relieves or worsens symptoms
- Medications used
-
History:
Cardiac Enzyme Measurements for Myocardial Infarction
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Important Points:
- Troponin I and Troponin T: Highly specific markers rapidly rise after MI, remain elevated for several days
- CK-MB: Level rises within 3-6 hours of MI, peaks at 12-24 hours, declines after 2-3 days
Elevated Red Blood Cell Count in COPD
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Clinical Manifestation:
- Polycythemia: Increased red blood cell production to compensate for decreased oxygen levels
Low Hemoglobin and Fluid Retention
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Suspected Condition:
- Heart Failure: Low hemoglobin can lead to reduced oxygen-carrying capacity, contributing to fluid retention and pulmonary congestion
Basic Metabolic Panel for Myocardial Infarction
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Rationale:
- Monitors serum electrolytes (potassium, sodium, magnesium) which are vital for heart function.
- Electrolyte imbalances can worsen heart function and complicate post-MI recovery
Physical Assessment Techniques for Oxygenation Problems
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Assessment Techniques:
- Respiratory Rate and Rhythm: Observe for rate, depth, and ease of breathing
- Auscultation of Lung Sounds: Assess for normal breath sounds, crackles, wheezes, or diminished sounds
- Pulse Oximetry: Measures oxygen saturation in the blood
- Color: Assess for signs of cyanosis
- Respiratory Effort: Observe for use of accessory muscles
Chronic Obstructive Pulmonary Disease (COPD) and Pneumonia - Common Subjective Symptom
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Symptom:
- Dyspnea (difficulty breathing): Both conditions can impair airflow and cause breathlessness
Signs of Cardiac Muscle Hypoxia - Objective Data
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Assessment Findings:
- ECG Changes: ST-segment depression, T-wave inversion
- Vital Signs: Tachycardia, hypertension
- Auscultation: S3 gallop, murmurs
Postoperative Complication Prevented by Deep Breathing Exercises
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Complication:
- Atelectasis (lung collapse): Shallow breathing post-surgery can lead to collapse of the alveoli, reducing oxygen exchange. Deep breathing exercises promote lung expansion and prevent this.
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Description
This quiz helps nurses identify key findings that necessitate a focused cardiopulmonary assessment. Select all that apply from the given options to test your understanding of critical signs and symptoms. It's essential for effective patient care in clinical settings.
