Questions and Answers
A patient's arterial pressure drops upon standing. How should the nurse report this finding to the oncoming shift?
A nurse is teaching a patient about the distribution of blood. Which information indicates the patient has a correct understanding of the teaching?
A patient has taken a medication that causes the arterioles to dilate. What will likely happen to the cardiac afterload?
The nurse would most likely administer the combination product isosorbide dinitrate/hydralazine [BiDil] to patients of which ethnic heritage?
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A patient has reduced cardiac output. Which compensatory response would the nurse expect to occur in this patient?
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The nurse is evaluating the effectiveness of treatment for heart failure in a patient. Which finding indicates a therapeutic effect?
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The nurse is preparing to administer a daily dose of digoxin [Lanoxin]. What is the priority nursing intervention?
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Which assessment is most important for the nurse to obtain prior to administering digoxin to a patient with heart failure?
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The nurse assesses a patient's pulse before administering digoxin and notes a rate of 55 beats/min. What is the priority intervention by the nurse?
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A patient has received a medication that constricts the blood vessels. What effect will this have on the blood pressure?
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A patient is prescribed digoxin to treat heart failure. Which biochemical parameter should be assessed by the nurse to ensure safe drug administration?
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In the failing heart, arterial pressure falls, stimulating the baroreceptor reflex to increase sympathetic nervous system activity. The nurse understands increased sympathetic activity will produce which response?
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A patient's preload is decreased. How should the nurse interpret this information?
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A nurse discovers that a patient has a cardiac output of 5 L/min. What else should the nurse assess to determine cardiac output besides stroke volume?
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A patient is given medication to make the blood vessels constrict. The nurse understands that what occurs with this medication?
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The nurse is administering captopril to a patient with heart failure. Which best describes the effects of this drug?
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Study Notes
Orthostatic Hypotension
- Arterial pressure drop upon standing indicates orthostatic hypotension.
Blood Distribution
- The majority of blood in the body is found in the venous system.
Cardiac Afterload
- Dilation of arterioles leads to a decrease in cardiac afterload.
Administering BiDil
- Isosorbide dinitrate/hydralazine [BiDil] is primarily administered to African American patients.
Compensatory Responses
- In patients with reduced cardiac output, the renin-angiotensin-aldosterone system (RAAS) is activated.
Effective Heart Failure Treatment
- Absence of neck vein distention when the head of the bed is elevated indicates a therapeutic effect in heart failure patients.
Priority Nursing Interventions
- Before administering digoxin, analyze heart rate and rhythm as a priority intervention.
Pulse Assessment
- Assessing the pulse is crucial prior to administering digoxin to patients with heart failure.
Digoxin Administration
- If a patient's pulse is 55 beats/min, withhold the digoxin dose.
Blood Pressure and Vessel Constriction
- Constricting blood vessels will elevate blood pressure.
Biochemical Parameters for Digoxin
- Serum potassium concentration should be assessed to ensure safe administration of digoxin.
Sympathetic Nervous System Response
- In failing hearts, increased sympathetic activity results in tachycardia.
Preload Assessment
- A decrease in preload indicates a reduction in end-diastolic volume.
Cardiac Output Determinants
- Heart rate must also be assessed alongside stroke volume to determine cardiac output accurately.
Effects of Vasoconstriction
- Medication that constricts blood vessels increases vascular resistance.
Captopril Effects
- Captopril works by blocking the production of angiotensin II in patients with heart failure.
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