RN Targeted Medical Surgical Cardiovascular Flashcards
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Questions and Answers

What potential complication should a nurse recognize in a client with endocarditis?

  • Heart failure
  • Diabetes
  • Valvular disease (correct)
  • Hypertension
  • What client statement indicates a potential complication following permanent pacemaker insertion?

    I can't get rid of these hiccups

    What INR value indicates effective warfarin therapy in a client with a history of DVT?

    INR 2.0

    What adverse effect should a nurse monitor for in a client receiving furosemide?

    <p>Lightheadedness</p> Signup and view all the answers

    What client statement indicates a need for further clarification before undergoing CABG?

    <p>I took my warfarin last night according to my usual schedule</p> Signup and view all the answers

    Which area of the ECG rhythm strip should a nurse examine to observe for atrial depolarization?

    <p>A</p> Signup and view all the answers

    What laboratory values indicate a need for dietary teaching for a client with peripheral arterial disease?

    <p>Cholesterol 190 mg/dL, HDL 25 mg/dL, LDL 160 mg/dL</p> Signup and view all the answers

    What finding indicates effective treatment of pulmonary edema related to heart failure?

    <p>Absence of adventitious breath sounds</p> Signup and view all the answers

    What intervention should a nurse prepare for when a client's rhythm changes to supraventricular tachycardia?

    <p>Vagal stimulation</p> Signup and view all the answers

    Which client is at risk for developing peripheral arterial disease?

    <p>A client who has diabetes mellitus</p> Signup and view all the answers

    What manifestation should a nurse expect to find in a client with left-sided heart failure?

    <p>Weak peripheral pulses</p> Signup and view all the answers

    What intervention is contraindicated for a client 1 week postoperative from an anterior myocardial infarction?

    <p>Assisting with thrombolytic therapy</p> Signup and view all the answers

    What finding should a nurse report before a client undergoes coronary angiography?

    <p>Previous allergy to shellfish</p> Signup and view all the answers

    What finding should a nurse monitor for and report immediately in a client with heart failure and atrial fibrillation?

    <p>Slurred speech</p> Signup and view all the answers

    What is the first action a nurse should take for a client in hypertensive crisis?

    <p>Elevate the head of the client's bed</p> Signup and view all the answers

    What action should a nurse take if a client on heparin therapy develops hematuria and has an aPTT of 96 seconds?

    <p>Stop the heparin infusion</p> Signup and view all the answers

    What adverse effect should a client with a new prescription for an ACE inhibitor report to their provider?

    <p>Persistent cough</p> Signup and view all the answers

    Which lifestyle modifications should a nurse include in teaching for clients with hypertension? (Select all that apply)

    <p>Regular exercise program</p> Signup and view all the answers

    What finding should a nurse report for a client who is 8 hours postoperative from CABG?

    <p>BP 160/80 mm Hg</p> Signup and view all the answers

    What finding should a nurse monitor for in a client with bradydysrhythmia?

    <p>Confusion</p> Signup and view all the answers

    What finding should a client with heart failure report immediately to their provider?

    <p>Weight gain of 0.9 kg/ 2 lb in 24 hr</p> Signup and view all the answers

    What action should a nurse take first for a client receiving diuretics and experiencing weakness and an irregular heart rate?

    <p>Review serum electrolyte values</p> Signup and view all the answers

    What statement indicates the need to contact the provider for a client scheduled for exercise electrocardiography?

    <p>I smoked a cigarette this morning to calm my nerves about having this procedure</p> Signup and view all the answers

    Where should a transdermal nitroglycerin patch be placed according to the nurse's teaching?

    <p>On an area of skin away from skin folds and joints</p> Signup and view all the answers

    What statement regarding chest pain should a nurse include in teaching for a client who is 2 days postoperative from a heart transplant?

    <p>You might no longer be able to feel chest pain</p> Signup and view all the answers

    What focused assessment should a nurse conduct to differentiate between arterial and venous ulcers?

    <p>Inquire about the presence or absence of claudication</p> Signup and view all the answers

    What finding can indicate shock in a client 1 hour postoperative from an aortic aneurysm repair?

    <p>Urine output of 20 mL/hr</p> Signup and view all the answers

    What value is diagnostic of a myocardial infarction after an onset of chest pain?

    <p>Creatine kinase-MB</p> Signup and view all the answers

    Identify the area a nurse should inspect when evaluating the PMI.

    <p>D</p> Signup and view all the answers

    What finding should a nurse expect in a client with dilated cardiomyopathy?

    <p>Dyspnea on exertion</p> Signup and view all the answers

    Study Notes

    Endocarditis and Complications

    • Valvular disease often develops from endocarditis due to inflammation or infection.

    Pacemaker Complications

    • Hiccups post pacemaker insertion can signal lead wire perforation, affecting diaphragm stimulation.

    Warfarin Therapy

    • An INR of 2.0 is ideal for clients with DVT on warfarin, in the recommended range of 2.0-3.0.

    Heart Failure Medication Effects

    • Furosemide can cause significant drops in blood pressure, leading to lightheadedness.

    Preoperative Protocols

    • Clients scheduled for CABG must discontinue anticoagulants like warfarin days beforehand to avoid bleeding.

    ECG Assessment

    • Atrial depolarization is observable in section A of the ECG rhythm strip.

    Peripheral Arterial Disease Dietary Needs

    • A client with cholesterol at 190 mg/dL, HDL at 25 mg/dL, and LDL at 160 mg/dL requires dietary education for managing levels.

    Pulmonary Edema Treatment

    • Absence of adventitious breath sounds indicates effective treatment and improvement of pulmonary edema.

    Supraventricular Tachycardia Management

    • Prepare vagal stimulation techniques to revert from supraventricular tachycardia while having resuscitation equipment ready.

    Risk Factors for Peripheral Arterial Disease

    • Diabetes mellitus increases the risk of microvascular damage and exacerbates peripheral arterial disease.

    Signs of Left-sided Heart Failure

    • Weak peripheral pulses indicate poor cardiac output typically associated with left-sided heart failure.

    Contraindications for Thrombolytic Therapy

    • Major surgery within the last 3 weeks is a contraindication for thrombolytic therapy post-myocardial infarction.

    Allergy Considerations in Angiography

    • Report previous shellfish allergies before coronary angiography due to potential iodine reactions.

    Monitoring Atrial Fibrillation

    • Slurred speech is critical to report, as it can signify inadequate brain circulation due to embolism risks.

    Hypertensive Crisis Management

    • Elevate the client’s head to lower blood pressure and enhance oxygenation in cases of hypertensive crisis.

    Heparin Therapy and Monitoring

    • An aPTT of 96 seconds with hematuria requires immediate cessation of heparin to prevent further bleeding.

    ACE Inhibitor Side Effects

    • Clients on ACE inhibitors should report persistent cough as it may necessitate treatment alteration.

    Lifestyle Modifications for Hypertension

    • Promoting limited alcohol consumption, regular physical activity, and cessation of tobacco use as key lifestyle changes.

    Post-CABG Monitoring

    • Report a postoperative blood pressure of 160/80 mm Hg due to risks of increased vascular pressure and bleeding.

    Confusion and Bradydysrhythmia

    • Monitor for confusion in clients experiencing bradydysrhythmia due to compromised systemic perfusion.

    Heart Failure Discharge Teaching

    • Instruct clients to report a weight gain of 0.9 kg (2 lb) in 24 hours, indicating potential fluid retention worsening heart failure.

    Electrolyte Imbalance Assessment

    • Review serum electrolytes when a client on loop diuretics and digitalis presents with weakness and irregular heart rate.

    Smoking and Stress Prior to Testing

    • Reschedule exercise electrocardiography if the client smoked beforehand as it influences test outcomes.

    Transdermal Nitroglycerin Usage

    • Apply transdermal patches away from skin folds and joints to ensure proper adhesion and effectiveness.

    Post-Heart Transplant Pain Sensation

    • Clients may be unable to recognize chest pain post-heart transplant due to heart denervation.

    Assessment of Leg Ulcers

    • Assess the presence or absence of claudication to differentiate between arterial and venous ulcers.

    Postoperative Shock Indicators

    • Urine output below 30 mL/hr after aortic aneurysm repair signifies potential shock requiring reporting.

    Diagnosing Myocardial Infarction

    • Elevated creatine kinase-MB levels are indicative of myocardial injury and essential in diagnosing myocardial infarction.

    Inspecting the PMI

    • The point of maximal impulse (PMI) is best assessed at the left fifth intercostal space in the midclavicular line.

    Dilated Cardiomyopathy Symptoms

    • Dyspnea on exertion is a common symptom of dilated cardiomyopathy due to impaired ventricular function and output.

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    Description

    Enhance your nursing skills with these flashcards focusing on cardiovascular conditions like endocarditis and pacemaker care. This quiz provides key insights into potential complications and management strategies. Ideal for nursing students preparing for medical-surgical exams.

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