Chapter 34: Hypertension PT5

50問 • 1年前

問題一覧

A nurse assesses a client who has aortic regurgitation. In which location in the illustration shown below should the nurse auscultate to best hear a cardiac murmur related to aortic regurgitation?

Location A

A nurse is caring for a client with a history of renal insufficiency who is scheduled for a cardiac catheterization. Which actions should the nurse take prior to the catheterization? (Select all that apply.)

Assess for allergies to iodine., Administer intravenous fluids., Assess blood urea nitrogen (BUN) and creatinine results.

A nurse assesses a client who is recovering after a coronary catheterization. Which assessment findings in the first few hours after the procedure require immediate action by the nurse? (Select all that apply.)

Serum potassium of 2.9 mEq/L, Expanding groin hematoma, Rhythm changes on the cardiac monitor

A nurse reviews a clients laboratory results. Which findings should alert the nurse to the possibility of atherosclerosis? (Select all that apply.)

Total cholesterol: 280 mg/dL, Triglycerides: 200 mg/dL, Low-density lipoprotein cholesterol: 160 mg/dL

A nurse prepares a client for a pharmacologic stress echocardiogram. Which actions should the nurse take when preparing this client for the procedure? (Select all that apply.)

Prepare for continuous blood pressure and pulse monitoring, Give the client nothing by mouth 3 to 6 hours before the procedure, Explain to the client that dobutamine will simulate exercise for this examination

A nurse caresfor a client who is recovering from a right-sided heart catheterization. For which complications of this procedure should the nurse assess? (Select all that apply.)

Thrombophlebitis, Pulmonary embolism, Cardiac tamponade

Which description is correct about cardiac output?

Amount of blood pumped out by the ventricles in a given period of time

Which responsibility is the nurse's while assisting with data collection after noting general appearance?

Measure height, weight, and vital signs

A patient has diabetes with hypertension and is admitted for frequent bouts of hypoglycemia. Which prescription drug might be causing the hypoglycemia?

Atenolol (Tenormin)

Which manner defines a consistent blood pressure of 155/96 mm Hg?

High

Which cause is considered the leading cause of death for individuals with hypertension?

Cardiovascular disease

Which age-related change can affect blood pressure?

Atherosclerotic changes in vessels

Which goals of diet therapy are appropriate for the person with hypertension? (Select all that apply.)

Maintain ideal body weight., Prevent fluid retention.

A 45-year-old white female patient asks the nurse how she can reduce the risk for developing hypertension. The patient is 65 inches tall and weighs 160 lb. She has a history of anxiety, type 2 diabetes mellitus, and arthritis. The patient smokes 1 pack of cigarettes per day. Which risk factors for hypertension should the nurse discuss with this patient? (Select all that apply.)

Height, Weight, Smoking status

A patient was instructed by the health care provider to attempt relaxation techniques for good blood pressure control. The patient asks the nurse for clarification. Which examples of relaxation techniques should the nurse include in the discussion with the patient? (Select all that apply.)

Yoga, Meditation, Guided imagery

When reviewing a client's history, what risk factor is most significant for developing CAD?

Weighing 25 pounds above norm

To reduce a client's hyperlipidemia, a client is advised to follow a low-cholesterol diet. When the client asks the nurse how cholesterol acts as a cardiac risk factor, what is the best explanation?

Excess fat in the blood thickens the lining of the arteries.

When the nurse inquiries about the client's diet, the client tells the nurse that breakfast usually includes sausage, eggs, hash browns, and white bread and butter. To help the client comply with a low-cholesterol diet, what healthful alternative should the nurse recommend?

Cereal for eggs

Lifestyle changes prove insufficient for reducing the client's cholesterol level. Atorvastatin, an antihyperlipidemic medication, is prescribed. After providing medication instructions, the best evidence that the client knows this drug's potential side effects is when the client states it may cause which adverse effect?

Muscle pain

The client with CAD is scheduled for a stress electrocardiogram (ECG). When the client asks why an ECG has been ordered, what is an accurate nursing explanation for its purpose?

It shows how the heart performs during exercise.

A client with CAD experiences periodic chest pain and is diagnosed with angina pectoris. If the client is typical of others who have angina pectoris, the nurse would expect the client to report that chest pain is best relieved by what nonpharmacological measure?

Resting in a chair

Sublingual nitroglycerin tablets are prescribed for whenever the client experiences chest pain. What is the correct manner the nurse should instruct the client to self-administer a nitroglycerin tablet?

Place the tablet under the tongue

What information should the nurse explain is a sign the nitroglycerin tablets need replacing?

"They won't tingle in your mouth."

What should the nurse advise the client, if the chest pain is not relieved after taking one nitroglycerin tablet?

Take another tablet in 5 minutes.

Because the client has daily repeated episodes of angina, the nitroglycerin tablets are discontinued and replaced with an order for a daily nitroglycerin transdermal patch. What nursing action is most appropriate when applying a new transdermal patch?

Rotate the application site

What assessment finding should signal the nurse to withhold applying the client's nitroglycerin patch?

Blood pressure of 94/62 mm Hg

A client diagnosed with angina has been advised to reduce consumption of saturated fat to control the progression of coronary artery disease (CAD). When the nurse assesses the client's dietary compliance, what is the best evidence that the client is using an appropriate fat for cooking?

The client uses liquid corn oil

When a client experiences an increased number of anginal episodes, a cardiac catheterization and coronary arteriogram are ordered. What nursing action can best help reduce the client's anxiety in this situation?

Listen to the client's feelings about the scheduled tests.

The nurse implements the teaching plan for cardiac catheterization and coronary arteriogram. What information the nurse provides is accurate?

You will feel warm as the dye is instilled."

The nurse recognizes an allergy to what substance presents a high risk when the client undergoes a cardiac catheterization?

Shellfish

After the coronary arteriogram, in what position should the nurse maintain the client's affected leg used for inserting the cardiac catheter?

Extended

When the client is returned to the room on the nursing unit, what should the nurse plan to do first?

Palpate the client's distal peripheral pulses.

A client with CAD will undergo percutaneous transluminal coronary angioplasty (PTCA). The nurse knows that the client understands the explanation of the PTCA procedure when the client makes which statement?

A balloon-tipped catheter will be inserted into my coronary artery."

While the client takes propranolol, what assessment finding can the nurse expect?

The client's pulse will be slower than in the past.

The client is told to take 81 mg of aspirin daily while waiting for the scheduled percutaneous transluminal coronary angioplasty (PTCA). What is the best nursing explanation for the drug therapy in this situation?

Aspirin tends to prevent blood clots.

When the client returns to the room after the percutaneous transluminal coronary angioplasty (PTCA) procedure, what assessment finding should be reported immediately?

Chest pain

A client is undergoing a coronary artery bypass graft (CABG) procedure. The nurse assesses the client's mental status upon being transferred from the postanesthesia recovery (PAR) room. What is the best explanation the nurse can attribute to incorrect answers to the nurse's questions?

The client is influenced by anesthesia.

Where is it best for the nurse to assess an incision when checking the client's leg following CABG surgery? In the area of the:

saphenous vein.

Which action indicates that the nurse needs to provide more instruction to a unlicensed assistive person (UAP) on how to accurately assess the client's pulse rate?

The UAP places a thumb over the radial artery.

The client reports having acute pain in the incisional area. How would acute pain most likely affects the client's vital signs during the nurse's assessment?

Pulse rate will be rapid.

When the client uses a patient-controlled analgesia (PCA) infusion pump, what nursing instruction is most important to include?

Press the control button whenever you feel you need pain medication."

What information about the client's use of a patient-controlled analgesia (PCA) pump is most important to communicate to the staff on the next shift?

The number of doses administered

What nursing assessment is a priority to determine if the client is experiencing a side effect of opioid analgesia?

Check the client's bowel elimination.

After the coronary artery bypass graft (CABG) surgery, what nursing assessment finding provides the best evidence that collateral circulation at the donor graft site is adequate?

The client's toes are warm when touched

The nurse prepares to ambulate a client for the first time following cardiac surgery. What item is best for the nurse to use?

Gait belt

An older adult patient with hypertension has been taking atenolol (Tenormin) for several weeks and reports feeling depressed. Which action is most appropriate for the nurse to take?

Notify the health care provider so that another drug may be substituted.