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Med-surg Ch. 38
Terms in this set (45)
What should be the temperature of warm cardioplegia?
What should a patient do if he has new-onset angina at home?
'Ingest 4 low-dose aspirins 81 mg each.
Which is the most suitable body temperature for cardiopulmonary bypass?
Which drug is an inotrope that may be used to maintain organ perfusion in a patient who had heart failure after a myocardial infarction (MI)?
The nurse is assessing a patient with chest pain to evaluate whether the patient is suffering from angina or myocardial infarction (MI). Which symptom is indicative of an MI?
Substernal chest pressure relieved only by opioids
A patient with coronary artery disease (CAD) is prescribed carvedilol. What side effect does the nurse monitor for during the assessment?
Shortness of breath
Which statement correctly describes the of the purpose intra-aortic balloon pump (IABP) as treatment for cardiogenic shock?
The IABP improves coronary blood flow during diastole and reduces afterload during systole.
A patient with angina reports chest discomfort. Which principle related to angina pain is important for the nurse to remember?
The administration of nitroglycerin (NTG) will improve oxygen supply.
When assessing a patient with evolving myocardial infarction (MI), for which associated symptom should the nurse be alert?
Prompt pain management with myocardial infarction is essential for which reason?
Pain relief improves oxygen supply and decreases oxygen demand.
What is the disadvantage of off-pump coronary artery bypass (OPCAB) surgery performed on patients with coronary artery disease (CAD)?
Need for skilled surgeons
A patient has undergone percutaneous coronary intervention (PCI) through the right femoral artery and has received bivalirudin infusion during the procedure. What is the nurse's priority action when the patient returns?
Monitor the insertion site for bleeding.
A patient has been admitted to the emergency department with chest pain and tightness and shortness of breath. After an initial assessment, the nurse suspects the patient has acute coronary syndrome (ACS). What will the nurse expect the health care provider to do immediately based on the recommendations provided by the American Heart Association (AHA)?
Administer morphine sulphate to the patient.
What medication is administered prior to nitrates to reduce headache discomfort?
The telemetry nurse is assessing a 12-lead electrocardiogram (ECG) of a patient with coronary artery disease. Which finding indicates the patient has had an acute myocardial infarction (MI)?
Q wave noted on ECG
An LPN/LVN is scheduled to work on the inpatient 'step- down' cardiac unit. Which patient does the charge nurse assign to the LPN/LVN?
66-year-old who has a prescription for a nitroglycerin patch and is scheduled for discharge to a group home later today
A patient has sustained an ST-segment myocardial infarction (STEMI) to the anterior wall and new-onset third- degree heart block. Which intervention does the nurse anticipate will be prescribed by the health care provider?
Which assessment finding takes precedence when a patient returns from percutaneous transluminal coronary angioplasty?
The groin dressing has a 10-cm round bloodstain.
Which patient activity best reflects the goal of phase 3 cardiac rehabilitation?
Developing a plan to walk briskly for physical conditioning
The nurse is caring for a patient who had coronary artery What manifestations indicate bypass graft (CABG) surgery. presence the of postpericardiotomy syndrome in the patient? Select all that apply.
Pericardial and pleural pain
A patient comes to the emergency department with chest discomfort. Which action does the nurse perform first?
Obtains the patient's description of the chest discomfort
The patient presents to the emergency room with severe chest pain. After administration of two sublingual nitroglycerin tablets, the patient is now reporting pain of 2 on a scale of 1-10. What action by the nurse is priority?
Prepare to administer a third nitroglycerin tablet.
To validate that a patient has had a myocardial infarction (MI), the nurse assesses for positive findings on which tests?
Creatine kinase-MB (CK-MB) and troponin
When administering morphine sulfate to a patient with a myocardial infarction, the nurse observes for which adverse effects? Select all that apply.
A patient with myocardial infarction has received tissue plasminogen activator (t-PA). What sign indicates that the patient has had a positive outcome with successful reperfusion?
The monitor shows episodes of ventricular tachycardia.
The nurse is providing health education to a patient with coronary artery disease after surgical intervention. What instructions should the nurse give to this patient? Select all that apply.
'Avoid straining activities.
"Avoid exercising when your pulse increases more than 20 beats/min.'
Which atypical symptoms may be present in a female patient experiencing myocardial infarction (MI)? Select all that apply.
When planning care for a patient in the emergency department, which interventions are needed in the acute phase of myocardial infarction? Select all that apply.
The cardiac care nurse is administering tissue plasminogen activator (t-PA) to a patient with myocardial infarction. Which finding during administration causes the nurse to notify the health care provider immediately?
Unilateral facial drooping
A patient weighing 165 lbs reports having chest discomfort for the past 50 minutes. The primary health care provider prescribes thrombolytic therapy followed by aspirin and IV heparin. Subcutaneous administration of low-molecular- weight heparin (LMWH) was prescribed followed by the administration of IV heparin. What is the dose of heparin that the nurse should administer? Record your answer using a whole number. mg
A patient diagnosed with evolving myocardial infarction abruptly develops ventricular fibrillation. Which is the priority action for the nurse at this time?
What statement by the nurse is most important for a patient experiencing a myocardial infarction who is upset and tells the nurse he or she is afraid of dying?
'I am sure you are scared, but I am not going to leave you.'
The nurse in the coronary care unit is caring for a group of patients who have had myocardial infarction. Which patient does the nurse see first?
Patient with third-degree heart block on the monitor
A patient diagnosed with coronary artery disease (CAD) is prescribed metoprolol. During a follow-up visit, the patient reports weight gain, cough, shortness of breath, and swelling in the legs. The nurse draws which conclusion?
The patient has developed heart failure.
The nurse is caring for a patient following cardiopulmonary bypass surgery. Which finding causes the nurse to intervene immediately?
The patient's temperature is 96.2°F (35.7°C).
A patient has just returned from coronary artery bypass graft (CABG) surgery. For which finding does the nurse contact the surgeon?
Chest tube drainage 175 mL last hour
The nurse is caring for a patient in phase 1 cardiac rehabilitation. Which suggestion does the nurse make?
Placing a chair in the shower for independent hygiene
What medications should the nurse assess the patient for prior to administering nitroglycerin for chest pain? Select all that apply.
The visiting nurse is seeing a patient postoperative for coronary artery bypass graft. Which nursing action should be performed first?
Monitor for dysrhythmias.
The nurse is concerned that a patient who had a myocardial infarction (MI) has developed cardiogenic shock. Which findings indicate shock? Select all that apply.
Cool, diaphoretic skin
Crackles in the lung fields
Anxiety and restlessness
The nurse is caring for a patient 36 hours after coronary artery bypass grafting (CABG), with a priority problem of intolerance for activity related to imbalance of myocardial oxygen supply and demand. Which finding causes the nurse to terminate an activity and return the patient to bed?
Respiratory rate 28/min
The nursing student is assisting with the care of a patient who has undergone coronary artery bypass grafting (CABG). Which statement by the student about the procedure indicates a need for further teaching by the supervising nurse?
'Best outcomes from CABG occur when coronary arteries have less than a 50% occlusion.'
A patient undergoing coronary artery bypass grafting (CABG) asks why the surgeon has chosen to use the internal mammary artery for the surgery. Which response by the nurse is correct?
'These arteries remain open longer.
An older adult patient, 4 hours after coronary artery bypass graft (CABG), has a blood pressure of 80/50 mm Hg. What action does the nurse take?
Assess pulmonary artery wedge pressure (PAWP).
A patient who is undergoing robotic for surgery coronary artery disease (CAD) asks the nurse about disadvantages of surgery. the Which fact about robotic surgery would the nurse provide?
Surgery time is longer.
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