care Of Clients With Cardiovascular Disorders

1. A client with angina pectoris asks the nurse, "What information does ECG provide?" The nurse would appropriately respond that ECG gives information about the:

Electrical conduction of the myocardium.

Oxygenation and perfusion of the heart.

Contractile status of the ventricles.

Physical integrity if the muscle.

Electrical conduction of the myocardium. ECG directly reflects the transmission of electrical cardiac impulses throughout the heart.

Explanation

Electrical conduction of the myocardium. ECG directly reflects the transmission of electrical cardiac impulses throughout the heart.

2. When teaching the client with myocardial infarction (MI), the nurse explains that the pain is associated with MI is caused by:

Left ventricular overload.

Impending circulatory collapse.

Extracellular electrolyte imbalances.

Insufficient oxygen reaching the heart muscle.

Insufficient oxygen reaching the heart muscle, causes increased lactic acid production due to anaerobic metabolism. Lactic acid initiates nerve endings in the myocardium, thereby causing chest pain.

Explanation

Insufficient oxygen reaching the heart muscle, causes increased lactic acid production due to anaerobic metabolism. Lactic acid initiates nerve endings in the myocardium, thereby causing chest pain.

3. Proper hand placement for chest compression during CPRis essential to reduce the risk of which of the following complications?

Gastrointestinal bleeding

Myocardial infarction

Emesis

Rib fracture

Proper hand placement during chest compression is essential to reduce the risk of RIB FRACTURES, which may lead to pneumothorax and other internal injuries.

Explanation

Proper hand placement during chest compression is essential to reduce the risk of RIB FRACTURES, which may lead to pneumothorax and other internal injuries.

4. Which of the following is an uncontrollable risk factors that has been linked to the development of coronary artery disease (CAD)?

Exercise

Obesity

Gender

High-cholesterol level

Gender has been linked to coronary artery disease and is uncontrollable or non-modifiable risk factor.

Explanation

Gender has been linked to coronary artery disease and is uncontrollable or non-modifiable risk factor.

5. Which of the following in NOT a characteristic of chest pain in myocardial infarction (MI)?

It last for more than 30minutes.

It radiates to the entire chest, neck and left arm.

It is relieved by rest.

It is crushing in character.

MI is not be relieved by rest.

Explanation

MI is not be relieved by rest.

6. How should the nurse instruct the client with angina pectoris to take sublingual nitroglycerine when chest pain occurs?

Take one tablet every 2 to 5 min until the pain subsides.

Take one tablet and rest for 10minutes. Call the physician is the pain persists after 10minutes.

Take one tablet, then an additional tablet every 5 minutes for a total of three tablets. all the physician if pain persists after three tablets.

Take one tablet. If pain persists after 5 minutes, take two tablets. If pain still persists 5 minutes after, call the physician.

Take nitroglycerine at a maximum dose of 3 tablets at 5minutes interval. If pain persists after three tablets, suspect MI. Then the nurse should call the physician.

Explanation

Take nitroglycerine at a maximum dose of 3 tablets at 5minutes interval. If pain persists after three tablets, suspect MI. Then the nurse should call the physician.

7. The rescuer understands that the compression-to-ventilation ratio in CPR is:

5:1

15:1

30:2

15:2

the compression-ventilation ratio for CPR is 30:2 in all ages.

Explanation

the compression-ventilation ratio for CPR is 30:2 in all ages.

8. Which of the following may precipitates the chest pain in myocardial infarction?

Taking a warm bath.

Having frequent rest period.

Eating a large meal.

Avoiding exposure to cold.

Eating large meal may precipitates chest pain in the client with angina pectoris. The other precipitating factors are: exertion, exposure to colds and strong emotion.

Explanation

Eating large meal may precipitates chest pain in the client with angina pectoris. The other precipitating factors are: exertion, exposure to colds and strong emotion.

9. The type of artificial cardiac pacemaker which provides a specific number of electrical firings per minute is:

Fixed rate pacemaker

Demand rate pacemaker

Temporary pacemaker

Permanent pacemaker

The type of artificial cardiac pacemaker which provides a specific number of electric firings per minute is FIXED RATE PACEMAKER.

Explanation

The type of artificial cardiac pacemaker which provides a specific number of electric firings per minute is FIXED RATE PACEMAKER.

10. The following interventions should be included in the nursing care plan of the client with MI, EXCEPT:

Place the client in semi-Fowler's position.

Administer oxygen by small cannula as ordered.

Encourage use of bedpan for defecation

Provide low sodium, low fat and low cholesterol diet.

Use of bed pan on defecation encourage use of Valsalva Maneuver. Valsalva Maneuver increases cardiac workload and may precipitates another MI attack. Use of bedside commode is more preferred, because this will not include use of Valsalva maneuver.

Explanation

Use of bed pan on defecation encourage use of Valsalva Maneuver. Valsalva Maneuver increases cardiac workload and may precipitates another MI attack. Use of bedside commode is more preferred, because this will not include use of Valsalva maneuver.

11. Which of the following signs and symptoms would most likely be experienced by a client with right-sided congestive heart failure?

Dyspnea, crackles, ankle edema

Engorged neck vein, enlarged liver, weight gain

Hemoptysis, hypertension, pallor

Syncope, hemolytic anemia, clubbing of fingers

Engorged neck vein, enlarged liver, weight gain are the signs and symptoms experienced by the client with right-sided congestive heart failure. The signs and symptoms are due to damming back of blood on the venous circuit.

Explanation

Engorged neck vein, enlarged liver, weight gain are the signs and symptoms experienced by the client with right-sided congestive heart failure. The signs and symptoms are due to damming back of blood on the venous circuit.

12. The nurse administers digoxin to the client with congestive heart failure. The nurse should first check which of the following?

Pulse rate

Apical pulse

Blood pressure

Respiratory rate

Check the APICAL PULSE (heart rate) first before digoxin administration. Digoxin slows down heart rate (negative chronotropic effect). If the heart rate is below 60bpm, withhold the medication because it causes bradycardia. If the heart rate is 129bpm and above, withholds the medication because it can cause rebound tachycardia.

Explanation

Check the APICAL PULSE (heart rate) first before digoxin administration. Digoxin slows down heart rate (negative chronotropic effect). If the heart rate is below 60bpm, withhold the medication because it causes bradycardia. If the heart rate is 129bpm and above, withholds the medication because it can cause rebound tachycardia.

13. The client will undergo left-sided cardiac catheterization. Which of the following should not be included in patient teaching?

"You will experience warm sensation as the contrast medium is injected."

"You will receive anesthesia."

"You will be placed in a tunnel- like device."

"You have to tell me if you have any allergy to seafoods."

"You should placed in a tunnel-like device," SHOULD NOT be included in patient teaching for cardiac catheterization. Cardiac catheterization involves radiographic studies of the heart structures following administration of contract medium through a catheter.

Explanation

"You should placed in a tunnel-like device," SHOULD NOT be included in patient teaching for cardiac catheterization. Cardiac catheterization involves radiographic studies of the heart structures following administration of contract medium through a catheter.

14. Which of the following indicates congestive heart failure?

BUN=15mg./dl

CVP=7 cm.; H2O

Serum potassium = 4m Eq/L

Hourly urine output = 30 to 60 mls.

CVP of 17 cm. water indicates congestive heart failure and a circulatory overload. The normal CVP reading is 5-12cm.water.

Explanation

CVP of 17 cm. water indicates congestive heart failure and a circulatory overload. The normal CVP reading is 5-12cm.water.

15. Which of the following results of enzyme studies does not includes the presence of myocardial infarction?

Elevated Ck-MB

Elevated SGOT (AST)

Elevated LDH

Elevated SGPT (ALT)

Elevated SGPT (ALT)DOES NOT indicates the presence of MI. The MI does not produce SGPT. Only liver cells produce SGPT.

A, B, C are enzymes studied that indicates the presence of MI.

Explanation

Elevated SGPT (ALT)DOES NOT indicates the presence of MI. The MI does not produce SGPT. Only liver cells produce SGPT.

A, B, C are enzymes studied that indicates the presence of MI.