Heart Failure
A patient with left-sided HF develops crackles, dyspnea, and SpO₂ 86%. What is the priority nursing action?
Place the patient in High-Fowler's position and administer oxygen as indicated.
Irregularly irregular rhythm with no distinct P waves?
Atrial fibrillation
Before giving a beta blocker, what two vital signs are especially important?
Heart rate and blood pressure
Predictable chest pain with exertion that improves with rest or nitroglycerin?
Stable angina
Patient has sinus tachycardia and a temperature of 103°F. What should the nurse investigate/treat first?
The underlying cause — the fever/infection
JVD, peripheral edema, ascites, and hepatomegaly indicate which type of HF?
Right-sided heart failure
A patient is in VTach. What is the most important assessment?
Check for a pulse.
Patient taking lisinopril has K⁺ = 5.9. What is occurring?
Hyperkalemia
Angina caused by coronary artery vasospasm that often occurs at rest?
Variant (Prinzmetal) angina
Patient is receiving their first dose of a new medication and needs to get out of bed. Who should assess the patient and response before ambulation is delegated?
The nurse
A patient with HF gains 4 lb over 2 days. What does this indicate?
Fluid retention
Patient is pulseless and in ventricular fibrillation. Priority intervention?
CPR and immediate defibrillation
Patient taking an ACE inhibitor develops lip and tongue swelling. What is the priority concern?
Angioedema
Infective endocarditis vegetations break off. What complication can occur?
Emboli/thromboembolic complications
Patient with A-fib is prescribed an anticoagulant. What complication should the nurse monitor for?
Bleeding
Severe dyspnea + crackles + pink, frothy sputum. What complication?
Acute pulmonary edema
Regular narrow-complex tachycardia at 190/min, no visible P waves, BP 124/76. What should the nurse anticipate FIRST?
Vagal maneuver
Patient taking nitroglycerin has BP 82/48 and severe dizziness. What should the nurse do?
Hold/stop further nitroglycerin and address the hypotension according to the prescription/protocol; notify the provider as appropriate.
Patient with hypertrophic cardiomyopathy. What should the nurse avoid encouraging?
A. Dehydration
B. Medication adherence
C. Follow-up
D. Appropriate activity restrictions
A. Dehydration
Sudden severe headache + vomiting + vision changes. What should the nurse suspect?
Hemorrhagic stroke / intracranial bleeding
Acute HF + severe dyspnea + crackles + SpO₂ 82%. What should the nurse do FIRST?
A. Daily weight
B. High-Fowler's
C. Oral beta blocker
D. Encourage fluids
B. Place the patient in High-Fowler's position
Frequent PVCs + potassium 2.8 mEq/L. Priority?
A. Beta blocker
B. Correct electrolyte abnormality
C. Cardioversion
D. Ambulation
B. Correct the electrolyte abnormality as prescribed
Patient taking a statin develops severe muscle pain/weakness and dark urine. What should the nurse suspect?
Rhabdomyolysis
What is the primary mechanical problem in restrictive cardiomyopathy?
A. Cannot contract
B. Cannot relax/fill normally
C. Excessive dilation
D. Excessive coronary blood flow
B. Cannot relax and fill normally
HR 190, narrow regular rhythm. Patient becomes hypotensive, confused, and develops chest pain. Priority intervention?
A. Vagal maneuver
B. Oral beta blocker
C. Synchronized cardioversion
D. Cough
C. Synchronized cardioversion