pharmacology
A patient is admitted with acute decompensated heart failure. Which of the following interventions whould the nurse anticipate to decrease preload
Administering IV diuretics
Administering digoxin
Providing supplemental oxygen
Administering a beta blocker
Administering IV diuretics
A patient with chronic heart failure comes to the clinical reporting a 5 pound weight gain over the past week. Which is the nurse's priority assessment?
Checking apical pulse rate and rhythm
Inspecting for peripheral edema and JVD
Assessing heart sounds for murmurs
Evaluating dietary compliance
2. Inspecting for peripheral edema and JVD
Theres volume issues where would we find it in our assessment
Which plan would be appropriate in helping to control CHF in an infant?
1. Promoting fluid restriction
2. Feeding a low salt formula
3. Feeding in semi Fowler position
4. Encouraging breast milk
3. Feeding in semi Fowler position
The nurse would not need to restrict flu-ids, as the child likely would not be getting overloaded with oral fluids. 1. The infant likely will have sodium depletion because of the chronic diuretic use; the infant needs a normal source of sodium, so low-sodium formula would not be used. 2. The infant has a great deal of difficulty feeding with CHF, so even getting the maintenance fluids is a challenge. The infant is fed in the more upright position so that fluid in the lungs can go to the base of the lungs, allowing better expansion. 3. Breast milk has slightly less sodium than does formula, and the child needs a normal source of sodium because of the diuretic.
The nurse is caring for a patient with stable angina. Which assessment finding would be consistent with this medical diagnosis?
1. Persistent ECG changes
2. Increasing nocturnal pain
3. Correlation between activity level and pain
4. Evidence of impaired cardiac output such as weak peripheral pulses.
3. Stable angina is the most common and predictable form of angina. It occurs with a predictable amount of activity or stress and usually occurs when the work of the heart is increased by physical exertion, exposure to the cold, or by stress.
The nurse noted the rash was present on the trunk, extremities, and face. The child's cheeks were bright red. The nurse is aware this type of rash is consistent with:
1. measles.
2. roseola.
3. varicella.
4. fifth disease.
4. fifth disease. In fifth disease, the child has a generalized rash and the cheeks have a slapped-cheek
Which new assessment in a client receiving IV furosemide signals perfusion requiring provider notifications?
A. BP 118/72 -> 102/66 after diuresis
B. heart rate 86->92
C. urine output 45 ml/hr -> 12 mL/Hr
D.Weight down 1.2 kg since yesterday
C. urine output 45 ml/hr -> 12 mL/Hr
You are writing a teaching plan for a patient diagnosed with HF. What would be an important aspect to
include in the teaching plan?
a) Self-care
b) Foot care
c) Dressing changes
d) Nutrition
ANSWER: A
Rationale: Major goals for the patient may include promoting activity and reducing fatigue, relieving fluid overload symptoms, decreasing anxiety or increasing the patient's ability to manage anxiety, encouraging the patient to verbalize his or her ability to make decisions and influence outcomes, and teaching the patient about the self-care program. Nowhere in the scenario is there any indication that the patient needed teaching on foot care, dressing changes, or nutrition.
The mother of a toddler reports that the child father had just had an MI. Because of this information the nurse recommends the child have a(n)
1. ECG
2. Lipid profile
3. Echocardiogram
4. Cardiac catheter
2. Lipid profile
Current recommendations are for a lipid profile in children over 2 years with a first- or second-degree relative with stroke (CVA), MI, angina, or sudden cardiac death. Also screen if parent, sibling, or grandparent has cholesterol of 240 mg/dL or greater. 1. Current recommendations are for a lipid profile in children over 2 years with a first- or second-degree relative with stroke (CA), MI, angina, or sudden cardiac death. Also screen if parent, sibling, or grandparent has cholesterol of 240 mg/dIL or greater. 2. Current recommendations are for a lipid profile in children over 2 years with a first- or second-degree relative with stroke(CVA), MI, angina, or sudden cardiac death. Also screen if parent, sibling, or grandparent has cholesterol of 240 mg/dL or greater. 3. Current recommendations are for a lipid profile in children over 2 years with a first- or second-degree relative with stroke(CVA), MI, angina, or sudden cardiac death. Also screen if parent, sibling, or grandparent has cholesterol of 240 mg/dL or greater
The nurse is caring for a patient recovering from a coronary angioplasty with stent placement. Which intervention is a priority for the patient at this time?
1. Securing chest tubes to bedding
2. Maintaining leg extension on the affected side
3. Discontinuing intravenous lines when taking oral fluids
4. Treating chest pain with intravenous morphine as needed
2. The cardiac catheter used to insert the stent is usually inserted via the femoral artery, a large, high-pressure vessel. The leg is maintained in extension for a prescribed period after the procedure to reduce the risk of bleeding, hematoma formation, or clot formation at the insertion site.
The causative agent for erythema infectiosum, fifth disease, is:
1. paramyxovirus
2. parvovirus B19
3. human herpes virus types 1 and 2
4. group A ß-hemolytic streptococci
2. parvovirus B19
A patient is prescribed lovastatin (Mevacor) for hyperlipidemia. What should the nurse instruct the patient about this medication?
A. Abstain from alcohol use while taking this drug
B. Take the drug with meals to minimize gastric distress
C. Promptly report muscle pain or tenderness to the physician
D. Consume a diet that includes no more than 20% of calories from saturated fat.
c. Lovastatin is a first line drug for treating hyperlipidemia and can cause myopathy. All patients should be instructed to report muscle pain and weakness or brown urine, which is an indication of muscle breakdown.
Which of the following foods should the nurse teach a client with heart failure to limit when following a 2-g sodium diet?
a) Apples
b) Tomato juice
c) Whole wheat bread
d) Beef tenderloin
ANWER: B
Rationale: Canned foods and juices such as tomato juice are typically high in sodium and should be avoided in a sodium-restricted diet. Canned foods and juices in which sodium has been removed or limited are available. The client should be taught to read labels carefully. Apples and whole wheat breads are not high in sodium. Beef tenderloin would have less sodium than canned foods or tomato juice.
A nurse is caring for a child with KD. A student nurse who is on the unit ask if there are medications to treat this disease. The nurses response to the student nurse is
1. medication is not the treatment for this disease
2. Immunoglobulin G and ace inhibitors
3. Immunoglobulin G and asprin
4. Immunoglobulin G and ibuprofen Immunoglobulin G and asprin
3. Immunoglobulin G and asprin
The nurse is planning care for a patient receiving fibrinolytic therapy for a pulmonary embolism. Which nursing diagnosis is the priority?
The correct answer is risk for bleeding because fibrinolytic therapy (such as alteplase) works by dissolving clots, which significantly increases the patient’s risk for hemorrhage—the most serious and life-threatening complication.
The nurse would delay the administration of DTaP when the mother says that her infant:
1. has diarrhea.
2. had a temperature of 40.5° C (105° F) from the previous inoculation.
3. is teething.
4. is traveling with her to Europe in a week
b. had a temperature of 40.5° C (105° F) from the previous inoculation. A contraindication to giving the DTaP vaccine is a 40.5° C (105° F) 500 A child was sent to the school nurse because of a rash
a patient with advanced heart failure is prescribed a combination of beta blockers, ACE inhibitors, and diuretics. Which benefits do these medications collectively offer? Select all that apply
A. afterload reduction
B. enhance myocardial contractility
C. decrease fluid overload
D. improved oxygen carrying capacity
E. Reduce heart rate
F. preload reduction
A,C,E,F
which findings are most consistent with fluid volume overload? SATA
A. crackles at lung base
B. flat neck veins
C. Bounding peripheral pulses
D. S3 heart sounds
E. decreased skin turgor
F. weight gain of 1-2 kg in 24-48 hr
A, C,D,F
TOF involves which defects? SATA
1. VSD
2. Right ventricular hypertrophy
3. left ventricular hypertrophy
4. PS
5. Pulmonic atresia
6. overridiing aorta
7. PDA
1,2,4,6
The nurse is planning to teach a client about coronary angiography. Which information should the nurse include? (Select all that apply.)
A. There will be a flushing sensation while the dye is injected during the procedure.
B.You will not be able to eat or drink for several hours after the procedure.
C. You will need to remain in bed with your leg straight after the procedure.
D. Pulses on your Feet will need to be checked frequently after the procedure.
E.Pressure will be applied to the insertion site after the procedure.
A, C, D, E
A coronary angiogram, obtained through a procedure known as cardiac catheterization, is a radiographic study of the circulation of the coronary arteries. The client will be on bedrest for up to 8 hours after the procedure with his leg straight, and pedal pulses will be checked every 15 minutes following the procedure. There will be a flushing sensation while the dye is injected during the procedure. After the procedure, the client will have pressure applied to the insertion site when the sheath is removed. Food and drink are allowed as tolerated.
Hypoxic spells in the intant with a CHD can cause which of the following. Select all that apply.
1. Polycythemia.
2. Blood clots.
3. CVA.
4. Developmental delays.
5. Pericarditis.
6. Brain damage.
7. Alkalosis
8. Hypertension
1,2,3,4,6
Captopril (Capoten), furosemide (Lasix), and metoprolol (Toprol XL) are ordered for a client with systolic heart failure. The client's blood pressure is 136/82 and the heart rate is 65. Prior to medication administration at 9 am, the nurse reviews the following lab tests. Which of the following should the nurse do first?
Lab Results:
Sodium 140 mEq/L
Potassium 6.8 mEq/L
Chloride 101 mEq/L
CO2 content 26 mEq/L
BUN 18 mg/dL
Creatinine 1.0 mg/dL
Hemoglobin 12 g/dL Hematocrit 37%
a) Administer the medication
b) Call the physician
c) Withhold the captopril
d) Question the metoprolol dose
ANSWER: C
Rationale: The nurse should withhold the dose of captopril; captopril is an ACE-inhibitor and a side effect of the medication is hyperkalemia. The BUN and creatinine, which are normal, should be viewed prior to administration since renal insufficiency is another potential side effect of an ACE-I. The heart rate is within normal limits. The nurse should question the dose of metoprolol if the client's heart rate is bradycardic. The hemoglobin and hematocrit are normal for a female. The nurse should report the high potassium level and that the captopril was withheld.
A 60 year old female was diagnosed with mitral stenosis. As a result the nurse realizes the patient has incomplete emptying of the
a. Right atrium
b. right ventricle
c. left atrium
d. left ventricle
c. left atrium
TOF involves which defects? Select all that apply.
1. VSD.
2. Right ventricular hypertrophy.
3. Left ventricular hypertrophy.
4. PS.
5. Pulmonic atresia.
6. Overriding aorta.
7. PDA.
1,2,4,6
The nurse is providing discharge teaching about a cardiac diet to a client following a myocardial infarction. Which client statement indicates that the nurse's teaching has been successful? (Select all that apply.)
A. "I am going to have a roast beef sandwich for lunch."
B."As soon as I get out of here, I'm going to my favorite steakhouse to celebrate!"
C."I don't like vegetable oil spread, so I will seek a different healthy butter alternative."
D. "I will continue cooking my food in coconut oil because of its many health benefits."
E. "I am happy that I won't have to give up my almond butter sandwiches!"
A,C,E
Clients with coronary artery disease (CAD) should reduce their consumption of saturated fats and cholesterol and should increase fiber intake. The goal is to lower the client's low-density lipoprotein (LDL). Roast beef is a lean cut of meat and therefore is appropriate in moderation. Almonds are high in fiber, and almond butter and peanut butter are full of monounsaturated fats, which are recommended to be a client's source of fat. Coconut oil and red meat, like steak, are high in saturated fat and should be avoided. Clients should be encouraged to find alternatives to their favorite foods that work with their prescribed diet.
Between 0700 and 1900 the client had a continuous bladder irrigation running at 150 mL/hr.At 1900 thenursing assistant reported that the output from the catheter was 2500 mL.What is the client's total urineoutput for 12 hour shift?Record your answer using a whole number
700 ml