| Examination of a patient in a supine position reveals distended jugular veins from the base of the neck to the angle of the jaw. This finding indicates | Increased central venous pressure |
| When caring for a patient who has intermittent claudication, the cardiac-vascular nurse advises the patient to | Walk as tolerated |
| The cardiac-vascular nurse reviews recommended activities with a patient who sustained a myocardial infarction. The patient states, "It doesn't really matter what I do or don't do. I will either get better or die." This statement reflects | Feelings of loss of control |
| A patient who is in the 10th week of outpatient cardiac rehabilitation continues to exhibit symptoms of depression. When developing a discharge plan, the cardiac-vascular nurse includes | A referral for counseling and possible medication |
| When reviewing a patient's four-week diet history, the cardiac-vascular nurse identifies a pattern of high calorie intake on Monday, Wednesday, and Friday nights. The patient states that the patient's spouse recently started taking a night class on those evenings at a local university. The patient's diet history indicates | An individual coping behavior |
| A patient who underwent a percutaneous, transluminal coronary angioplasty four weeks ago has a subsequent ejection fraction of 30%. The patient returns for a follow-up visit. Examination reveals lungs that are clear to auscultation and slight pedal edema. The patient's medications are digoxin (Lanoxin), furosemide (Lasix), enalapril maleate (Vasotec), and aspirin. The patient reports a 5-lb (2.27-kg) weight gain over the past two days. The cardiac-vascular nurse's initial action is to | Inquire about the patient's medication compliance |
| As the cardiac-vascular nurse prepares to administer an experimental cardiac drug to a patient who is participating in a research study, the patient states that he or she no longer wants the medication. The nurse advises the patient that | He or she has a right to refuse the medication and to withdraw from the study |
| Which is the primary consideration when preparing to administer thrombolytic therapy to a patient who is experiencing an acute myocardial infarction (MI)? | Time since onset of symptoms |
| A 55-year-old patient who is diagnosed with an evolving myocardial infarction (MI) insists on going home. The cardiac-vascular nurse encourages the patient to be admitted because the greatest risk within the first 24 hours of sustaining an MI is | Ventricular fibrillation |
| A patient comes to the emergency department with reports of a swollen and painful leg but denies sustaining any injury. Physical examination reveals a tense calf muscle, decreased sensation to the foot and leg, and absent pedal pulses. The cardiac-vascular nurse asks the patient when the symptoms began because | Irreversible anoxic injury to muscles and nerves can occur in as few as four hours |
| A primary prevention for reducing a female patient's risk of developing coronary heart disease is to | Avoid excessive weight gain during pregnancy |
| What is an important aspect of caring for the patient with a cardiovascular disorder? | Understanding the risk factors and incorporating them into patient teaching |
| What are major diagnostic tests to evaluate cardiovascular function? | Chest Radiograph, Arteriography, Cardiac Catheterization, ECG, Echocardiogram, Telemetry, Stress test, PET, and thallium scanning |
| What are common laboratory examinations to evaluate cardiovascular function are | Blood cultures, CBC, PT, INR, PTT, ESR, serum electrolytes. lipids, Arterial blood gases, BNP, serum cardiac markers |
| A Myocardial muscle protein released into the circulation after Myocardial injury, useful in diagnosing an MI | Troponin I |
| Includes a variety of conditions that obstruct blood flow in the coronary arteries | CAD "Coronary Artery Disease" |
| What happens when the Myocardial Oxygen demand exceeds the Myocardial oxygen supply? | Ischemia of the heart muscle occurs, resulting in chest pain or angina |
| What includes in patient teaching to minimize the pain of angina pectoris? | Taking Nitroglycerin before exertion
Eating small amounts more frequently rather than two or three larger meals in a day
Balancing Exercise periods with rest
Avoiding exposure to extreme weather conditions
Quitting Smoking |
| What are some Subjective data for the patient with MI? | Heavy pressure or squeezing pressure in chest
Retrosternal pain radiating to left arm and jaw
Anxiety
Nausea and Dyspnea |
| What are Objective datas for the patient with MI? | Pallor
Hypertension
Cardiac Rhythm changes
Vomiting
Fever
Diaphoresis |
| What are possible nursing diagnoses for the patient with MI? | Pain [ Acute ]
Tissue Perfusion [ Ineffective ]
Activity Intolerance
Decreased Cardiac Output
Anxiety
Constipation |
| What are Cardiac Rehabilitation services designed to do? | Help pt's with heart disease recover faster and return to full and productive lives |
| What does cardiac rehabilitation improve? | Patient compliance |
| What does HF lead to? | Congested state of the heart, lungs, and systemic circulation as a result of the heart's inability to act as an effective pump |
| What should HF be viewed as? | A Neurohormonal problem that progresses as a result of chronic release in body of substances such as catecholamines [ epinephrine and norepinephrine ] |
| It is important to realize that 1 L of fluid equals to | 1 kg or 2.2 lb, so a weight gain of 2.2 lbs signifies a gain of 1 L of body fluid |
| What are the signs and symptoms of HF with left ventricular failure? | Dyspnea, cough, frothy, blood tinged sputum, pulmonary crackles, and evidence of pulmonary vascular congestion with p;eural effusion |
| What are the signs and symptoms of Right Ventricular failure of HF? | Edema in feet, ankles, and sacrum which may progress into the thigh and external genitalia; liver congestion, Ascites, and distended jugular veins |
| What are Medical managements of HF? | Increasing cardiac efficiency with digitalis
Vasodilators
Ace Inhibitors
Administering a beta blocker [ Carvedilol ] for mild to moderate HF
Lowering oxygen requirements through bed rest
Providing oxygen
If pt is hypoxic treating edema and pulmonary congestion |
| What are nursing interventions for the patient with valvular heart disease? | Administering prescribed meds [ diuretics, digoxin, antidysrhythmics]
Monitoring I&O and daily weight
Auscultating breath and heart sounds
Taking BP
Assessing capillary perfusion
Pedal pulses and presence of edema |
| What can you teach patient with valvular heart disease? | Dietary management
Activity limitations
Importance of antibiotic prophylaxis before invasive procedures |
| Most patients with cardiomyopathy commonly have | Severe progressively deteriorating cause and majority older than 55 and die within 2 yrs of onset signs and symptoms |
| PVD is any abnormal condition that affects what? | The blood vessels outside the heart and the lymphatic vessels |
| The underlying problem associated with PVD | Arteriosclerosis |
| When does Hypertension occur? | When there is a sustained elevated systolic blood pressure greater than 140 mm Hg and or sustained elevated diastolic bp of greater than 90 mm Hg on two or more readings |
| The nursing interventions for hypertension primarily focuses on | BP management through patient teaching
Risk factor recognition
Drug Therapy |
| An enlarged dilated portion of an artery and may be the result of | Arteriosclerosis, trauma or a congenital defect |
| What are the hazards of cigarette smoking and its relationship to thromboangiitis obliterans [ Beurger's disease ] ? | Are the primary focuses of teaching the patient with the disease |
| What are the two major venous disorders? | Thrombophlebitis and varicose veins |
| Thrombophlebitis may result in calf pain on the | Dorsiflexion of the foot which is referred to a positive homans sign |
| A positive homans sign appears in only | 10% of patients with DVT |
| What should a patient be taught about Thrombophlebitis? | Avoid prolonged sitting or standing
Avoid dehydration
Reduce weight if obese
Perform dorsiflexion-extension exercises of feet and legs do not cross legs at the knees to elevate legs when sitting |
| What is the best nursing action that will lessen the severity of a patient's orthostatic hypotension? | Change his position routinely, especially from horizontal to vertical |
| A patient admitted to the hospital with a diagnosis a heart failure. Recently the patient's symptoms have been getting worse as a result of Arteriosclerosis. In establishing a patient care plan, what is the primary goal of treatment? | Reduce the workload of the heart |
| When caring for patient whose health care provider has ordered furosemide LASIX, what will the nurse recognize when the medication is having teh desired effect? | Production of urine is increased
The patient's weight decreases |
| A patient receives a diagnosis of angina pectoris, with no subsequent cardiac involvement. The health care provider prescribes Nitroglycerin. What explanation would the nurse give to the patient about why it is given sublingually? | Superficial blood vessels promote rapid absorption of the medication |
| The nurse is assessing a patient and suspects the patient is experiencing thrombophlebitis in the lower leg. What symptoms would the nurse assess? | Edema of the extremity
Calf is warm to the touch
Pain in the effected extremity |
| When a patient is receiving heparin therapy, what would be the nurse's most appropriate action? | Observe emesis, urine, and stools for blood |
| A patient is admitted to the medical floor with a diagnosis of HF. Which assessment findings are consistent with the medical diagnosis? | Increase in abdominal girth
Pitting Edema |
| A 10 yr old patient is diagnosed with rheumatic fever. Of all the manifestations seen in rheumatic, which is most likely to lead to permanent comlications? | Carditis |
| A patient has a diagnosis of hypertension, when providing discharge teaching what should the nurse include? | Instruction to limit sodium intake to 2g/day
Education on continuing to take antihypertensive meds as prescribed |
| An 86 yr old patient is receiving an intravenous infusion at 83 mL/hr via an electronic infusion pump. Why is it vital that the IV lines of older adult patients be monitored carefully? | These patients are at an increased risk for developing fluid overload of the circulatory system |
| How does Venous stasis ulcers or leg ulcers occur? | From chronic deep vein insufficiency and stasis of blood in the venous system of the legs |
| A leg ulcer is an open, necrotic lesion that results when an inadequate supply of | Oxygen rich blood and nutrients reaches the tissue, resulting in cell death, tissue sloughing and skin impairment |
| A tortuous, dilated vein with incompetent valves, with highest incidence of in women ages 40 to 60 yrs, approximately 15% adult population are affected | Varicose vein |
| What causes Varicose Veins? | Congenitally defective valves, or valve that becomes incompetent |
| What is the easiest most cost effective method to decrease the risk of DVT "Deep Vein Thrombosis"? | Early Mobilization |
| What is the major risk during the acute phase of DVT? | Dislodgment of thrombus which can migrate to the lungs causing a pulmonary embolus |
| What can develop after a DVT? results in swelling of the extremity | Postphlebetic syndrome an Inflammation of the vein at site of the Thrombus can temporary or long term complication |
| Patients on bed rest must be instructed to change position, dorsiflex their feet and rotate ankles every | 2-4 hrs, Ambulatory pt's should ambulate at least 3 times a day |
