CAD and MI

A client is scheduled for a cardiac catheterization using a radiopaque dye. Which of the following assessments is most critical before the procedure?

• Intake and output
• Baseline peripheral pulse rates
• Height and weight
• Allergy to iodine or shellfish

Which of the following instructions should be included in the discharge teaching for a patient discharged with a transdermal nitroglycerin patch?

• “Apply the patch to a non hairy, nonfatty area of the upper torso or arms.”
• “Apply the patch to the same site each day to maintain consistent drug absorption.”
• “If you get a headache, remove the patch for 4 hours and then reapply.”
• “If you get chest pain, apply a second patch right next to the first patch.”

A client with myocardial infarction has been transferred from a coronary care unit to a general medical unit with cardiac monitoring via telemetry. A nurse plans to allow for which of the following client activities?

• Strict bed rest for 24 hours after transfer
• Bathroom privileges and self-care activities
• Unsupervised hallway ambulation with distances under 200 feet
• Ad lib activities because the client is monitored

Which client has pain most consistent with myocardial infarction (MI) requiring notification of the health care provider?

• Client with abdominal pain and belching
• Client with pressure in the mid-abdomen and profound diaphoresis
• Client with dyspnea on exertion (DOE) and inability to sleep flat who sleeps on four pillows
• Client with claudication and fatigue

 Which diagnostic test result is consistent with a diagnosis of heart failure (HF)?

• Serum potassium level of 3.2 mEq/L
• Ejection fraction of 60%
• B-type natriuretic peptide (BNP) of 760 ng/dL 
• Chest x-ray report showing right middle lobe consolidation

A client admitted for heart failure has a priority problem of hypervolemia related to compromised regulatory mechanisms. Which assessment result obtained the day after admission is the best indicator that the treatment has been effective?

• The client has diuresis of 400 mL in 24 hours.
• The client’s blood pressure is 122/84 mm Hg.
• The client has an apical pulse of 82 beats/min.
• The client’s weight decreases by 2.5 kg. 

Tags

NGSS.HS-LS1-3

The nurse is educating a group of women about the differences in symptoms of myocardial infarction (MI) in men versus those in women. Which information should be included?

• Men do not tend to report chest pain.
• Men are more likely than women to die after MI.
• Men more than women tend to deny the importance of symptoms.
• Women may experience extreme fatigue and dizziness as sole symptoms. 

A client has been admitted to the hospital with chest pain radiating down the left arm. The pain has been unrelieved by rest and antacids. Which test result best confirms that the client sustained a myocardial infarction?

• C-reactive protein of 1 mg/dL
• Homocysteine level of 13 mmol/L
• Creatine kinase (CK) of 125 mg/dL
• Troponin of 5.2 ng/mL 

Which statement about diagnostic cardiovascular testing is correct?

• Complications of coronary arteriography include stroke, nonlethal dysrhythmias, arterial bleeding, and thromboembolism.
• An alternative to injecting a medium into the coronary arteries is intravascular ultrasonography. 
• Holter monitoring allows periodic recording of cardiac activity during an extended period of time.
• The left side of the heart is catheterized first and may be the only side examined.

Following a treadmill test and cardiac catheterization, the client is found to have coronary artery disease, which is inoperative. He is referred to the cardiac rehabilitation unit. During his first visit to the unit he says that he doesn’t understand why he needs to be there because there is nothing that can be done to make him better. The best nursing response is:

• “Cardiac rehabilitation is not a cure but can help restore you to many of your former activities.”
• “Here we teach you to gradually change your lifestyle to accommodate your heart disease.”
• “You are probably right but we can gradually increase your activities so that you can live a more active life.”
• “Do you feel that you will have to make some changes in your life now?”