JERSEY COLLEGE MED SURG PREP U CHP 29 MANAGEMENT
OF PATIENTS WITH COMPLICATIONS FROM HEART DISEASE
QUESTIONS AND ANSWERS!!
The nurse is administering digoxin to a client with heart failure. What laboratory
value may predispose the client to digoxin toxicity?
Answers potassium level of 2.8 mEq/L
(Conditions that may predispose a client to digoxin toxicity include hypokalemia
(evidenced by a potassium level less than 3.5 mEq/L), hypomagnesemia
(evidenced by a magnesium level less than 1.5 mEq/L), hypothyroidism,
hypoxemia, advanced myocardial disease, active myocardial ischemia, and altered
autonomic tone. Hypermagnesemia (evidenced by a magnesium level greater than
2.5 mEq/L), hypercalcemia (evidenced by an ionized calcium level greater than 5.3
mg/dl), and hypernatremia (evidenced by a sodium level greater than 145 mEq/L)
aren't associated with a risk of digoxin toxicity.)
A client is admitted to the ICU with a diagnosis of heart failure. The client is
exhibiting symptoms of weakness, ascites, weight gain, and jugular vein distention.
The nurse would know that the client is exhibiting signs of what kind of heart
failure?
Answers Right-sided heart failure
(Signs and symptoms of Right Ventricular Failure include: Weakness; Ascites;
Weight gain; Nausea, vomiting; Dysrhythmias; Elevated central venous pressure;
Jugular vein distention. The scenario does not indicate whether the heart failure is
chronic or acute. Therefore, options A, B, and C are incorrect.)
The nurse is providing discharge instructions to a client with heart failure preparing
to leave the following day. What type of diet should the nurse request the dietitian
to discuss with the client?
, Answers Low-sodium diet
(Medical management of both left-sided and right-sided heart failure is directed at
reducing the heart's workload and improving cardiac output primarily through
dietary modifications, drug therapy, and lifestyle changes. A low-sodium diet is
prescribed, and fluids may be restricted. Because the client will be on a diuretic
such as Lasix, he may become potassium depleted and would need potassium in
the diet. A low-cholesterol and low-fat diet may be ordered but are not specific to
the heart failure.)
The diagnosis of heart failure is usually confirmed by which of the following?
Answers Echocardiogram
(Although the chest X-ray can indicate cardiomegaly and the ECG can indicate a
left ventricular abnormality, it is the echocardiogram that is diagnostic. This test
measures ejection fraction (EF) which, if greater than 40% and accompanied with
signs and symptoms of heart failure, indicates diastolic dysfunction and impaired
ventricular relaxation.)
The nurse is interviewing a client during an initial visit at a cardiologist's office.
What symptom will the nurse expect to find as an early symptom of chronic heart
failure?
Answers fatigue
(Fatigue is commonly the earliest symptom of chronic heart failure; it is caused by
decreased cardiac output and tissue oxygenation. Pedal edema and nocturia are
symptoms of heart failure, but they occur later in the course of the condition. An
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