EAQ with NGN: Cardiac (Questions & Answers) Rated 100%

1. Client was brought to the emergency department by his son with reports of difficulty breathing and inability to walk short distances without becoming extremely short of breath. Client is a 72-year-old African American man with a history of obesity, hypertension, coronary artery disease, and diabetes mellitus. Client reports fatigue related to difficulty sleeping at night as a result of a nonproductive cough that is unresolved with cough drops. Client reports a weight gain of 10 pounds in the past week, despite his decreased appetite. The son reports that his father has been unable to care for himself as a result of the fatigue and increasing shortness of breath. He states "he has not showered in over a week." Assessment findings: Cardiovascular: Sinus tachycardia with occasional premature ventricular contractions (PVCs). No murmur noted Respiratory: Tachypnea, inspiratory crackles auscultated throughout bilateral - The nurse is preparing a plan of care for the client. Based on the information provided, choose the potential condition with anticipated medication and side effect from the list of options provided. Potential condition: heart failure Anticipated Medications: -nitroglycerin -furosemide Side effects to monitor: -hypotension -hypokalemia 2. A 64-year-old male client has arrived for an appointment at the outpatient clinic because of difficulty breathing and a rash. History:Hypertension Hypothyroidism Depression Erectile dysfunction Chronic back pain Hyperlipidemia Anterior wall myocardial infarction (MI) at age 44.Up until the MI, he smoked two packs of cigarettes per day for 25 years. After the MI, he completed a cardiac rehabilitation program. His only current physical activity is walking around at work. He reports sleeping on two pillows and waking at night one to two times per week, gasping with difficulty breathing and having to get up during the night to urinate. He has noticed increased irritability and anxiety. Client reports joint and back pain in the evenings. He has increasing shortness of breath when he walks more than 30 feet and is concerned about a red scaly rash on his left lower leg. His body mass index (BMI) is 32 kg/m2. He works - The nurse reviews the patient history and physical in the EHR to identify relevant cues requiring follow-up. Choose the most likely options for the information missing from the statement by selecting from the lists of options provided. The nurse identifies symptoms related to a possible cardio-respiratory concern including [nocturia] and [paroxysmal nocturnal dyspnea]. 3. "" "" 1100: Physical assessment performed: Client is alert and appears visibly anxious. -Cardiac: Tachycardic; chest pain rated 6/10 scale; shortness of breath upon minimal exertion; hypertension noted.-Eyes: Recent reports of blurry vision. Negative for scleral icterus. -Gastrointestinal (GI): Active bowel sounds. Client reports that he does not feel hungry and has not been eating much at all this past week. -Respiratory: Tachypnea. Crackles auscultated in bilateral lower lobes. -Neurologic: Headache reported. No loss of consciousness. -Urinary: Client reports nocturia and clear yellow urine in adequate amounts. - The nurse is analyzing client assessment data to determine a particular client problem or condition. Based on the information provided, answer the following assessment item. Which finding indicates that this client has impaired perfusion? [SATA] -Sleeping on two pillows -Waking up at night with difficulty breathing -Getting up at nigh to urinate -Shortness of breath when walking -Tachycardia 4. "" "" - The nurse reviews the patient information in the EHR. For each assessment finding, click to indicate whether findings from this client's assessment are generally associated with right heart failure (HF), left HF, or both right and left HF. Each row must have only one response option selected. -Pulse 118 bpm: both right and left HF -Respirations 30 breaths/min: Left HF -S3/S4 gallop: Left HF -Crackles in bilateral lower lobes: Left HF -Coughing up pink-tinged sputum: Left HF -2+ edema at the sacrum: Right HF-2+ edema in lower legs and feet: Right HF 5. "" "" - The healthcare team in the emergency department quickly develops a collaborative plan of care to address the client's needs. For each body system, click to specify the potential nursing intervention that would be appropriate for the care of the client. Each body system may support more than one potential nursing intervention. Each category must have at least one response option selected. Neurologic: -morphine 1mg intravenous every hour as needed for pain and anxiety Respiratory: -chest x-ray -supplemental oxygen -furosemide 40mg IV every 8 hours Cardiovascular: -12-lead electrogram (ECG) -digoxin 0.5mg orally every day -continuous telemetry 6. "" "" 1230: Admitted to telemetry unit. Awaiting new orders. 1300: Orders received and followed. Client resting comfortably.48 hours later: The client has been stabilized in the hospital for 48 hours and will be discharged home. He will continue taking his home medications of simvastatin and lisinopril. He received a new prescription for metoprolol succinate. His morning assessment reveals these findings: Vital signs: Temperature: 98.8° F (37.1° C) Heart rate (HR): 84 beats/min Respiratory rate (RR): 20 breaths/min Blood pressure (BP): 118/76 mm Hg Oxygen saturation is 94% on room air. Assessment: S1 S2, no S3 or S4 Lungs clear, no adventitious breath sounds No cough 1+ edema at the sacrum 2+ edema in lower legs and feet Scaly red rash on the left lower leg ORDERS: 1300: Continue home meds of simvastatin and lisinopril Supplemental oxygen to keep oxygen saturation above 95% Continuous telemetry monitoring V - The nurse provides medication teaching about metoprolol succinate before the client is discharged. Which information would the nurse include when teaching the client about metoprolol succinate? [SATA]-The drug will decrease your heart rate -The drug is shown to decrease mortality in persons with heart failure -Arise slowly to avoid dizziness -A common side effect is fatigue -Report worsening heart failure to the healthcare provider promptly 7. "" ""