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NURX211 Health Differences Across The Life Span 1 Exam
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NURX211 Health Differences Across TheLife Span 1 Exam
Cardiovascular Problems
Which is a goal of using morphine sulfate to treat acute myocardial infarction?
To decrease cardiac workload
To prevent cardiac dysrhythmias
To produce mild diuresis
To enhance anticoagulation - Answer *1) Morphine sulfate is the drug of choice for
treating acute myocardial infarction because it reduces preload and thus decreases
cardiac workload overall.
2) Morphine sulfate does not prevent dysrhythmias. Acute dysrhythmias are a possible
complication of thrombolytic therapy.
3) Morphine sulfate does not have diuretic properties. It can lead to constipation.
Patients who have had an acute myocardial infarction may be prescribed a diuretic as
part of continuing treatment for underlying coronary artery disease.
4) Morphine sulfate does not enhance anticoagulation. That function is served by
thrombolytic agents, which dissolve clots throughout the circulation.
Cardiovascular Problems
Which class of medication prescribed for an African American patient with hypertension
would the RN question before administering?
,(Select all that apply.)
Beta-adrenergic blockers
Angiotensin-converting enzyme (ACE) inhibitors
Alpha1 blockers
Calcium channel blockers
Direct renin inhibitors - Answer *1) African Americans with low-renin hypertension do
not respond well to Beta-adrenergicblockers, unless they are combined or given with a
diuretic.
*2) African Americans with low-renin hypertension do not respond well to
Angiotensin-converting enzyme (ACE) inhibitors, unless they are combined or given with
a diuretic.
3) The group with low-reninhypertension responds well to Alpha1 blockers to control
hypertension.
4) The group with low-reninhypertension also responds well to calcium channel
blockers to help control hypertension.
*5) This is not correct because the patient already has low reninbeing produced. If this
medication is administered, the side effects could be magnified because of the low renin
levels.
Cardiovascular Problems
Which nursing intervention is a priority for a patient diagnosed with an acute myocardial
infarction (MI) who is experiencing fatigue, chest pain, and feelings of doom?
, Apply supplemental oxygen between 2 to 6 liters per minute.
Ask open-ended questions about what is upsetting the patient.
Request that a physician assess this patient within 2 hours for pain.
Request that the patient ambulate in the hallway to reduce pain. - Answer *1)
Application of oxygen increases the oxygen saturation to provide oxygen to all tissues.
2) Although the patient may have some of these symptoms with anxiety or stress, this is
a medical emergency and more physical interventions need to be performed, rather
than therapeutic communication.
3) A physician should assess this patient sooner than a 2-hour window of time. As this is
a medical emergency, there should be an immediate assessment performed by the
health care provider.
4) Exercising will increase the oxygen demand, which will increase the distress that this
patient is experiencing during cardiogenic shock.
Cardiovascular Problems
A patient has a new diagnosis of hypertension. The physician has written an order to
start hydrachlorothiazide (HTCZ) 12.5 mg by mouth every day. Which statement by the
patient to the RN indicates that further teaching is needed about the medication?
"I will include foods with potassium in my diet."
"I will take the medication on an empty stomach."
"I will use sunblock when in direct sunlight."
"I will make sure I change positions slowly." - Answer 1) HTCZ is a potassium-wasting
diuretic. Including potassium-rich foods in the diet could minimize the incidence of the
patient developing hypokalemia.
*2) Patients are encouraged to take the medication with food to avoid GI upset.
, 3) Patients that take HCTZ develop photosensitivity, therefore sunblock is encouraged
when the patient is in direct sunlight.
4) Patients can develop orthostatic (postural) hypertension when on HTCZ.
Cardiovascular Problems
An RN is caring for a patient on the cardiac unit. During assesment, the patient's blood
pressure is recorded as 80/42. The patient also reports shortness of breath and chest
pain. The cardiac monitor shows an atrial rate of 318 and a ventricular rate of 90 with
saw-toothed P waves. The RN knows to prepare for which intervention?
Administer adenosine (Adenocard).
Discontinue all anticoagulant medications.
Administer potassium chloride to correct hypokalemia.
Call a code and begin CPR. - Answer *1) The rhythm and symptoms described above
are caused by atrial flutter. Atrial flutter involves an atrial rate between 250 and 400
bpm, ventricular rate between 75 and 150 bpm, and saw-toothed shaped waves also
called F waves. Management involves the use of vagal maneuvers or administration of
adenosine (Adenocard) which cause sympathetic block and slowing of conduction in the
AV node and may stop the tachycardia.
2) Atrial flutter should be treated with antithrombotic therapy in the same manner as
with atrial fibrillation.
3) Hypokalemia is often an underlying cause of premature atrial complex, not atrial
flutter. PACs are not described above.
4) The patient described above has a pulse and is conscious, so the patient does not
require a code team or CPR at this time.
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