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Information related to the patient's health and medication history that th enurse identifies as significant during assessment of the cardiovascular system is a history of
a) metastatic cancer b) calcium supplementation c) frequent viral pharyngitis d) use of recreational/abused drugs |
D) Recreational or abused drugs, especially stimulants, such as cocaine and methamphetamine, are a growing cause of cardiac dysrhymias and problems associated with tachycardia, and IV injection of abused drugs is a risk factor for inflammatory and infectious conditions of the heart. Streptococcal, but not viral, pharyngitis is a risk factor for rheumatic heart disease. Although calcium is involved in the contraction of muscles, calcium supplementation is not a significant factor in heart disease, nor is metastatic cancer. ch32
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When palpating the patient's popliteal pulse, the nurse feels a vibration at the site. This finding is recorded as a:
a) thready, weak pulse b) bruit at the artery site c) bounding pulse volume d) thrill of the popliteal artery |
D) A palpable vibration of a blood vessel is called a thrill and usually indicates turbulent blood flow through the vessel. A weak, thready pulse has little pressure and is difficult to palpate. A bruit is an abnormal buzzing or humming sound that may be auscultated over pathologic vessels, and a bounding pulse is an extra full, hard pulse that may occur with atherosclerosis or hypervolemia. ch32
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A normal positional BP in lying, sitting, and standing positions is:
a) 106/70, 100/65, 90/62 b) 114/82, 110/76, 108/74 c) 120/82, 110/80, 100/78 d) 134/84, 130/80, 126/80 |
D) Normal reduction in BP in a standing position is up to 15 mm Hg in SBP and from 3-5 mm Hg in DBP. Reductions greater than these are abnormal and may be caused by drugs, fluid loss, or pathologic conditions. ch32
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Evaluation of ECG responses to normal activity over a period of a day or two is performed with:
a) serial ECG's b) Holter monitoring c) electrophysiology studies d) positron emission tomography (PET) |
B) Holter monitoring involves placing electrodes on the chest attached to a recorder that will record ECG rhythm for 24 to 48 hours while the pt engages in normal daily activities. The recording is later analyzed for cardiac dysrhythmias. Frequent, but not continuous ECGs are serial ECGs. An electrophysiology study is an invasive test that records intracardiac electrical activity in different cardiac structures, and PET uses radioisotopes to evaluate myocardial perfusion and metabolic function. ch32
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When caring for a patient after a cardiac catheterization with coronary angiography, which of the following findings would be of most concern to the nurse?
a) swelling at the cath insertion site b) development of raised wheals on the pt's trunk c) absence of pulses distal to the cath insertion site d) pt assessment of pain at the insertion site as 4 on a 10-point scale |
C) An absence of pulses distal to the cath insertion site indicates that clotting around the site is occluding blood flow to the extermity and is an emergency that requires immediate medical attention. Some swelling and pain at the site are expected, but the site is also monitored for bleeding,and a pressure dressing and perhaps a sandbag may be applied. Hives may occur as a result of iodine sensitivity and will require treatment, but the priority is the lack of pulses. ch 32
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Which of the following factors have value as predictors of increased risk for coronary artery disease or evidence of myocardial injury? (Select all that apply.)
a) Increased apolipoprotein A-1 b) Increased apolipoprotein B c) Increased C-reactive protein d) Increased creatine kinase (CK) -MM e) Decreased homocysteine f) Increased lipoprotein-associated phospholipase A2 |
B
c f oh well...ch32 |
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A patient with a tricuspid valve disorder will have impaired blood flow between the:
a) vena cava b) left atrium and left ventricle c) right atrium and right ventricle d) right ventricle and pulmonary artery |
C
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