Exam 13: Cardiovascular Alterations

A 72-year-old woman is brought to the ED by her family.The family states that she's "just not herself." Her respirations are slightly labored,and her heart monitor shows sinus tachycardia (rate 110 beats/min)with frequent premature ventricular contractions (PVCs).She denies any chest pain,jaw pain,back discomfort,or nausea.Her troponin levels are elevated,and her 12-lead electrocardiogram (ECG)shows elevated ST segments in leads II,III,and aVF.The nurse knows that these symptoms are most likely associated with which diagnosis?

The patient is admitted with a suspected acute myocardial infarction (AMI).In assessing the 12-lead electrocardiogram (ECG)changes,which findings would indicate to the nurse that the patient is in the process of an evolving Q wave myocardial infarction (MI)?

The patient presents to the ED with sudden,severe sharp chest discomfort,radiating to the back and down both arms,as well as numbness in the left arm.While taking the patient's vital signs,the nurse notices a 30-point discrepancy in systolic blood pressure between the right and left arm.Based on these findings,the nurse should:

A patient is having a stent and asks why it is necessary after having an angioplasty.Which response by the nurse is best?

Which comment by the patient indicates a good understanding of a diagnosis of coronary heart disease?

While instructing a patient on what occurs with a myocardial infarction,the nurse plans to explain which process?

The nurse is assessing a patient with left-sided heart failure.Which symptom would the nurse expect to find?

A patient presents to the ED complaining of severe substernal chest pressure radiating to the left shoulder and back that started about 12 hours ago.The patient delayed coming to the ED,hoping the pain would go away.The patient's 12-lead ECG shows ST-segment depression in the inferior leads.Troponin and CK-MB are both elevated.What does the nurse understand about thrombolysis in this patient?

A patient with a 10-year history of heart failure presents to the emergency department reporting severe shortness of breath.Assessment reveals crackles throughout the lung fields and labored breathing.The patient takes beta blockers,ACE inhibitors,and diuretics as directed.What treatment strategies does the nurse plan to implement for immediate short-term management? (Select all that apply.)

The patient is admitted with an acute myocardial infarction (AMI).Three days later the nurse is concerned that the patient may have a papillary muscle rupture.Which assessment data may indicate a papillary muscle rupture?

A patient is admitted with angina.The nurse anticipates which drug regimen to be initiated?

The patient presents to the ED with severe chest discomfort.A cardiac catheterization and angiography shows an 80% occlusion of the left main coronary artery.Which procedure will be most likely performed on this patient?

A patient is admitted to the emergency department with clinical indications of an acute myocardial infarction.Symptoms began 3 hours ago.The facility does not have the capability for percutaneous coronary intervention.Given this scenario,what is the priority intervention in the treatment and nursing management of this patient?

The patient has undergone open chest surgery for coronary artery bypass grafting.One of the nurse's responsibilities is to monitor the patient for which common postoperative dysrhythmia?

An essential aspect of teaching that may prevent recurrence of heart failure is

Which clinical manifestations are indicative of right ventricular failure? (Select all that apply.)

A patient is admitted with an acute myocardial infarction (AMI).The nurse monitors for which potential complications? (Select all that apply.)

Percutaneous coronary intervention is contraindicated for patients with lesions in which coronary artery?

A patient is having a cardiac evaluation to assess for possible valvular disease.Which study best identifies valvular function and measures the size of the cardiac chambers?

A patient is admitted with an acute myocardial infarction (AMI).The nurse knows that an angiotensin-converting enzyme (ACE)inhibitor should be started within 24 hours to reduce the incidence of which process?