Exam 12: Cardiovascular Disorders

Three days after an anterior wall MI, a patient is in the critical care unit.The patient is receiving oxygen at 4 L/min by nasal cannula; nitroglycerin paste, 1-inch q6h; and Lopressor 25 mg PO q12h.The monitor shows that the patient is beginning to have premature ventricular contractions (PVCs).Over the course of the next several hours, the PVCs increase in frequency to more than 15 per minute, with occasional runs of multifocal bigeminal PVCs.The patient's vital signs follow: heart rate, 84 beats/min; sinus rhythm with described PVCs; blood pressure, 124/68 mm Hg; respirations, 20 breaths/min; and SpO₂, 92%.Laboratory values are blood pH, 7.44; potassium, 4.4 mEq/L; and magnesium, 1.0 mEq/L.Which of the following, if ordered, would be inappropriate for this patient?

You are teaching a patient with endocarditis about his diagnosis.Which statement below is correct?

A patient presents with severe substernal chest pain.The patient exclaims, "This is the most severe pain I have ever felt!" The patient reports that the pain came on suddenly about 2 hours ago and that three sublingual nitroglycerin tablets have not relieved the pain.The 12-lead ECG reveals only the following abnormalities: T-wave inversion in leads I, aVL, V₄, and V₅; pathologic Q waves in leads II, III, and aVF; ST segment elevation in leads V₁, V₂, V₃, and V₄.Which of the following is probably accurate about this patient?

Which of the following clinical manifestations are indicative of left ventricular failure?

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

A 66-year-old patient is admitted to the critical care unit with a diagnosis of acute inferior MI.A 12-lead electrocardiogram (ECG)is done to validate the area of infarction.Which finding on the ECG is most conclusive for infarction?

Which of the following assessment findings is most specific for acute onset of pulmonary edema?

A patient is admitted to the ICU with diagnosis of fever of unknown origin.The patient is complaining of fatigue, malaise, joint pain, and shivering.VS include: T 103F, HR 90 beats/min, RR 22 breaths/min, BP 132/78, and O₂ sat 94% on 2L/NC.Blood cultures are ordered.The patient has a history of MI 3 months ago.The nurse suspects that the patient has developed

Which of the following cholesterol values indicates a heightened risk for the development of CAD?

Dyspnea with wheezing, a nonproductive cough, and pulmonary crackles that progress to the gurgling sounds of pulmonary edema is described as