Nokea
The nurse is caring for a patient post coronary artery bypass graft who rates his/her pain as an 8 out of 10 on the subjective pain scale. Should the nurse choose to administer morphine sulfate intravenously as it has benefits to cardiac patients (select one that does not apply)?
- A. Decreasing myocardial oxygen supply
- B. Decreasing myocardial oxygen consumption
- C. Decreasing heart rate
- D. Increasing blood pressure
Correct Answer: D
Rationale: Morphine sulfate, a potent opioid analgesic, can cause vasodilation leading to a decrease in blood pressure rather than an increase. Choice A is incorrect as morphine can decrease myocardial oxygen consumption by reducing the workload of the heart. Choice B is incorrect as morphine can decrease heart rate as a side effect. Choice C is incorrect as morphine typically decreases blood pressure rather than increasing it.
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The nurse is caring for a patient in the cardiac unit recovering from a cardiac bypass graft procedure. The patient's spouse comes out to the hallway and expresses concern about the patient's confusion since surgery was 3 days ago. An appropriate response by the nurse would be:
- A. Let me call the doctor right away.
- B. What specific concerns do you have?
- C. It is common for confusion to occur after this procedure.
- D. I'll have the counselor come meet you in the room.
Correct Answer: C
Rationale: Choice C is the correct answer because confusion can be a common occurrence after cardiac surgeries due to factors such as anesthesia, medication, and the stress of the procedure. By acknowledging the spouse's concern and explaining that confusion is a known potential outcome, the nurse provides reassurance and education. Choices A, B, and D are incorrect because they do not directly address the spouse's concern about the patient's confusion or provide appropriate information about the situation.
A patient is considering options to manage his/her coronary artery disease. The nurse explains a coronary artery bypass graft procedure will:
- A. Cure the patient's coronary artery disease.
- B. Replace the leaking valve in the heart.
- C. Connect grafts to aorta to improve blood flow.
- D. Place a permanent pacemaker on the heart muscle.
Correct Answer: C
Rationale: The correct answer is C. A coronary artery bypass graft procedure involves connecting grafts to the aorta to improve blood flow to the heart muscle by bypassing blocked or narrowed coronary arteries. This procedure does not cure coronary artery disease but helps improve blood supply to the heart. Choices A, B, and D are incorrect because a bypass graft procedure does not cure the underlying disease, replace heart valves, or involve the placement of a pacemaker.
The nurse is caring for a patient post-coronary artery bypass graft procedure who is on a nitroglycerin intravenous drip. The nurse understands the importance of nitroglycerin with this procedure as:
- A. Decreasing myocardial oxygen supply.
- B. Increasing preload.
- C. Decreasing cardiac output.
- D. Decreasing afterload.
Correct Answer: D
Rationale: Nitroglycerin is a vasodilator that works by decreasing afterload, which is the pressure the heart must work against to eject blood during systole. By reducing afterload, nitroglycerin helps the heart pump more effectively and decreases the workload on the heart. This results in improved cardiac output and decreased myocardial oxygen demand. Choices A, B, and C are incorrect because nitroglycerin does not decrease myocardial oxygen supply, increase preload, or decrease cardiac output.
The nurse is educating a patient who was discharged from the hospital after having cardiac surgery one week ago. The nurse recognizes the patient understands medication management when he/she states:
- A. I need to take my Lisinopril daily to reduce my risk of heart failure
- B. I only need to take the metoprolol when I feel my heart skip a beat
- C. I should carry my nitroglycerin pills in my pocket at all times
- D. I should only take the pain pills when my pain is really bad
Correct Answer: A
Rationale: The correct answer is A. Lisinopril is commonly prescribed post-cardiac surgery to manage blood pressure and reduce the risk of heart failure. It is important for the patient to take Lisinopril daily as prescribed to achieve optimal outcomes. Choice B is incorrect as metoprolol is usually prescribed on a regular schedule to manage heart conditions, not just when symptoms occur. Choice C is incorrect because nitroglycerin should be kept in a cool, dry place, not in a pocket where it could be exposed to heat or moisture. Choice D is incorrect as pain medication should be taken as prescribed for adequate pain control, not just when pain is severe.