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A client develops cardiogenic pulmonary edema and is extremely apprehensive. What medication can the nurse administer with a health care provider's prescription that will relieve anxiety and slow respiratory rate?
- A. Furosemide
- B. Nitroglycerin
- C. Dopamine
- D. Morphine sulfate
Correct Answer: D
Rationale: Morphine seems to help relieve respiratory symptoms by depressing higher cerebral centers, thus relieving anxiety and slowing respiratory rate. Morphine also promotes muscle relaxation and reduces the work of breathing. Furosemide is a loop diuretic and will decrease fluid accumulation but will not reduce anxiety. Nitroglycerin will promote smooth muscle relaxation in the vessel walls and will relieve pain but not reduce anxiety. Dopamine is an inotrope that will increase the force of ventricular contraction but will not alleviate anxiety.
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The nurse documents pitting edema in the bilateral lower extremities of the client. What does this documentation mean?
- A. There is excess fluid volume in the interstitial space in areas affected by gravity.
- B. There is excess fluid volume in the venous system of the lower extremities.
- C. There is excess fluid volume in the arterial system of the lower extremities.
- D. There is excess fluid volume in the hepatic system.
Correct Answer: A
Rationale: Dependent pitting edema (excess fluid volume in the interstitial space in body areas affected by gravity) in the feet and ankles can be observed. This type of edema may seem to disappear overnight but really is temporarily redistributed by gravity to other tissues, such as the sacral area. The other options are not descriptive of pitting edema.
A client is taking furosemide for the treatment of heart failure. What food should the nurse suggest that is rich in potassium?
- A. Pasta
- B. Peanut butter
- C. Coffee
- D. Angel food cake
Correct Answer: B
Rationale: Peanut butter is rich in potassium. Pasta, coffee, and angel food cake are low potassium items.
What disease process(es) contributes to chronic heart failure? Select all that apply.
- A. Tachyarrhythmias
- B. Valvular disease
- C. Pancreatic disease
- D. Renal failure
- E. Pulmonary insufficiency
Correct Answer: A,B,D
Rationale: Hypertension, tachyarrhythmias, valvular disease, cardiomyopathy, and renal failure can contribute to chronic heart failure. Pancreatic disease and pulmonary insufficiency do not contribute to chronic heart failure.
The nurse observes a client with an onset of heart failure having rapid, shallow breathing at a rate of 32 breaths/minute. What blood gas analysis does the nurse anticipate finding initially?
- A. Metabolic acidosis
- B. Metabolic alkalosis
- C. Respiratory acidosis
- D. Respiratory alkalosis
Correct Answer: D
Rationale: At first, arterial blood gas analysis may reveal respiratory alkalosis as a result of rapid, shallow breathing. Later, there is a shift to metabolic acidosis as gas exchange becomes more impaired.
The nurse is caring for a client with heart failure. What procedure should the nurse prepare the client for in order to determine the ejection fraction to measure the efficiency of the heart as a pump?
- A. Echocardiogram
- B. A pulmonary arteriography
- C. A chest radiograph
- D. Electrocardiogram
Correct Answer: A
Rationale: The heart's ejection fraction is measured using an echocardiogram or multiple gated acquisition scan. A pulmonary arteriography is used to confirm cor pulmonale. A chest radiograph can reveal the enlargement of the heart. An electrocardiogram is used to determine the activity of the heart's conduction system.