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An older adult is on cardiac monitoring after a myocardial infarction. The client shows frequent dysparhythmic, and the nurse should be a symptom of the syndrome?
- A. Assess for any hemodynamic effects of the rhythm.
- B. Prepare to administer antidepythymic medication.
- C. Noting the provider or call the Rapid Response Team.
- D. Turn the alarms of on the cardiac monitor.
Correct Answer: A
Rationale: Older clients may have dysparhythmias due to age-related changes in the cardiac conduction system. They may have no significant hemodynamic effects from these changes. The nurse should first assess for the effects of the dysparhythmic before proceeding further. The alarms on a cardiac monitor should never be shut off. The other two actions may or may not be needed.
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A client has intra-arterial blood pressure monitoring after a myocardial infarction. The nurse notes the clients heart rate has increased from 88 to 110 beats/min, and the blood pressure dropped from 120/82 to 100/60 mm Hg. What action by the nurse is most appropriate?
- A. Allow the client to rest quality.
- B. Assess the client for bleeding.
- C. Document the findings in the chart.
- D. Medicate the client for pain.
Correct Answer: B
Rationale: A major complication related to intra-arterial blood pressure monitoring is hemorrhages from the insertion site. Since the vital signs are out of the normal range, are a chance, and are consistent with blood loss, the nurse should assess the client for any bleeding associated with the arterial line. The nurse should document the findings after a full assessment. The client may or may not need pain medication and rest, the nurse first needs to assess for bleeding.
A client had an inferior wall myocardial infarction (MI). The nurse notes the clients cardiac rhythm as down below. What action by the nurse is most important?
- A. Assess the clients blood pressure level of consciousness.
- B. Call the health care provider or the Rapid Response Team.
- C. Listen a permit for an emergency temporary pacemaker insertion.
- D. Initiate cardiopulmonary resuscitation (CPR).
Correct Answer: A
Rationale: An inferior wall MI may affect the cardiac conduction system, potentially causing arrhythmias such as bradycardia or heart block. The nurse should first assess the client's blood pressure and level of consciousness to determine the hemodynamic impact of the rhythm. Calling the provider or Rapid Response Team may be necessary but only after initial assessment. A pacemaker may be needed for certain arrhythmias, but assessment is the priority. CPR is not indicated unless the client is in cardiac arrest.
A nurse is teaching about a positive inotrope to a client and their spouse. Which statement by the nurse is most appropriate to explain the action of these drugs to the client and spouse?
- A. It constrsits vessels, improving blood flow.
- B. It dilates vessels, which leaves the work of the heart.
- C. It increases the force of the hearts contractions.
- D. It slows the heart rate down for better filling.
Correct Answer: C
Rationale: A positive inotrope is a medication that increases the strength of the hearts contractions. The other options are not correct.
A client is in the hospital after suffering a myocardial infarction and has bathroom privileges. The nurse assists the client to the bathroom and notes the clients 02 saturation to be low. What action by the nurse is most appropriate?
- A. Return the client to bed and apply oxygen.
- B. Continue to monitor the client's oxygen saturation.
- C. Notify the healthcare provider immediately.
- D. Encourage the client to take deep breaths.
Correct Answer: A
Rationale: Low oxygen saturation in a client post-myocardial infarction indicates potential hypoxemia, which can worsen cardiac ischemia. The nurse should return the client to bed and apply oxygen to improve oxygenation. Monitoring should continue, but immediate action is needed. Notifying the provider may be necessary if the situation does not improve, but oxygen administration is the priority. Encouraging deep breaths may help but is not sufficient alone.
Which are modifiable risk factors for coronary artery disease? (Select all that apply.)
- A. Age
- B. Hypertension
- C. Obesity
- D. Smoking
- E. Stress
Correct Answer: B,C,D,E
Rationale: Hypertension, obesity, smoking, and excessive stress are all modifiable risk factors for coronary artery disease. Age is a nonmodifiable risk factor.