Nokea
The client is being given a cardio-selective beta blocker because of which possible reasons? Select all that apply.
- A. Hypotension
- B. Hypertension
- C. Dysrhythmias
- D. Cardiac arrest
Correct Answer: C
Rationale: The correct answer is C: Dysrhythmias. Cardio-selective beta blockers are commonly used to manage dysrhythmias by blocking the effects of adrenaline on the heart, helping to regulate the heart rate and rhythm. This is achieved by blocking beta-1 receptors in the heart, without affecting beta-2 receptors in the lungs.
Incorrect choices:
A: Hypotension - Beta blockers can actually worsen hypotension by reducing the heart rate and cardiac output.
B: Hypertension - While beta blockers can be used to treat hypertension, cardio-selective beta blockers are not typically the first choice for this condition.
D: Cardiac arrest - Beta blockers are used in some cases to prevent cardiac arrest, but they are not the primary treatment for this emergency situation.
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A patient admitted to the coronary care unit (CCU) with an ST-segment-elevation myocardial infarction (STEMI) is restless and anxious. The blood pressure is 86/40 mm Hg, and heart rate is 132 beats/min. Based on this information, which nursing diagnosis is a priority for the patient?
- A. Acute pain related to myocardial infarction
- B. Anxiety related to perceived threat of death
- C. Stress overload related to acute change in health
- D. Decreased cardiac output related to cardiogenic shock
Correct Answer: D
Rationale: The correct answer is D: Decreased cardiac output related to cardiogenic shock. In this case, the patient's low blood pressure and high heart rate indicate poor cardiac output. Cardiogenic shock is a life-threatening condition where the heart cannot pump enough blood to meet the body's needs. This is a priority nursing diagnosis as it requires immediate intervention to stabilize the patient's hemodynamics and prevent further deterioration.
Choices A, B, and C are incorrect because while they are valid concerns for the patient, they are not as immediately life-threatening as cardiogenic shock. Acute pain, anxiety, and stress overload can all be addressed once the patient's hemodynamic stability is ensured. However, without addressing the decreased cardiac output and cardiogenic shock first, the patient's condition could rapidly worsen and lead to serious consequences.
A patient admitted to the coronary care unit (CCU) with an ST-segment-elevation myocardial infarction (STEMI) is restless and anxious. The blood pressure is 86/40 mm Hg, and heart rate is 132 beats/min. Based on this information, which nursing diagnosis is a priority for the patient?
- A. Acute pain related to myocardial infarction
- B. Anxiety related to perceived threat of death
- C. Stress overload related to acute change in health
- D. Decreased cardiac output related to cardiogenic shock
Correct Answer: D
Rationale: The correct answer is D: Decreased cardiac output related to cardiogenic shock. In a patient with STEMI, the low blood pressure (86/40 mm Hg) and high heart rate (132 beats/min) indicate poor cardiac output. Cardiogenic shock is a life-threatening condition that occurs due to decreased cardiac output. Restlessness and anxiety can be signs of inadequate tissue perfusion in cardiogenic shock. Addressing decreased cardiac output is crucial to prevent further deterioration.
A: Acute pain is a common symptom in STEMI but not the priority when the patient is in cardiogenic shock.
B: Anxiety is a valid concern, but the primary focus should be on addressing the physiological instability caused by decreased cardiac output.
C: Stress overload can be a contributing factor, but the immediate priority is managing the cardiogenic shock to stabilize the patient's condition.
A few days after experiencing a myocardial infarction (MI) and successful percutaneous coronary intervention, the patient states, “It was just a little chest pain. As soon as I get out of here, I’m going for my vacation as planned.” Which reply would be most appropriate for the nurse to make?
- A. “What do you think caused your chest pain?”
- B. “Where are you planning to go for your vacation?”
- C. “Sometimes plans need to change after a heart attack.”
- D. “Recovery from a heart attack takes at least a few weeks.”
Correct Answer: C
Rationale: Rationale: Choice C is correct because it addresses the patient's perception and gently introduces the idea that plans may need to change post-MI. It acknowledges the patient's experience while subtly hinting at the importance of considering adjustments for health reasons.
Summary of Incorrect Choices:
A: This choice focuses on the cause of chest pain, which is not the immediate concern post-MI.
B: While discussing vacation plans is relevant, it does not address the patient's potentially unrealistic expectations.
D: While recovery time is important, stating a specific timeline may not be necessary or applicable to every patient's situation.
Which finding is associated with a blue tinge around the lips and conjunctiva?
- A. Finger clubbing
- B. Central cyanosis
- C. Peripheral cyanosis
- D. Delayed capillary filling time
Correct Answer: B
Rationale: Central cyanosis reflects systemic hypoxemia.
Define Unstable Angina.
- A. Chest pain at rest
- B. Chest pain during exertion
- C. Chest pain relieved by nitroglycerin
- D. None of the above
Correct Answer: A
Rationale: Unstable angina is characterized by chest pain occurring at rest and not relieved by usual treatments.