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The client with a history of angina pectoris is being discharged after coronary artery bypass graft (CABG) surgery. Which statement by the client indicates a need for further teaching?
- A. I will avoid lifting heavy objects for at least 6 weeks.
- B. I will call the doctor if I develop a fever or drainage from my incisions.
- C. I will take my pain medication before doing any activities that might cause discomfort.
- D. I can resume my normal activities, including driving, as soon as I feel like it.
Correct Answer: D
Rationale: The correct answer is D because after CABG surgery, patients need to follow specific guidelines for resuming activities, and driving is typically restricted for a certain period to ensure safety and proper recovery. Resuming normal activities too soon, including driving, can pose risks to the client's health and safety. It is essential to emphasize to the client the importance of following the healthcare provider's recommendations regarding activity restrictions post-surgery to prevent complications and promote optimal recovery. Choices A, B, and C are correct statements that align with post-CABG discharge instructions, emphasizing the importance of avoiding heavy lifting, monitoring for signs of infection, and managing pain effectively.
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A client with heart failure is prescribed an angiotensin-converting enzyme (ACE) inhibitor. The nurse should reinforce which instruction?
- A. Take the medication at bedtime.
- B. Report a persistent dry cough.
- C. Increase potassium-rich foods in the diet.
- D. Avoid taking the medication with meals.
Correct Answer: B
Rationale: The correct answer is to instruct the client to report a persistent dry cough. ACE inhibitors can cause a common side effect of a persistent dry cough, which should be promptly reported to the healthcare provider for further evaluation and possible medication adjustment. Option A is incorrect because the timing of ACE inhibitor administration is usually not specified to be at bedtime. Option C is incorrect as increasing potassium-rich foods can lead to hyperkalemia when taking ACE inhibitors. Option D is incorrect because ACE inhibitors can be taken with or without food.
The LPN/LVN is assisting in the care of a client with chronic heart failure who is receiving digoxin (Lanoxin). Which sign should the nurse monitor for that could indicate digoxin toxicity?
- A. Bradycardia
- B. Tachycardia
- C. Hypertension
- D. Hyperglycemia
Correct Answer: A
Rationale: Bradycardia is a common sign of digoxin toxicity and should be closely monitored. Digoxin toxicity can lead to various cardiac dysrhythmias, with bradycardia being a significant indicator. Monitoring the client's heart rate is crucial to detect and manage digoxin toxicity promptly. Tachycardia, hypertension, and hyperglycemia are not typically associated with digoxin toxicity. Tachycardia is more commonly seen with inadequate treatment of heart failure, hypertension is a possible but less common effect, and hyperglycemia is not a typical sign of digoxin toxicity.
The client with a history of angina pectoris reports chest pain unrelieved by nitroglycerin. Which action should the nurse take next?
- A. Administer another dose of nitroglycerin.
- B. Notify the healthcare provider immediately.
- C. Have the client lie down and rest.
- D. Encourage the client to take deep breaths.
Correct Answer: B
Rationale: When a client with a history of angina pectoris reports chest pain unrelieved by nitroglycerin, it may indicate a myocardial infarction, also known as a heart attack. In this situation, the nurse should immediately notify the healthcare provider to ensure prompt evaluation and appropriate intervention. Delay in seeking medical attention for chest pain unrelieved by nitroglycerin can be life-threatening, as it might be a sign of a more serious cardiac event. Administering another dose of nitroglycerin (Choice A) without further evaluation can be risky, as the client's condition may require a different intervention. Having the client lie down and rest (Choice C) or encouraging deep breaths (Choice D) are not appropriate actions in this scenario where a more serious cardiac event needs to be ruled out.
Prior to a cardiac catheterization, what instruction should the client be reminded of?
- A. You will need to be NPO for 6 to 8 hours before the procedure.
- B. You will not be able to move around during the procedure.
- C. You will be required to lie still for several hours after the test.
- D. You will not have to drink any fluids immediately before the test.
Correct Answer: A
Rationale: Being NPO (nothing by mouth) for 6 to 8 hours before a cardiac catheterization is crucial to prevent complications such as aspiration during the procedure. This helps ensure the safety and accuracy of the test results by minimizing the risk of food or liquid in the stomach interfering with the procedure. Choice B is incorrect because the client will need to lie still during the procedure to ensure its accuracy. Choice C is incorrect as the client is typically required to lie flat for a few hours after the test, not several hours. Choice D is incorrect as the client is usually not allowed to drink fluids immediately before the test to prevent complications.
The nurse is preparing to administer an intravenous dose of furosemide (Lasix) to a client with heart failure. The nurse should monitor for which potential side effect?
- A. Hypertension
- B. Hyperkalemia
- C. Hypokalemia
- D. Hypoglycemia
Correct Answer: C
Rationale: Furosemide is a loop diuretic that works by promoting the excretion of water and electrolytes, including potassium. This loss of potassium can lead to hypokalemia, which can be a potential side effect of furosemide administration. Hypokalemia can result in cardiac dysrhythmias and other complications, especially in clients with heart failure who may already have compromised cardiac function. Therefore, monitoring for signs of hypokalemia, such as muscle weakness, cardiac irregularities, and fatigue, is essential when administering furosemide. Choice A, hypertension, is incorrect because furosemide is actually used to treat hypertension by reducing excess fluid in the body. Choice B, hyperkalemia, is incorrect as furosemide causes potassium loss, leading to hypokalemia. Choice D, hypoglycemia, is unrelated to the mechanism of action of furosemide and is not a common side effect associated with its administration.