Nokea
The nurse reminds the patient who is taking warfarin for the treatment of peripheral artery disease not to eat excessive green and yellow vegetables for which reason?
- A. Potassium in the vegetables can cause additional bleeding
- B. Green and yellow vegetables cause loose bowel movements
- C. Vitamin $\mathrm{K}$ in the vegetables counteracts the anticoagulant effect
- D. Potassium in the vegetables can cause hyperkalemia to develop
Correct Answer: C
Rationale: The patient taking warfarin should not eat excessive amounts of vitamin $\mathrm{K}$ containing foods, such as green and yellow vegetables. Vitamin $\mathrm{K}$ counteracts the anticoagulant effect, and blood clots could develop.
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What is the transesophageal echocardiogram (TEE) used for?
- A. Detect thrombi before a cardioversion.
- B. Check for cardiac arrhythmias.
- C. Detect the presence of an aneurysm
- D. Measure effectiveness of diuretic therapy.
- E. Locate obstructions in the coronary artery.
Correct Answer: A,C
Rationale: The TEE is used to check for thrombi before cardioversion, and to visualize the presence of an aneurysm.
The nurse is reinforcing instructions on a patient who will be taking digoxin. Which sign of digoxin toxicity should the nurse include?
- A. Ringing in the ears
- B. Bradycardia
- C. Headache
- D. Visual disturbance
- E. Hematuria
- F. Anorexia
Correct Answer: B,C,D,F
Rationale: Major signs of digoxin toxicity are bradycardia (HR <60), headache, visual disturbances, anorexia, as well as fatigue and arrhythmias.
Which information should be taught to patients starting on anticoagulant therapy for a valvular disorder?
- A. Increase the dose of aspirin for better therapy.
- B. Take medication at the same time each day.
- C. Report to health care provider cuts that do not stop bleeding with direct pressure.
- D. No restrictions for food or drink.
- E. Report for prescribed blood tests (PTT, INR, CBC, blood sugar).
Correct Answer: B,C
Rationale: Aspirin should not be used with anticoagulant therapy because it will increase bleeding. Gums, nosebleeds, excessive bruising, and cuts that do not stop bleeding with direct pressure should be reported to the health care provider. Alcohol and dark green and yellow vegetables should be avoided because they contain vitamin K. Normal blood tests for anticoagulant therapy are PTT, INR, and PT.
The patient has become very dyspneic, respirations are 32, and the pulse is 100. The patient is coughing up frothy red sputum. What should be the initial nursing intervention?
- A. Lay the patient flat to reduce hypotension and the symptoms of cardiogenic shock.
- B. Place patient in side-lying position to reduce the symptoms of atrial fibrillation.
- C. Place patient upright with legs in dependent position to reduce the symptoms of pulmonary edema.
- D. Lay the patient flat and elevate the feet to increase venous return in cardiogenic shock.
Correct Answer: C
Rationale: Signs and symptoms of pulmonary edema are restlessness; vague uneasiness; agitation; disorientation; diaphoresis; severe dyspnea; tachypnea; tachycardia; pallor or cyanosis; cough producing large quantities of blood-tinged, frothy sputum; audible wheezing and crackles; and cold extremities. The legs in a dependent position will decrease venous return and ease the pulmonary edema.
The nurse takes into consideration that age-related changes can affect the peripheral circulation because of which factor?
- A. sclerosed blood vessels.
- B. hypotension.
- C. inactivity.
- D. poor nutrition.
Correct Answer: A
Rationale: Aging causes sclerotic changes in the blood vessels that lead to decreased elasticity and narrowing of the vessel lumen.