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The patient, age 26, is hospitalized with cardiomyopathy. While assisting with data collection from the patient, the nurse recognizes that the increased incidence of cardiomyopathy in young adults who have minimal risk factors for cardiovascular disease is related to which factor?
- A. Cocaine use
- B. Viral infection
- C. Vitamin B1 deficiency
- D. Pregnancy
Correct Answer: A
Rationale: Cardiomyopathy caused by cocaine abuse triggers intense vasoconstriction of the coronary arteries and peripheral vasoconstriction. Cocaine also causes high circulating levels of catecholamines, which may further damage myocardial cells, leading to ischemic or dilated cardiomyopathy. The cardiomyopathy produced is difficult to treat. Interventions deal mainly with the HF that ensues.
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The nurse would assess closely for which sign of right-sided heart failure?
- A. cough.
- B. increasing abdominal girth.
- C. shortness of breath.
- D. edema of feet and ankles.
- E. distended jugular veins.
- F. orthopnea.
Correct Answer: B,D,E
Rationale: Indicators of right-sided heart failure are distended jugular veins, anorexia, abdominal distention from ascites, liver enlargement with right upper quadrant pain, and edema of feet and ankles.
A patient with atrial fibrillation may experience decreased cardiac output, due to
Correct Answer: Incomplete ventricular filling
Rationale: Since the atria quiver, rather than contract, the normal atrial kick is lost, leading to a decrease in the cardiac output.
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.
What do dark or 'cold' spots on a thallium scan indicate?
- A. Tissue with adequate blood supply
- B. Dilated vessels
- C. Areas of neoplastic growth
- D. Tissue that has inadequate perfusion
Correct Answer: D
Rationale: Thallium scans show adequate perfused areas by the collection of thallium. Dark spots or 'cold spots' indicate tissues that have inadequate perfusion.
The nurse points out which factor as a modifiable risk for coronary artery disease (CAD)?
- A. Diabetes mellitus
- B. Heredity
- C. Smoking
- D. Hypertension
- E. Hyperlipidemia
- F. Age
Correct Answer: A,C,D,E
Rationale: Modifiable risks for the development of CAD include smoking, hyperlipidemia, hypertension, diabetes mellitus, obesity, sedentary lifestyle, and stress.