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Cardiac, Respiratory, Blood Practice Questions 1.A nurse is caring for a client who has heart failure and a prescription for digoxin 125 mcg PO daily. Available is digoxin PO 0.25 mg/tablet. How many tablets should the nurse administer per dose? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.) _0.5_ tablet(s) 2. A nurse is assessing a client who has fluid overload. Which of the following findings should the nurse expect? (Select all that apply.) A. Increased heart rate B. Increased blood pressure C. Increased respiratory rate D. Increase hematocrit E. Increased temperature 3. A nurse is reviewing the EKG strip of a client who has prolonged vomiting. Which of the following abnormalities on the client's EKG should the nurse interpret as a sign of hypokalemia? A. Abnormally prominent U wave B. Elevated ST segment C. Wide QRS D. Inverted P wave 4. A client who has a history of myocardial infarction (MI) is prescribed aspirin 325 mg. The nurse recognizes that the aspirin is given due to which of the following actions of the medication? A. analgesic B. anti-inflammatory C. antiplatelet aggregate D. antipyretic 5. While performing an admission assessment for a client, the nurse notes that the client has varicose veins with ulcerations and lower extremity edema with a report of a feeling of heaviness. Which of the following nursing diagnoses should the nurse identify as being the priority in the client's care? A. Impaired tissue perfusion B. Alteration in body image C. Alteration in activity tolerance D. Impaired skin integrity 6. A nurse is assessing a client who is receiving one unit of packed RBCs to treat intraoperative blood loss. The client reports chills and back pain, and the client's blood pressure is 80/64 mm Hg. Which of the following actions should the nurse take first? A. Stop the infusion of blood. Peripheral artery disease (PAD) and peripheral venous disease (PVD) have a lot in common. Both are conditions that involve the vascular (or circulatory) system and affect the blood vessels in areas outside your heart. That means they are both types of peripheral vascular disease. Blood vessels -- arteries and veins -- are tube-like structures that allow blood, oxygen, and waste to travel through your body. When arteries don’t work properly,
your feet and legs can’t get enough oxygen and other needed supplies, like nutrients. And when veins aren’t working, there can be a buildup of blood materials, like fluid, in your limbs. The two diseases differ in several key ways. PAD means you have narrowed or blocked arteries -- the vessels that carry oxygen-rich blood as it moves away from your heart to other parts of your body. PVD, on
the other hand, refers to problems with veins -- the vessels that bring your blood back to your heart. Most often PAD happens because of atherosclerosis, when plaque, cholesterol, and other substances build up within an artery’s wall and make it narrower inside. If enough plaque builds up, it can block blood flow inside the artery. (Blood clots can also get in the way of the flow.) Like PVD , there also seems to
be a genetic component to PAD. When the blood is blocked it lowers the amount of oxygen and nutrients that get to your limbs. This can create lasting damage to your skin, nerves, and muscle tissue. Less-common causes of PAD include injuries to the arteries, unusually shaped muscles or ligaments, and infections. PVD has several different forms. With chronic venous insufficiency, the valves in your veins allow blood to flow backwards in the wrong direction. This can create pressure and
strain that damage the tissues causing bulging of your veins, especially if you are pregnant, overweight, or tend to sit or stand in one position for a long time. On the milder end, this condition can lead to spider veins -- small, raised, swollen blood vessels that twist and turn. As the problem becomes more severe, it can become painful and lead to varicose veins, which are larger but not life-threatening. Half of people with PAD don’t have symptoms. Those who do often feel cramping in one or both of their lower legs when they are active but not when they rest. This is called intermittent claudication. In the most severe form of PAD, called critical limb-threatening ischemia, the blood supply is so low the limbs begin to show visible damage. Other PAD symptoms can include: An early symptom of PVD can be small, damaged veins appearing on the legs or feet, called spider veins. With more severe disease, veins can appear twisted and large (varicose veins). These visible changes can come along with uncomfortable symptoms in your legs including: If you have symptoms that make you suspect you have PAD or PVD, schedule a doctor visit and ask about them. Tests to diagnose PAD include the ankle brachial index, which compares blood pressure levels in your ankles and your arms.
Imaging tests like ultrasound and angiography can help health care providers take a look at what’s going on in your vascular system. To diagnose PVD, doctors use Duplex ultrasound, an imaging test to look at your leg veins and blood flow. PAD treatment can involve medications that prevent blood clots, like the antiplatelet drugs aspirin and clopidogrel.
Your doctor may also prescribe other drugs to control high blood pressure and cholesterol. Exercise training and medications like cilostazol can improve walking capacity. Healthy habits like getting more exercise and quitting smoking also can help. Some people need a procedure called revascularization to open their arteries. Revascularization can be either a traditional surgery or a less-invasive procedure using a catheter. In very advanced PAD, doctors may need to amputate all or
part of a leg. PVDtreatments include simple measures to ensure your blood keeps moving properly: Other options include medicines to encourage blood flow. Your doctor may also recommend procedures such as laser or radiofrequency ablation, where heat from a catheter closes affected veins. More severe PVD cases
may benefit from sclerotherapy, in which an injected chemical causes scarring to close diseased veins, or surgery. To prevent PAD and PVD, take care of yourself: get regular exercise, eat a healthy diet, and don’t smoke. It’s also important to take steps to control other conditions you may have like high blood pressure, high cholesterol, and diabetes. Ask your doctor about any symptoms you have. If
you can catch the conditions early on, it’s possible to prevent milder forms from getting worse. What clinical symptoms might the nurse expect to find in a client with a central venous pressure?Coarse breath sounds and pitting lower extremity edema.. Bradycardia and cool, clammy extremities.. Increasing jugular venous distention and clear lung sounds.. Tachycardia and warm, flushed extremities.. What is most important for the nurse to emphasize to prevent a stroke?The most recent prevention guidelines for stroke and TIA place greater emphasis on lifestyle, based on the growing evidence that supports the role of lifestyle modification in vascular risk reduction. As a nurse, you can play a key role in helping stroke and TIA patients achieve evidence-based lifestyle changes.
How should the nurse assess for mechanical capture of the pacemaker?Confirmation of mechanical capture should be done by feeling for a pulse. Additionally, mechanical capture can be confirmed using ultrasound and by observing ventricular contraction. If the patient is conscious, little sedation can be considered to reduce the feeling of discomfort associated with cardiac pacing[12].
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Which clinical finding would the nurse anticipate in a client with chronic venous insufficiency
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