NURSING 353 Print ATI Medical Surgical Cardiovascular and Hematology flashcards Easy Notecards-converted

NURSING 353 Print ATI Medical Surgical Cardiovascular and Hematology flashcards Easy Notecards-converted 1. A nurse is assessing a client who has late-stage heart failure and is experiencing fluid volume overload. Which of thefollowing findings should thenurse expect? Weight gain 1 kg (2.2 lb) in 1 day. A weight gain of 1 kg (2.2 lb) in 1 day alerts thenurse that theclient is retaining fluid and is at risk of fluid volume overload. This is an indication that theclient's heart failure is worsening. 2. A nurse is assessing a client who has an abdominal aortic aneurysm. Which of thefollowing manifestations should thenurse expect? Lower back discomfort Abdominal aortic aneurysm involves a widening, stretching, or ballooning of theaorta. Back and abdominal pain indicate that theaneurysm is extending downward and pressing on lumbar spinal nerve roots, causing pain. 3. A nurse is caring for a client who is in hypovolemic shock. While waiting for a unit of blood, thenurse should administer which of thefollowing IV solutions? 0.9% sodium chloride Solutions of 0.9% sodium chloride, as well as Lactated Ringer's solution, are used for fluid volume replacement. Sodium chloride, a crystalloid, is a physiologic isotonic solution that replaces lost volume in theblood stream and is theonly solution to use when infusing blood products. 4. A nurse is planning care for a client who has pernicious anemia. Which of thefollowing interventions should thenurse include in theplan? Initiate weekly injections of vitamin B12. The nurse should initiate weekly injections of vitamin B12 for a client who has pernicious anemia, and then decrease to monthly. Pernicious anemia is caused by a lack of intrinsic factor needed to absorb vitamin B12 from thegastrointestinal tract. 5. A nurse is administering a unit of packed red blood cells (RBCs) to a client who is postoperative. theclient reports itching and has hives 30 min after theinfusion begins. Which of thefollowing actions should thenurse take first? Stop theinfusion of blood. The nurse should apply theurgent vs. nonurgent priority-setting framework. Using this framework, thenurse should consider urgent needs thepriority because they pose more of a threat to theclient. thenurse might also need to use Maslow's hierarchy of needs, theABC priority-setting framework, or nursing knowledge to identify which finding is themost urgent. thenurse should stop theinfusion of blood because theclient has manifestations of an allergic reaction. 6. A nurse is caring for a client who had a myocardial infarction 5 days ago. theclient has a sudden onset of shortness of breath and begins coughing frothy, pink sputum. thenurse auscultates loud, bubbly sounds on inspiration. Which of thefollowing adventitious breath sounds should thenurse document? Coarse crackles A client who had a recent myocardial infarction is at risk for left- sided heart failure. Crackles are breath sounds caused by movement of air through airways partially or intermittently occluded with fluid and are associated with heart failure and frothy sputum. Crackling sounds are heard at theend of inspiration and are not cleared by coughing. 7. A nurse is assessing a client who has fluid volume overload from a cardiovascular disorder… Jugular vein distension Moist crackles Increased Heart Rate 8. A nurse is assessing a client who has right-sided heart failure. Which of thefollowing findings should thenurse expect? Dependent edema Blood return from thevenous system to theright atrium is impaired by a weakened right heart. thesubsequent systemic venous backup leads to development of dependent edema. 9. A nurse is providing teaching to a client who has anemia and a new prescription for epoetin alfa. Which of thefollowing information should thenurse include in theteaching? Hypertension is a common adverse effect of this medication. The nurse should teach that a common adverse effect of epoetin alfa is hypertension because of therise in theproduction of erythrocytes and other blood cell types. Epoetin alfa is a synthetic version of human erythropoietin. Epoetin alfa is used to treat anemia associated with kidney disease or medication therapy. It increases and maintains thered blood cell level. 10. A nurse is reviewing a client's repeat laboratory results 4 hr after administering fresh frozen plasma (FFP). Which of thefollowing laboratory results should thenurse review? Atrial rate of 300/min with QRS complex of 80/min The nurse should interpret this finding as atrial flutter, which indicates a lack of conduction between theatria and ventricles. theadditional atrial beats are not conducting. 11. A nurse on a telemetry unit is caring for a client who has an irregular radial pulse. Which of thefollowing ECG abnormalities should thenurse recognize as atrial flutter? Atrial rate of 300/min with QRS complex of 80/min The nurse should interpret this finding as atrial flutter, which indicates a lack of conduction between theatria and ventricles. theadditional atrial beats are not conducting. 12. A nurse is planning care for a client who is having a percutaneous transluminal coronary angioplasty (PTCA) with stent placement. Which of thefollowing actions should thenurse anticipate in thepostprocedure plan of care? Monitor for bleeding. Bleeding is a post-procedure complication of PTCA because of theadministration of heparin during theprocedure and theremoval of thefemoral (or brachial) sheath. Manual pressure or a closure device is used to obtain hemostasis to thesite. theclient remains on bed rest until hemostasis is assured. 13. A nurse is preparing to transfuse a unit of packed red blood cells (RBCs) to a client who has anemia. Which of thefollowing actions should thenurse take first? Witness theinformed consent. The nurse should apply theleast invasive priority-setting framework. This framework assigns priority to nursing interventions that are least invasive to theclient, as long as those interventions do not jeopardize client safety. thenurse should take interventions that are not invasive to theclient before interventions that are invasive; therefore, as witnessing theinformed consent is theleast invasive, it is theaction that should be performed first. Unless it is an emergency, informed consent should be obtained prior to initiating a blood transfusion to a client. 14. A nurse is caring for a client who has hemophilia. theclient reports pain and swelling in a joint following an injury. Which of thefollowing actions should thenurse take? Prepare for replacement of themissing clotting factor. Hemophilia is a hereditary bleeding disorder in which blood clots slowly and abnormal bleeding occurs. It is caused by a deficiency in themost common clotting factor, factor VIII (hemophilia A). Aggressive factor replacement is initiated to prevent hemarthrosis that can result in long-term loss of range of motion in repeatedly affected joints. 15. A nurse is completing a medication history for a client who reports using fish oil as a dietary supplement. Which of thefollowing substances in fish oil should thenurse recognize as a health benefit to theclient? Omega-3 fatty acids Fish oil contains omega-3 fatty acids, which can help lower therisk of cardiovascular disease and stroke by decreasing triglyceride levels. 16. A nurse is assessing a client who has pericarditis. Which of thefollowing manifestations should thenurse expect? Dyspnea with hiccups The client who has pericarditis will experience dyspnea, hiccups, and a nonproductive cough. These manifestations can indicate heart failure from pericardial compression due to constrictive pericarditis or cardiac tamponade. 17. A nurse is assessing for cardiac tamponade on a client who had coronary artery bypass grafts. Which of thefollowing actions should thenurse take? Auscultate blood pressure for pulsus paradoxus. The client who has cardiac tamponade will have pulsus paradoxus when thesystolic blood pressure is at least 10 mm Hg higher on expiration than on inspiration. This occurs because of thesudden decrease in cardiac output from thefluid compressing theatria and ventricles. 18. A nurse is providing teaching about lifestyle changes to a client who had a myocardial infarction and has a new prescription for a beta blocker. Which of thefollowing client statements indicates an understanding of theteaching? "Before taking my medication, I will count my radial pulse rate." A beta blocker will induce bradycardia. theclient should take her pulse rate for 1 min before self- administration. 19. A nurse is completing an assessment for a client who has a history of unstable angina. Which of thefollowing findings should thenurse expect? Chest pain lasts longer than 15 min. The client who has unstable angina will have chest pain lasting longer than 15 min. This is due to thereduced blood flow in a coronary artery due to atherosclerotic plaque and thrombus formation causing partial arterial obstruction, or from an artery spasm. 20. A nurse is caring for a client who is postoperative following vein ligation and stripping for varicose veins. Which of thefollowing actions should thenurse take? Position theclient supine with his legs elevated when in bed. The nurse should elevate theclient's legs above his heart to promote venous return by gravity. During discharge teaching, thenurse should reinforce theimportance of periodic positioning of thelegs above theheart. 21. A nurse in a clinic is assessing thelower extremities and ankles of a client who has a history of peripheral arterial disease. Which of thefollowing findings should thenurse expect? Dry, pale skin with minimal body hair A client who has peripheral arterial disease can display dry, scaly, pale, or mottled skin with minimal body hair because of narrowing of thearteries in thelegs and feet. This causes a decrease in blood flow to thedistal extremities, which can lead to tissue damage. Common manifestations are intermittent claudication (leg pain with exercise), cold or numb feet at rest, loss of hair on thelower legs, and weakened pulses. 22. A nurse is caring for a client who has heart failure and whose telemetry reading displays a flattening of theT wave. Which of thefollowing laboratory results should thenurse anticipate as thecause of this ECG change? Potassium 2.8 mEq/L A flattened T wave or thedevelopment of U waves is indicative of a low potassium level. 23. A nurse is reviewing laboratory values for an adult client who has sickle cell anemia and a history of receiving blood transfusions. For which of thefollowing complications should thenurse monitor? Iron toxicity The client who has received several blood transfusions is at risk for development of hemosiderosis, which is excess storage of iron in thebody. theexcessive iron can come from overuse of supplements or from receiving frequent blood transfusions, as in sickle cell anemia. 24. A nurse is monitoring a client who had a myocardial infarction. For which of thefollowing complications should thenurse monitor in thefirst 24 hr? Ventricular dysrhythmias After a myocardial infarction, theelectrical conduction system of theheart can be irritable and prone to dysrhythmias. Ischemic tissue caused by theinfarction can also interfere with thenormal conduction patterns of theheart's electrical system. 25. A nurse is transfusing a unit of O-negative fresh frozen plasma to a client whose blood type is B positive. Which of thefollowing actions should thenurse take? Remove theunit of plasma immediately and start an IV infusion of normal saline solution. A client who receives FFP that is not compatible can experience a hemolytic transfusion reaction. thenurse should stop thetransfusion and infuse 0.9% sodium chloride solution with new tubing. 26. A nurse is preparing to transfuse 250 mL of packed red blood cells (RBCs) to a client over 4 hr. Available is a blood administration set that delivers 10 gtt/mL. thenurse should set themanual blood transfusion to deliver how many gtt/min? (Round theanswer to thenearest whole number. Use a leading zero if it applies. Do not use a trailing zero.) 10 gtt/min 27. A nurse is monitoring a client who has heart failure related to mitral stenosis. theclient reports shortness of breath on exertion. Which of thefollowing conditions should thenurse expect? Increased pulmonary congestion Pulmonary congestion occurs due to right-sided heart failure. Because of thedefect in themitral valve, theleft atrial pressure rises, theleft atrium dilates, there is an increase in pulmonary artery pressure, and hypertrophy of theright ventricle occurs. In this case, dyspnea is an indication of pulmonary congestion and right-sided heart failure. 28. A nurse is caring for a client who has an abdominal aortic aneurysm and is scheduled for surgery. theclient's vital signs are blood pressure 160/98 mm Hg, heart rate 102/min, respirations 22/min, and SpO2 95%. Which of thefollowing actions should thenurse take? Administer antihypertensive medication for blood pressure. The nurse should administer antihypertensive medication for theelevated blood pressure because hypertension can cause a sudden rupture of theaneurysm due to pressure on thearterial wall. 29. A nurse is caring for a client who has a demand pacemaker inserted with therate set at 72/min. Which of thefollowing findings should thenurse expect? Telemetry monitoring shows QRS complexes occurring at a rate of 74/min with no pacing spikes. The nurse should not expect pacer spikes when theclient's pulse is greater than theset rate of 72/min, because theclient's intrinsic rate overrides theset rate of thepacemaker. 30. A nurse is assessing a client for manifestations of aplastic anemia. Which of thefollowing findings should thenurse expect? Petechiae and ecchymosis The client who has aplastic anemia will have manifestations of petechiae and ecchymosis. Dyspnea on exertion also can be present. In aplastic anemia, all three major blood components (red blood cells, white blood cells, and platelets) are reduced or absent, which is known as pancytopenia. Manifestations usually develop gradually. ...

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