Nclex cardiovascular system
The pain of MI is not relieved by rest and nitroglycerin and requires opioid analgesics, such as morphine
sulfate, for
... [Show More] relief. The pain of angina may radiate to the left shoulder, arm, neck, or jaw. It often is
precipitated by exertion or stress, is accompanied by few associated symptoms, and is relieved by rest and
nitroglycerin. The pain of MI also may radiate to the left arm, shoulder, jaw, and neck. It typically begins
spontaneously, lasts longer than 30 minutes, and frequently is accompanied by associated symptoms (such
as nausea, vomiting, dyspnea, diaphoresis, or anxiety).
A client admitted to the hospital with chest pain and a history of type 2 diabetes mellitus is
scheduled for cardiac catheterization. Which medication would need to be withheld for 24 hours
before the procedure and for 48 hours after the procedure?
Metformin (Glucophage) needs to be withheld 24 hours before and for 48 hours after cardiac
catheterization because of the injection of contrast medium during the procedure. If the contrast medium
affects kidney function, with metformin in the system, the client would be at increased risk for lactic
acidosis. The medications in the remaining options do not need to be withheld 24 hours before and 48
hours after cardiac catheterization.
The nurse is reviewing an electrocardiogram rhythm strip. The P waves and QRS complexes are
regular. The PR interval is 0.16 second, and QRS complexes measure 0.06 second. The overall heart
rate is 64 beats/minute. Which would be a correct interpretation based on these characteristics?
Normal sinus rhythm is defined as a regular rhythm, with an overall rate of 60 to 100 beats/minute. The
PR and QRS measurements are normal, measuring 0.12 to 0.20 second and 0.04 to 0.10 second,
respectively.
Premature ventricular contractions can cause hemodynamic compromise. Therefore, the priority is to
monitor the blood pressure and oxygen saturation. The shortened ventricular filling time can lead to
decreased cardiac output. The client may be asymptomatic or may feel palpitations. Premature ventricular
contractions can be caused by cardiac disorders, states of hypoxemia, or by any number of physiological
stressors, such as infection, illness, surgery, or trauma, and by intake of caffeine, nicotine, or alcohol.
Nursing responsibilities after cardioversion include maintenance first of a patent airway, and then
oxygen administration, assessment of vital signs and level of consciousness, and dysrhythmia detection.
An implantable cardioverter defibrillator (ICD) is a small device that's placed in the chest or abdomen.
Doctors use the device to [Show Less]