MS - Ch. 29: Complications From Heart
Disease Exam Latest Update
A client with chronic heart failure is receiving digoxin 0.25 mg by mouth daily
and furosemide 20 mg by mouth twice daily. The nurse should assess the client
for what sign of digoxin toxicity? - ANSWER visual disturbances.
Digoxin toxicity may cause visual disturbances (e.g., flickering flashes of light,
colored or halo vision, photophobia, blurring, diplopia, and scotomata), central
nervous system abnormalities (e.g., headache, fatigue, lethargy, depression,
irritability and, if profound, seizures, delusions, hallucinations, and memory
loss), and cardiovascular abnormalities (e.g., abnormal heart rate, arrhythmias).
Digoxin toxicity doesn't cause taste and smell alterations. Dry mouth and urine
retention typically occur with anticholinergic agents, not inotropic agents such
as digoxin. Nocturia and sleep disturbances are adverse effects of furosemide
— especially if the client takes the second daily dose in the evening, which may
cause diuresis at night.
A nurse is caring for a client with heart failure. The nurse knows that the client
has left-sided heart failure when the client makes which statement? - ANSWER "I
sleep on three pillows each night."
Orthopnea is a classic sign of left-sided heart failure. The client commonly
sleeps on several pillows at night to help facilitate breathing. Swollen feet,
ascites, and anorexia are signs of right-sided heart failure.
A client with heart failure is having a decrease in cardiac output. What indication
does the nurse have that this is occurring? - ANSWER Blood pressure 80/46 mm
Hg
The body can compensate for changes in heart function that occur over time.
When cardiac output falls, the body uses certain compensatory mechanisms
designed to increase stroke volume and maintain blood pressure. These
compensatory mechanisms can temporarily improve the client's cardiac output
but ultimately fail when contractility is further compromised. A heart rate of 72
beats/minute is within normal range as well as the respiratory rate and oxygen
saturation.
, Which diagnostic study is usually performed to confirm the diagnosis of heart
failure? - ANSWER Echocardiogram
An echocardiogram is usually performed to confirm the diagnosis of heart
failure. ECG, serum electrolytes, and a BUN are usually completed during the
initial workup.
The nurse is teaching a client about medications prescribed for severe volume
overload from heart failure. What diuretic is the first-line treatment for clients
diagnosed with heart failure? - ANSWER furosemide
Loop diuretics such as furosemide, bumetanide, and torsemide are the
preferred first-line diuretics because of their efficacy in patients with and
without renal impairment. Spironolactone is a potassium diuretic. Mannitol is an
osmotic diuretic not used for heart failure. Metolazone is a potassium diuretic
not used for first treatment for heart failure. Diuretics should never be used
alone to treat HF because they don't prevent further myocardial damage.
While auscultating the heart sounds of a client with heart failure, the nurse hears
an extra heart sound immediately after the second heart sound (S2). How should
the nurse document this sound? - ANSWER a third heart sound (S3).
An S3 is heard following an S2, which commonly occurs in clients experiencing
heart failure and results from increased filling pressures. An S1 is a normal
heart sound made by the closing of the mitral and tricuspid valves. An S4 is
heard before an S1 and is caused by resistance to ventricular filling. A murmur
is heard when there is turbulent blood flow across the valves.
A client is exhibiting digitalis toxicity. Which of the following medications would
the nurse expect to be ordered for this client? - ANSWER Digoxin immune FAB
Digibind binds with digoxin and makes it unavailable for use. The digibind
dosage is based on the digoxin level and the patient's weight. Ibuprofen,
warfarin, and amlodipine are not used to reverse the effects of digoxin.
A patient is seen in the emergency department (ED) with heart failure secondary
to dilated cardiomyopathy. What key diagnostic test does the nurse assess to
determine the severity of the patient's heart failure? - ANSWER B-type
natriuretic peptide (BNP)
Disease Exam Latest Update
A client with chronic heart failure is receiving digoxin 0.25 mg by mouth daily
and furosemide 20 mg by mouth twice daily. The nurse should assess the client
for what sign of digoxin toxicity? - ANSWER visual disturbances.
Digoxin toxicity may cause visual disturbances (e.g., flickering flashes of light,
colored or halo vision, photophobia, blurring, diplopia, and scotomata), central
nervous system abnormalities (e.g., headache, fatigue, lethargy, depression,
irritability and, if profound, seizures, delusions, hallucinations, and memory
loss), and cardiovascular abnormalities (e.g., abnormal heart rate, arrhythmias).
Digoxin toxicity doesn't cause taste and smell alterations. Dry mouth and urine
retention typically occur with anticholinergic agents, not inotropic agents such
as digoxin. Nocturia and sleep disturbances are adverse effects of furosemide
— especially if the client takes the second daily dose in the evening, which may
cause diuresis at night.
A nurse is caring for a client with heart failure. The nurse knows that the client
has left-sided heart failure when the client makes which statement? - ANSWER "I
sleep on three pillows each night."
Orthopnea is a classic sign of left-sided heart failure. The client commonly
sleeps on several pillows at night to help facilitate breathing. Swollen feet,
ascites, and anorexia are signs of right-sided heart failure.
A client with heart failure is having a decrease in cardiac output. What indication
does the nurse have that this is occurring? - ANSWER Blood pressure 80/46 mm
Hg
The body can compensate for changes in heart function that occur over time.
When cardiac output falls, the body uses certain compensatory mechanisms
designed to increase stroke volume and maintain blood pressure. These
compensatory mechanisms can temporarily improve the client's cardiac output
but ultimately fail when contractility is further compromised. A heart rate of 72
beats/minute is within normal range as well as the respiratory rate and oxygen
saturation.
, Which diagnostic study is usually performed to confirm the diagnosis of heart
failure? - ANSWER Echocardiogram
An echocardiogram is usually performed to confirm the diagnosis of heart
failure. ECG, serum electrolytes, and a BUN are usually completed during the
initial workup.
The nurse is teaching a client about medications prescribed for severe volume
overload from heart failure. What diuretic is the first-line treatment for clients
diagnosed with heart failure? - ANSWER furosemide
Loop diuretics such as furosemide, bumetanide, and torsemide are the
preferred first-line diuretics because of their efficacy in patients with and
without renal impairment. Spironolactone is a potassium diuretic. Mannitol is an
osmotic diuretic not used for heart failure. Metolazone is a potassium diuretic
not used for first treatment for heart failure. Diuretics should never be used
alone to treat HF because they don't prevent further myocardial damage.
While auscultating the heart sounds of a client with heart failure, the nurse hears
an extra heart sound immediately after the second heart sound (S2). How should
the nurse document this sound? - ANSWER a third heart sound (S3).
An S3 is heard following an S2, which commonly occurs in clients experiencing
heart failure and results from increased filling pressures. An S1 is a normal
heart sound made by the closing of the mitral and tricuspid valves. An S4 is
heard before an S1 and is caused by resistance to ventricular filling. A murmur
is heard when there is turbulent blood flow across the valves.
A client is exhibiting digitalis toxicity. Which of the following medications would
the nurse expect to be ordered for this client? - ANSWER Digoxin immune FAB
Digibind binds with digoxin and makes it unavailable for use. The digibind
dosage is based on the digoxin level and the patient's weight. Ibuprofen,
warfarin, and amlodipine are not used to reverse the effects of digoxin.
A patient is seen in the emergency department (ED) with heart failure secondary
to dilated cardiomyopathy. What key diagnostic test does the nurse assess to
determine the severity of the patient's heart failure? - ANSWER B-type
natriuretic peptide (BNP)
