Med Surge Ch. 31: Cardiac Disorders NCLEX Questions and Answers Rated A+

Med Surge Ch. 31: Cardiac Disorders NCLEX Questions and Answers Rated A+ A patient with heart failure has an ejection fraction of 25%. What does this information indicate to the nurse about the patient's health status? 1. Ventricular function is severely impaired 2. Cardiac output is greater than normal, which overtaxes the heart 3. The amount of blood being ejected from the ventricles is within normal limits 4. Twenty-five percent of the blood entering the ventricle remains in the ventricle after systole 1. Normal ejection fraction is 60%. An ejection fraction of 25% indicates severe impairment of ventricular function; CO is decreased. A patient admitted 24 hours ago previously with heart failure has lost 1 kg of weight, has a heart rate of 88, which was 105 on admission, and now has crackles only in the bases of the lungs. How should the nurse interpret these assessment findings? 1. More aggressive treatment is needed 2. The patient's condition unchanged from admissions 3. The treatment regimen is achieving the desired effect 4. No further treatment is required at this time because the failure has resolved 3. The main goals for care of heart failure are to slow its progression, reduce cardiac workload, improve cardiac function, and control fluid retention. A weight loss of 1 kg and crackles in the lung bases indicate control of fluid retention. A HR of 88 indicates reduced cardiac workload and improved cardiac function. The patient's condition has improved since admission. Because the patient continues to have crackles in the lungs, heart failure has not completely resolved. A patient is diagnosed with left ventricular failure. Which findings should the nurse recognize as being consistent with this diagnosis? (Select all that apply) 1. Fatigue 2. Substernal chest pain during exercise 3. cm jugular vein distention at 30 degrees 4. Bilateral inspiratory crackles to midscapulae 5. Complaints of shortness of breath with minimal exertion 1,4,5 In left ventricular failure, the CO falls and pressure in the pulmonary vascular system increases. Fatigue is a common early manifestation. Pulmonary congestion causes shortness of breath with minimal exertion. On auscultation of the lungs, inspiratory crackles may be heard in the lung bases. Jugular vein distention is a manifestation of right ventricular failure. Chest pain with exercise can be due to angina pectoris or valvular disease. The nurse is caring for a patient undergoing pulmonary artery pressure monitoring. What should the nurse include when caring for this patient? (Select all that apply) 1. Maintain flush solution flow by gravity 2. Calibrate and level the system every shift 3. Secure the IV line to the bed linens 4. Change tubing to the insertion site every 72 hours 5. Report waveform dampening during wedge pressure measurements 2,4 Calibrating and leveling the system ring each shift ensures accuracy and consistency of measurements. To prevent infection, the tubing to the insertion site should be changed every 72 hours. There should be 300 mmHg of pressure on the flush solution at all times to prevent clot formation and catheter occlusion. The IV lines should not be secured to the bed linens. This could lead to accidental dislodging. Pressure trends and not individual readings should be monitored. Individual readings may not reflect the patient's