Med Surg ATI Cardiovascular and respiratory

Med Surg ATI Cardiovascular and respiratory A nurse is planning care for a client who is having a percutaneous transluminal coronary angioplasty (PTCA) with stent placement. Which of the following actions should the nurse anticipate in the postprocedure plan of care? Instruct the client on a long-term cardiac conditioning program. Administer scheduled doses of acetaminophen. Check for peak laboratory markers of myocardial damage. Monitor for bleeding. - ANS-Monitor for bleeding. Bleeding is a post-procedure complication of PTCA because of the administration of heparin during the procedure and the removal of the femoral (or brachial) sheath. Manual pressure or a closure device is used to obtain hemostasis to the site. The client remains on bed rest until hemostasis is assured. A nurse is caring for a client who is postoperative following vein ligation and stripping for varicose veins. Which of the following actions should the nurse take? - ANS-Position the client supine with his legs elevated when in bed. A nurse is caring for a client who has an abdominal aortic aneurysm and is scheduled for surgery. The client's vital signs are blood pressure 160/98 mm Hg, heart rate 102/min, respirations 22/min, and SpO2 95%. Which of the following actions should the nurse take? Administer antihypertensive medication for blood pressure. Monitor that urinary output is 20 mL/hr. Withhold pain medication to prepare for surgery. Take vital signs every 2 hr. - ANS-The nurse should administer antihypertensive medication for the elevated blood pressure because hypertension can cause a sudden rupture of the aneurysm due to pressure on the arterial wall. A nurse is caring for a client who has hemophilia. The client reports pain and swelling in a joint following an injury. Which of the following actions should the nurse take? Obtain blood samples to test platelet function. Prepare for replacement of the missing clotting factor. Administer aspirin for the client's pain. Place the bleeding joint in the dependent position - ANS-Prepare for replacement of the missing clotting factor. Hemophilia is a hereditary bleeding disorder in which blood clots slowly and abnormal bleeding occurs. It is caused by a deficiency in the most 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. A nurse is assessing a client for manifestations of aplastic anemia. Which of the following findings should the nurse expect? Plethoric appearance of facial skin Glossitis and weight loss Jaundice with an enlarged liver Petechiae and ecchymosis - ANS-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. A nurse is assessing a client who has right-sided heart failure. Which of the following findings should the nurse expect? Decreased capillary refill Dyspnea Orthopnea Dependent edema - ANS-Dependent edema Blood return from the venous system to the right atrium is impaired by a weakened right heart. The subsequent systemic venous backup leads to development of dependent edema.