cardiac/respiratory

A client has undergone thoracentesis and has been ordered to undergo a chest radiograph. Which of the following would the nurse identify for the client as the rationale for the radiograph

To check for pneumothorax

For a client who has undergone thoracentesis, a chest radiograph is done after the procedure to rule out a

pneumothorax

Which of the following nursing interventions is most important during a lung scan

Instruct the client not to hold his or her breath during the procedure

The client rests her or his arms and head on the pillow during a

thoracentesis

complications that may follow a thoracentesis are:

Subcutaneous emphysema, pulmonary edema, and cardiac distress

Of the following instructions, which is most important for the nurse to teach the client to help loosen secretions and increase comfort during medical treatment for sinusitis

increase fluid intake

When teaching a client who has undergone a tonsillectomy and adenoidectomy how to most avoid increasing pressure on the suture line, the nurse emphasizes

Avoiding coughing

Which of the following should the nurse encourage clients with asthma to consume liberally

zinc

Food allergens that may trigger asthma include

milk, eggs, and seafood.

A classic sign of ischemia is

pain

Leg pain, especially with activity, can indicate inadequate _______ to leg muscles.

oxygenation

It can accompany the inflammatory response when myocardial cells are damaged after an acute MI (heart attack) or infections such as rheumatic fever and bacterial endocarditis

fever

The nurse also determines any pulse deficit by counting the heart rate through auscultation at the apex while a second nurse simultaneously palpates and counts the radial pulse for a full minute. The difference, if any, is the

pulse deficit.

Pulse volume is described as feeling

full, weak, or thready

The use of accessory muscles (neck or abdominal muscles) during respiration is an indication that the client is having .

difficulty breathing

Cardiac disorders often are associated with changes in BP. If the client is not acutely ill, the nurse takes the BP with the client in the ______ (orthostatic vital signs

lying, sitting, and standing positions

The nurse takes the BP in both arms on admission and at least once daily thereafter. He or she reports a marked _____ in pressure between the left and right arms

difference

dizziness or light-headedness when changing positions can indicated

postural hypotension

The first heart sound (“lub”), referred to as S1, is the closing of the

mitral and tricuspid valves

S1 is heard loudest over the _____ of the heart and occurs nearly simultaneously with the palpated pulse

apex

The second heart sound (“dub”), referred to as S2, is the closing of the

aortic and pulmonic valves

____is heard loudest with the stethoscope at the second intercostal space to the right of the sternum.

S2

A sound that follows S1 and S2 is called an S3 heart sound or a

ventricular gallop

An extra sound just before S1 is an S4 heart sound, or

atrial gallop

An S4 sound often is associated with .

hypertensive heart disease

A friction rub may cause a _____ sound that is indicative of pericarditis

rough, grating, or scratchy

abnormal sounds, such as ______ caused by turbulent blood flow through diseased heart valves

murmurs and clicks

If the client has a problem with peripheral circulation, the nurse inspects the arms and legs for variations in skin ______and compares his or her bilateral findings with other areas of the body.

color and temperature

_____ occurs when blood is not pumped efficiently or plasma protein levels are inadequate to maintain osmotic pressure

Edema

A 2-lb weight gain in a short period indicates that the client has an additional ____ of fluid in the body

liter

With the client sitting at a 45° angle, the client turns his or her head to the left or right so the nurse can inspect the _______ Distention of this vein usually indicates increased fluid volume and pressure in the right side of the heart

external jugular vein.

With left-sided congestive heart failure, auscultation reveals a

crackling sound and possibly wheezes and gurgles

______are accompanied by dyspnea and an effort to sit up to breathe. If uncorrected, left-sided heart failure is followed by right-sided heart failure because the circulatory system is a continuous loop

Wet lung sounds

Confusion or disorientation can result from

cerebral ischemia

abnormal sodium, potassium, calcium, and magnesium levels may cause

dysrhythmias

A total serum cholesterol level above ____, a low-density lipoprotein level above _____, or a high-density lipoprotein level below _____suggests the propensity for development of ____

200 mg/dL
130 mg/dL
30 mg/dL
atherosclerotic heart disease

____, an enzyme in myocardial contractile tissue

Troponin

_____uses ultrasound waves to determine the functioning of the left ventricle and to detect cardiac tumors, congenital defects, and changes in the tissue layers of the heart

Echocardiography

The P wave represents the initiation of the electrical impulse that causes ______ of the atria

depolarization

The PR interval is the time it takes for the impulse to travel from its point of initiation, through the atrial conduction pathways, to the

AV node

The QRS complex, the collective term for the Q, R, and S waves, is the measurement of time that it takes for the impulse to spread throughout the ventricles from the _______, causing its subsequent depolarization.

AV node to the Purkinje fibers

The ST segment is a particularly sensitive indicator of _______. Ischemia causes the ST segment to sag below the baseline (isoelectric line). An elevated ST segment indicates _____.

ischemia and myocardial damage.
muscle injury

Ambulatory ECG, or Holter monitoring, is the recording of an ambulatory client's cardiac rate and rhythm over ____hours as the client performs daily activities

24 to 48

Allergies must be identified; those of primary concern before a cardiac catheterization are

iodine, shellfish, radiographic dye, and latex

Black lung disease is a collective term for diseases caused by the inhalation of

Coal dust

a chronic disease characterized by abnormal distention of the alveoli

Emphysema

Pulmonary hypertension results from _______

heart disease

The _______ are the largest sinuses and the most accessible to treatment

maxillary sinuses

The eustachian tubes are the means through which upper respiratory infections spread to the

middle ear.

Edema of the vocal cords frequently accompanies

laryngeal inflammation

A _____ may be done to remove tumors of the lung, bronchus, or chest wall

thoracotomy

the inability to exchange sufficient oxygen and carbon dioxide for the body's requirements

Respiratory failure

an accumulation of fluid in the interstitium and alveoli of the lungs.

Pulmonary edema

Obstruction of one of the pulmonary arteries or its branches

Pulmonary embolism

Are quiet and low pitched with long inspiration and short expiration

vesibular sounds

Are produced by air movement through the trachea

Bronchial sounds

characteristerized by wheezes or crackles

Adventitious breath sounds

Usually associated with acute infection; also radiation therapy

pneumonia

A complication of lung cancer or pneumonia

pleural effusion

Pneumonia or mechanical obstruction of the bronchi

lung abscess

Irreversible dilatation of the bronchi and the bronchioles

Bronchiectasis

Collapse of alveoli

Atelectasis

Abnormal distention of the alveoli

Pulmonary emphysema

Reversible obstructive disease of the lower airway

asthma

Tactile or vocal vibrations from the client's voice transmitted to the examiner's fingers

fremitus

______ occurs when two or more adjacent ribs fracture in multiple places and the fragments are free-floating

Flail chest

Lying on the unaffected side for at least 1 hour promotes _____on the affected side.

expansion of the lung

Why is a local anesthetic required for direct or indirect inspection of the larynx

depresses the gag reflex

Why is a local anesthetic required for direct or indirect inspection of the larynx

apply pressure and ice

Humidification and use of a nasal lubricant help to keep the

mucous membranes moist.

Why does a nurse place a client with pneumonia in the semi-Fowler's position

The semi-Fowler's position aids breathing and increases the amount of air taken with each breath

What interventions are required after a pulmonary angiography

Inspect the puncture site for swelling, discoloration, bleeding, or hematoma. Assess distal circulation and sensation to ensure that circulation is unimpaired. If bleeding occurs, apply pressure to the site

The density of the ______________________ safeguards the heart

parietal pericardium

The _______is the first tissue to be supplied with oxygenated blood with each heartbeat.

myocardium

It may take ______ years for a client who has had rheumatic fever to develop mitral stenosis

20 to 40

In ______________________ heart block, the atrial impulse never gets through and the ventricles develop their own independent rhythm

three degree

a dysrhythmia characterized by a heart rate between 100 to 150 beats per minute, but with a regular rhythm

sinus tachycardia

Prolonged constriction of the pulmonary artery results in

pulmonary hypertension

As cardiac output falls, anaerobic metabolism results in an accumulation of _____, which eventually can lead to metabolic acidosis

lactic acid

The heart is a double pump—the right side facilitates

pulmonary circulation

The heart is a double pump the left side is responsible for .

systemic circulation

The pulmonary artery is the only artery in adults that carries _____ blood

deoxygenated

Symptoms of mitral stenosis develop when the valve area is less than

2.5 square cm

Many clients with mitral valve prolapse are .

asymptomatic

The atrial waves in atrial flutter have a characteristic _____ pattern

sawtooth

The valves that prevent blood from flowing back into the ventricles after the heart contracts

semilunar valves

A nonemergency procedure to stop rapid atrial dysrhythmias

Elective electrical cardioversion

A neurohormone secreted by the ventricles upon sensing increased fluid pressure within the heart

B-type natriuretic peptide (BNP)

The repair of the fibrous ring that encircles the valve

Annuloplasty

Reveals myocardial ischemia

ECG

Distention of this vein usually indicates increased fluid volume and pressure in the right side of the heart.

External Jugular

is the amount of blood pumped per contraction of the heart.

Stroke volume

The stroke volume averages approximately

65 to 70 mL

During auscultation of the heart, the examiner hears a rough, grating, scratchy sound. What problem might the client have

pericarditis

An S4 sound often is associated with

hypertensive heart disease

A client with myocardiopathy is experiencing syncope. Which of the following instructions should the nurse provide specifically to address the consequences of syncope

Restrict driving or operating equipment

Which of the following topics would the nurse include in teaching the client with aortic regurgitation? Choose all that apply.

Reasons for antibiotic therapy
Reasons for antibiotic therapy
Methods to control hypertension.

Which of the following interventions are necessary when caring for a client with transvenous pacemaker?

Use only grounded electrical equipment in the room

Which of the following instructions is most important to include in the teaching plan for a client with right-sided heart failure

Elevate the legs while sitting

An electrical device used to manage a chronic bradydysrhythmia

Implanted pacemaker

Category of drugs that helps overcome afterload and reduce the exertion of the heart by decreasing circulatory fluid volume

Diuretic therapy

Blood chemistry

Triglyceride levels

Cardiac dysrhythmias

Electrocardiography

Functioning of the left ventricle

Echocardiography

Reveals heart enlargement and dilated aortic valve

Chest radiograph

Provides images of atypical valvular and myocardial function

Echocardiography

Treatment includes:Valsalva's maneuver, unilateral carotid massage, immersion of face in ice water for this heart condition

Supraventricular tachycardia

Between the right atrium and right ventricle

Tricuspid valve

Between the left atrium and left ventricle

Mitral valve

If the right side of the heart fails to pump efficiently, blood becomes congested in the

neck veins/external jugular vein

Distention of this vein usually indicates increased fluid volume and pressure in the right side of the heart.

external jugular

balloon valvuloplasty is given to clients with

mitral stenosis

The greater the stretch of the myocardium as the ventricles fill with blood, the stronger is the ventricular contraction. This phenomenon is called

Starling's law

a difference of 10 mm Hg or more between the first Korotkoff sound (heralding systolic blood pressure) heard during expiration and the first heard during inspiration

Pulsus paradoxus

promote the forward circulation of blood to sustain adequate cardiac output.

The four cardiac valves—aortic, mitral, tricuspid, and pulmonic

Why are clients with mitral valve prolapse syndrome advised to restrict or eliminate alcohol intake

Alcohol can suppress antidiuretic hormone, which leads to a loss of extracellular fluid

Why does the nurse encourage clients recovering from cardiac surgery to perform leg exercises every hour when they are awake

because contraction of skeletal leg muscles propels venous blood toward the heart.

What assessment findings are typical in a client with Buerger's disease

One or both feet are always cold. Some areas of the feet have numbness, burning, and tingling sensations

sparse hair growth

signs and symptoms of impending CHF

weight gain, ankle swelling, fatigue, dyspnea

An S4 sound often is associated with

hypertensive heart disease

an S4 heart sound, or atrial gallop is associated with _______.

hypertensive heart disease

an S3 heart sound or a ventricular gallop is associated with _______.

heart failure in an adult