NUR 398 CHAPTER 35 CARE OF PT. WITH CARDIAC
PROBLEMS
The use of which drug may pose a risk for the development of heart failure, especially in
older adults?
1
Insulin
2
Digoxin
3
Ibuprofen
4
Potassium chloride - Answers - 3
Long-term use of NSAIDs (ibuprofen, naproxen) may cause fluid and sodium retention.
Insulin controls blood glucose levels, which should help prevent heart disease and heart
failure. Digoxin is a medication used in the treatment of heart failure to increase stroke
volume and heart rate. Potassium chloride is used as a supplement to prevent or treat
electrolyte imbalance; this often results from diuretics used when treating heart
failure.Which medication is indicated for a patient diagnosed with restrictive
cardiomyopathy to block inappropriate sympathetic stimulation and tachycardia?
Which medication is indicated for a patient diagnosed with restrictive cardiomyopathy to
block inappropriate sympathetic stimulation and tachycardia?
1
Digoxin
2
Diltiazem
3
Metoprolol
4
Nitroglycerin - Answers - 3
Metoprolol is indicated for blocking inappropriate sympathetic stimulation and
tachycardia in patients diagnosed with restrictive cardiomyopathy. Digoxin and
nitroglycerin are indicated to increase cardiac output. Diltiazem is not indicated for
blocking inappropriate sympathetic stimulation and tachycardia.
The nurse is caring for a patient receiving digoxin therapy. Which finding would indicate
to the nurse that the patient is suffering from digoxin toxicity?
1
Weight gain
2
Blurred vision
3
Worsening heart failure
,4
Orthostatic hypotension - Answers - 2
Symptoms of digoxin toxicity include blurred vision, fatigue, bradycardia, dysrhythmia
and ectopic beats, and changes in mental status. Digoxin toxicity does not specifically
worsen heart failure (HF); however, bradycardia may occur. Weight gain occurs when
excess sodium is consumed or HF is worsening. Orthostatic hypotension is caused by
vasodilating medications, not inotropic agents.
Which factor reflects the most common etiology of heart failure?
1
Valvular disorders
2
Ventricular dilation
3
Fluid volume excess
4
Myocardial infarction (MI) - Answers - 4
About one-third of patients who have had MI develop heart failure. The second most
common cause of heart failure is structural changes such as valvular dysfunction. Fluid
volume excess may be a cause or result of heart failure. Ventricular dilation is a result of
fluid accumulation from pump failure, but it is not a cause or etiology.
What health care professional should be consulted when planning exercise for a patient
who had heart transplant surgery?
1
Case manager
2
Cardiac surgeon
3
Physical therapist
4
Discharge planner - Answers - 3
A physical therapist should be consulted to plan an appropriate exercise program for a
patient who has had a heart transplantation surgery. The case manager and discharge
planning will not be involved in planning an exercise program for the patient. The
cardiac surgeon may have input, but the exercise plan is not made by the cardiac
surgeon.
Which conditions can cause high-output heart failure? Select all that apply.
1
High fever
2
Septicemia
3
Valvular disease
4
, Hyperthyroidism
5
Coronary artery disease - Answers - 1,2,4
High-output failure is caused by increased metabolic needs or hyperkinetic conditions.
Fever, septicemia, and hyperthyroidism are conditions that cause high-output heart
failure. High-output heart failure can occur when cardiac output remains normal or
above normal. Valvular disease and coronary artery disease cause left-sided heart
failure.
A patient begins lisinopril therapy. What does the nurse consider at the start of therapy
with this medication?
1
Liver function tests
2
The risk for hypotension
3
The potential for bradycardia
4
The patient's ability to understand medication teaching - Answers - 2
Angiotensin-converting enzyme (ACE) inhibitors are associated with first-dose
hypotension and orthostatic hypotension, which are more likely in those older than 75
years. Although desirable, understanding of teaching is not essential. ACE inhibitors are
vasodilators; they do not affect heart rate. Renal function, not liver function, may be
altered by ACE inhibitors.
What are common signs and symptoms of right-sided heart failure? Select all that apply.
1
A hacking cough
2
Dependent edema
3
Increase in weight
4
Nausea and vomiting
5
Oliguria during the day - Answers - 2,3,4
In right-sided heart failure, the right ventricle cannot completely empty. Increased
volume and pressure develop in the venous system and peripheral edema results.
Nausea, weight gain, and dependent edema are symptoms of right-sided heart failure.
Nausea occurs due to direct consequence of liver engorgement resulting from fluid
retention. Weight gain is observed in the patient due to retention of fluids. Dependent
edema is observed, commonly in the ankles and legs and over the sacrum when the
patient is restricted to bed rest. A hacking cough and oliguria during the day are
symptoms of left-sided heart failure.
PROBLEMS
The use of which drug may pose a risk for the development of heart failure, especially in
older adults?
1
Insulin
2
Digoxin
3
Ibuprofen
4
Potassium chloride - Answers - 3
Long-term use of NSAIDs (ibuprofen, naproxen) may cause fluid and sodium retention.
Insulin controls blood glucose levels, which should help prevent heart disease and heart
failure. Digoxin is a medication used in the treatment of heart failure to increase stroke
volume and heart rate. Potassium chloride is used as a supplement to prevent or treat
electrolyte imbalance; this often results from diuretics used when treating heart
failure.Which medication is indicated for a patient diagnosed with restrictive
cardiomyopathy to block inappropriate sympathetic stimulation and tachycardia?
Which medication is indicated for a patient diagnosed with restrictive cardiomyopathy to
block inappropriate sympathetic stimulation and tachycardia?
1
Digoxin
2
Diltiazem
3
Metoprolol
4
Nitroglycerin - Answers - 3
Metoprolol is indicated for blocking inappropriate sympathetic stimulation and
tachycardia in patients diagnosed with restrictive cardiomyopathy. Digoxin and
nitroglycerin are indicated to increase cardiac output. Diltiazem is not indicated for
blocking inappropriate sympathetic stimulation and tachycardia.
The nurse is caring for a patient receiving digoxin therapy. Which finding would indicate
to the nurse that the patient is suffering from digoxin toxicity?
1
Weight gain
2
Blurred vision
3
Worsening heart failure
,4
Orthostatic hypotension - Answers - 2
Symptoms of digoxin toxicity include blurred vision, fatigue, bradycardia, dysrhythmia
and ectopic beats, and changes in mental status. Digoxin toxicity does not specifically
worsen heart failure (HF); however, bradycardia may occur. Weight gain occurs when
excess sodium is consumed or HF is worsening. Orthostatic hypotension is caused by
vasodilating medications, not inotropic agents.
Which factor reflects the most common etiology of heart failure?
1
Valvular disorders
2
Ventricular dilation
3
Fluid volume excess
4
Myocardial infarction (MI) - Answers - 4
About one-third of patients who have had MI develop heart failure. The second most
common cause of heart failure is structural changes such as valvular dysfunction. Fluid
volume excess may be a cause or result of heart failure. Ventricular dilation is a result of
fluid accumulation from pump failure, but it is not a cause or etiology.
What health care professional should be consulted when planning exercise for a patient
who had heart transplant surgery?
1
Case manager
2
Cardiac surgeon
3
Physical therapist
4
Discharge planner - Answers - 3
A physical therapist should be consulted to plan an appropriate exercise program for a
patient who has had a heart transplantation surgery. The case manager and discharge
planning will not be involved in planning an exercise program for the patient. The
cardiac surgeon may have input, but the exercise plan is not made by the cardiac
surgeon.
Which conditions can cause high-output heart failure? Select all that apply.
1
High fever
2
Septicemia
3
Valvular disease
4
, Hyperthyroidism
5
Coronary artery disease - Answers - 1,2,4
High-output failure is caused by increased metabolic needs or hyperkinetic conditions.
Fever, septicemia, and hyperthyroidism are conditions that cause high-output heart
failure. High-output heart failure can occur when cardiac output remains normal or
above normal. Valvular disease and coronary artery disease cause left-sided heart
failure.
A patient begins lisinopril therapy. What does the nurse consider at the start of therapy
with this medication?
1
Liver function tests
2
The risk for hypotension
3
The potential for bradycardia
4
The patient's ability to understand medication teaching - Answers - 2
Angiotensin-converting enzyme (ACE) inhibitors are associated with first-dose
hypotension and orthostatic hypotension, which are more likely in those older than 75
years. Although desirable, understanding of teaching is not essential. ACE inhibitors are
vasodilators; they do not affect heart rate. Renal function, not liver function, may be
altered by ACE inhibitors.
What are common signs and symptoms of right-sided heart failure? Select all that apply.
1
A hacking cough
2
Dependent edema
3
Increase in weight
4
Nausea and vomiting
5
Oliguria during the day - Answers - 2,3,4
In right-sided heart failure, the right ventricle cannot completely empty. Increased
volume and pressure develop in the venous system and peripheral edema results.
Nausea, weight gain, and dependent edema are symptoms of right-sided heart failure.
Nausea occurs due to direct consequence of liver engorgement resulting from fluid
retention. Weight gain is observed in the patient due to retention of fluids. Dependent
edema is observed, commonly in the ankles and legs and over the sacrum when the
patient is restricted to bed rest. A hacking cough and oliguria during the day are
symptoms of left-sided heart failure.
