ATI Med-Surg: Cardiovascular and Hematology – Flashcards
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You are reviewing lab results for a patient who is receiving heparin therapy. What value indicates that the heparin has reached a therapeutic level?
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60-80 seconds (Normal aPTT levels are approx. 30-45 seconds. For therapeutic anticoagulation, the aPTT should be approx. 1.5 to 2 times normal)
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You are caring for a client who had a myocardial infarction (MI) 24 hours ago. At this time, it is essential to look for what?
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Ventricular dysrhythmias (After an MI the electrical conduction system of the heart can be irritable and prone to arrhythmia. Ischemic tissue caused by the infarction can also interfere with normal conduction patterns of the heart's electrical system)
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You are collecting data from a client who has fluid volume excess, what manifestations should you recognize that indicates fluid volume excess?
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Jugular vein distension, decreased hematocrit, and increased heart rate.
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You are caring for a client who has pericarditis, what manifestations should you expect to find when collecting data?
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Dyspnea with a rapid respiratory rate (Chest pain with pericarditis will increase with deep inspiration due to increased pressure on the inflamed pericardial sac. This will make the client reluctant to take deep breaths resulting in dyspnea and tachypnea)
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You are caring for a client with dyspnea who is diagnosed as having congestive heart failure (CHF) related to mitral stenosis. You are aware that the cause of the dyspnea is due to what?
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Fluid accumulation in the lungs (A defect in the mitral valve will cause a backup of blood in the pulmonary vein, which returns oxygenated blood to the left atrium. This backup of blood leads to engorgement of the capillaries of the lung field and to an accumulation of fluid in the lungs)
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You are caring for a client who is admitted to the hospital for treatment of anemia. Lab results include hemoglobin 9.0 g/dL, hematocrit 28%, and serum albumin 2,7 g/dL. You interpret these findings to indicate that the clients diet is lacking in foods high in?
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Protein and Iron (Decreased serum albumin levels indicate inadequate protein intake. Decreased Hgb and HCT levels indicate iron deficiency anemia)
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A transfusion of packed red blood cells has been started on your assigned client. You should arrange for a coworker to cover the other clients that you are assigned to because you have to remain with the client for the first how many minutes?
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15 minutes (The greatest potential for a transfusion reaction is in the first 15 minutes)
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You realize that your client whose blood type is B positive is being transfused with a unit of AB positive fresh frozen plasma (FFP), what is the appropriate nursing action that you would take?
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Monitor for manifestations of a transfusion reaction (AB positive plasma is compatible with a B positive recipient who can receive either B or AB plasma)
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You are caring for a client who has thrombophlebitis, what is the laboratory test used to monitor heparin therapy?
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Activated partial thromboplastin time (aPTT)
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You are caring for a client with right sided congestive heart failure (CHF), you know that a manifestation of right sided CHF is what?
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Peripheral edema (Peripheral edema is caused by weakness in the right side of the heart caused by blood backup into the venous system. 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 edema)
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You are reinforcing teaching with a client who is diagnosed with angina pectoris and is scheduled to undergo a percutaneous transluminal coronary angioplasty (PTCA). You should explain to the client that PTCA is used to do what?
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Dilate an obstructed coronary artery (A catheter with an inflatable balloon tip is inserted into the obstructed coronary artery. The balloon is inflated, compressing atherosclerotic plaque against the coronary artery wall, resulting in dilation of the artery)
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You are caring for a client with pernicious anemia. You know that to treat this condition, the client will require what?
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Monthly injections of Vitamin B12 (Pernicious anemia is caused by a lack of intrinsic factor needed to absorb vitamin B12 from the gastrointestinal tract. Monthly injections is the definitive treatment to correct the vitamin B12 deficiency)
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You are caring for a client who has an infection. You should recognize that what type of cells found in blood plasma provides protection against infections?
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Leukocyte (Leukocyte, or white blood cells, provides protection against infectious agents, foreign organisms and defective tissues)
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You are caring for a client with suspected hypovolemic shock. What solution, given by IV, is appropriate in this circumstance?
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0.9% sodium chloride (Two IV solutions are used for acute volume expansion: 0.9% sodium chloride and lactated Ringer's solution. Sodium chloride is a physiologic isotonic solution that replaces lost volume in the blood stream)
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Four hours after receiving a transfusion of fresh frozen plasma (FFP) your client has repeat lab work drawn. What lab value should you interpret to evaluate the client's response to the transfusion?
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Prothrombin Time (FFP is plasma rich in clotting factors. It is given to treat acute clotting disorders and the desired effect is a decrease in the prothrombin time)
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You are caring for a postoperative client who requires 1 unit of blood because of a hemorrhage that occurred during surgery. Within 30 minutes of hanging the unit of blood, the client develops itching and hives. What do you do first?
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Stop the infusion of blood (These are manifestations of an allergic reaction to the transfusion and this is the proper first response)
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You are caring for a client 5 days following a myocardial infarction (MI). The client has sudden onset of shortness of breath. You note that the client appears air hungry and is coughing frothy, pink sputum. When auscultating the client's breath sounds, you expects to hear what bilateral lung sound?
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Crackles (A client who had a recent MI is at risk for congestive heart failure. Crackles are breath sounds caused by the movement of air through airways partially or intermittently occluded with fluid and are associated with CHF and frothy sputum)
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You are caring for a client whose abdominal aortic aneurysm is extending. The manifestations that you should expect to observe are what?
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Back and abdominal pain (Abdominal aortic aneurysm involves a widening, stretching, or ballooning of the aorta. Back and abdominal pain indicate that the aneurysm is extending downward and pressing on lumbar spinal nerve roots causing pain)
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A client reports to you that she is using several herbal and dietary supplements including flaxseed oil. You recognize that the health benefit of this supplement is to provide increased dietary?
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Omega-3 fatty acids (Omega-3 fatty acids have been shown to reduce the risk of cardiovascular disease and stroke)
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After administering digoxin (Lanoxin) to a client you notice that the client's breakfast is untouched and the client is reporting nausea. You check the client's vital signs and determine that the BP is 118/72, pulse is 56, and respiration's are 22. You interpret that the client is what?
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Exhibiting a toxic reaction to the medication (Digoxin toxicity results in nausea, vomiting, and bradycardia)
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You are explaining autologous transfusions to a preoperative client. You should explain that an autologous transfusion is the collection and?
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Reinfusion of the client's own blood (This procedure is done before or during a client's surgery to protect the client from accidental exposure to blood-borne diseases)
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You are collecting data from a client who has a history of arteriosclerosis obliterans. What manifestations of this condition should you expect to observe on the client's lower extremities and ankles?
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Thin, shiny skin with minimal body hair (Arteriosclerosis obliterans is a disease of the blood vessels characterized by narrowing of the arteries in the legs and feet. This causes a decrease in blood flow to the distal extremities which can lead to tissue damage. Common symptoms are intermittent claudication (leg pain with exercise), cold or numb feet at rest, loss of hair on the lower legs, and weakened pulses)
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After a myocardial infarction (MI), what vital signs and symptoms should you recognize as a possible indication of cardiogenic shock?
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Hypotension, tachycardia, weak pulse, cold and clammy skin, decreased urinary output, and cerebral hypoxia.
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A client is diagnosed as having essential (primary) hypertension. Serial blood pressure readings showed an average reading of 170/100. You should know that the client's primary hypertension condition has what?
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No identifiable cause ( Primary, or essential, hypertension has no identifiable cause. Secondary hypertension is related to an underlying pathology)
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You are caring for a client who is receiving chemotherapy and wants to know how the therapeutic results of epoetin alfa (Epogen, Procrit) will be determined. You should respond that an increase in what lab value will occur?
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Hemoglobin (Epoetin alfa is a synthetic version of human erythropoietin. It is used to treat anemia associated with kidney disease or medication therapy. It increases and maintains the red blood cell level so that blood transfusions are not needed. It will precipitate an increase in the levels of Hgb and HCT)
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What enzyme study should you recognize as the most reliable and earliest indicator of acute myocardial damage?
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Cardiac contractile protein troponin T (Is the most specific and earliest indicator for the diagnosis of acute myocardial infarction. It is always increased in cases of acute myocardial infarction)
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You are caring for a client following a vein ligation and stripping for varicose veins. You know that following the surgery, the client should be positioned?
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Supine with the legs elevated at a 15 degree angle (Postoperatively, the legs should be elevated to promote venous return by gravity)
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You are caring for a client who has a cardiac contusion. You understand that blunt chest trauma commonly results in damage to which part of the heart?
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Right Ventricle (The right ventricle lies directly behind the sternum. In a blunt injury, the impact of the right ventricle against the sternum wall will cause the greatest area of damage)
