A patient is suspected of having a decreased cardiac output due to dysrhythmias. Which of the following assessments would be included in a decreased cardiac output? Select all that apply

Correct Answer: A

Rationale: The correct answer is A: Elevated jugular venous distention. This is a common sign of decreased cardiac output as it indicates increased central venous pressure due to impaired cardiac function. Elevated JVD reflects inadequate cardiac output, leading to blood backing up into the jugular veins. Choices B, C, and D are incorrect. Polyuria is not typically associated with decreased cardiac output. Full and bounding pulses are usually seen in conditions of increased cardiac output, not decreased. Diaphoresis is a non-specific symptom and can be present in various conditions, not specifically indicative of decreased cardiac output.

Correct Answer: C

Rationale: The correct answer is C) Myocardial infarction associated with prolonged and complete coronary thrombosis. Explanation: ST segment elevation on an ECG is a classic indicator of myocardial infarction (MI), commonly known as a heart attack. This finding suggests that there is significant myocardial damage occurring due to prolonged and complete coronary thrombosis, where a coronary artery is completely blocked, leading to inadequate blood supply to the heart muscle. This lack of blood flow can cause irreversible damage to the myocardial cells, resulting in an MI. Why the other options are wrong: A) Transient ischemia typical of unstable angina: ST elevation is not typically seen in unstable angina, which is characterized by transient episodes of chest pain due to temporary reductions in blood flow to the heart. B) Lack of permanent damage to myocardial cells: ST elevation indicates ongoing myocardial damage, suggesting permanent damage to myocardial cells. D) Myocardial infarction associated with transient or incomplete coronary artery occlusion: ST elevation is more indicative of a complete blockage leading to myocardial infarction rather than a transient or incomplete occlusion. Educational context: Understanding ECG findings in the context of cardiovascular events is crucial for nurses caring for patients with chest pain. Recognizing ST segment elevation and its implications can guide timely interventions and improve patient outcomes. Nurses must be able to differentiate between various ECG patterns to provide appropriate care and collaborate effectively with the healthcare team in managing acute cardiovascular events.

Correct Answer: C

Rationale: In the context of using an Intra-Aortic Balloon Pump (IABP) to provide circulatory support for a patient, preventing arterial trauma is crucial for the patient's safety and well-being. The correct answer, option C, "Prevent hip flexion of the cannulated leg," is essential to avoid kinking or compression of the arterial line connected to the IABP. By preventing hip flexion of the cannulated leg, the nurse ensures that the arterial line remains patent and free of obstructions, reducing the risk of arterial trauma. Hip flexion can lead to mechanical stress on the arterial line, potentially causing damage that may compromise circulation and lead to complications. Option A, repositioning the patient every 2 hours, is not directly related to preventing arterial trauma during IABP use. While repositioning is important for preventing complications like pressure ulcers, it does not address the specific risk of arterial trauma associated with hip flexion. Checking the site for bleeding every hour, as suggested in option B, is important for monitoring for complications post-IABP insertion, but it does not directly address the mechanical issue of hip flexion causing arterial trauma. Covering the insertion site with an occlusive dressing, as mentioned in option D, is important for maintaining a sterile environment and preventing infections at the insertion site. However, it does not address the mechanical issue of hip flexion impacting arterial flow. In an educational context, understanding the importance of proper positioning and care during IABP use is crucial for nurses caring for patients requiring circulatory support. By grasping the rationale behind preventing hip flexion of the cannulated leg, nurses can provide safe and effective care to patients undergoing IABP therapy, ultimately improving patient outcomes and reducing the risk of complications.

Correct Answer: A

Rationale: In this scenario, the most appropriate action to take first when a patient with atrial fibrillation reports feeling dizzy while ambulating is to help the patient sit down (Option A). This is crucial for ensuring the patient's safety and preventing potential falls or injuries. By assisting the patient to sit down, you are addressing the immediate risk of the patient falling and causing harm. This action also allows you to quickly assess the patient's condition in a safe and controlled manner. Checking the patient's apical pulse (Option B) may provide some information about the patient's heart rate, but it is not the most urgent action in this situation. Similarly, while taking the patient's blood pressure (Option C) is important in assessing their cardiovascular status, it is not the primary concern when a patient reports feeling dizzy while ambulating. Having the patient breathe deeply (Option D) is not the most appropriate action to take first in this situation. While focusing on breathing techniques may be beneficial in certain situations, addressing the immediate risk of falling and assessing the patient's condition take precedence here. In an educational context, understanding the prioritization of actions in response to a patient's symptoms is vital for providing safe and effective care in a clinical setting. Nurses and healthcare providers must be able to quickly assess and respond to changes in a patient's condition to prevent adverse outcomes. Prioritizing interventions based on the patient's immediate needs is a fundamental aspect of nursing practice.

Correct Answer: D

Rationale: In this scenario, the correct answer is option D. This question addresses the critical thinking skills required for a healthcare provider preparing a client for an MRI. The rationale behind this answer is that before an MRI, it is crucial to ask the client about any metal implants or devices they may have, as these can interfere with the magnetic fields used in the procedure. Option A is partially correct as it highlights the importance of inquiring about metal implants, but it fails to cover the complete scope of necessary questions and preparations. Option B is essential for preparing the client by explaining the procedure and ensuring their cooperation but does not address the specific requirements for an MRI. Option C, administering sedatives if necessary, may be applicable in certain cases but is not a routine preparation step for an MRI. Educationally, understanding the importance of thorough patient assessment and preparation for diagnostic procedures like an MRI is crucial for healthcare providers. This question emphasizes the need for attention to detail, patient safety, and knowledge of specific requirements for different diagnostic tests. By focusing on the unique considerations for MRI, healthcare professionals can ensure optimal outcomes for their clients.