The client on nitroglycerin patches reports dizziness when standing up. What is the nurse's best response?

Correct Answer: A

Rationale: The correct response is A: Advise the client to rise slowly to prevent dizziness. Nitroglycerin patches can cause orthostatic hypotension, leading to dizziness when standing up quickly. By advising the client to rise slowly, the nurse can help prevent a sudden drop in blood pressure and reduce the risk of dizziness and falls. This response promotes client safety and addresses the underlying cause of the symptom. Choices B, C, and D are incorrect: B: Instructing the client to discontinue nitroglycerin patches is not appropriate without consulting the healthcare provider. Abruptly stopping nitroglycerin can lead to serious complications. C: Encouraging the client to rest and avoid physical activity does not address the issue of orthostatic hypotension caused by nitroglycerin patches. D: Suggesting an over-the-counter antiemetic is not indicated for dizziness related to orthostatic hypotension. It does not address the underlying cause

Correct Answer: C

Rationale: In this scenario, the correct answer is C) Potassium levels. The rationale behind this is that digoxin, a medication commonly used in heart failure, can lead to digitalis toxicity when potassium levels are low. Low potassium levels can potentiate the effects of digoxin on the heart, leading to toxicity. Monitoring the patient's potassium levels is crucial to prevent this potentially life-threatening complication. Option A) HR (Heart Rate) is important to monitor with digoxin therapy, but in this case, potassium levels are more critical to prevent digitalis toxicity. Option B) BP (Blood Pressure) is also important to monitor in heart failure patients, but it is not directly related to the risk of digitalis toxicity. Option D) GI function is not directly related to the risk of digitalis toxicity with these medications. Educationally, understanding the interactions and side effects of medications commonly used in heart failure is essential for nurses caring for these patients. Monitoring parameters like potassium levels can help nurses prevent adverse drug reactions and ensure patient safety. This question highlights the importance of comprehensive medication management and the need for vigilant monitoring in patients with chronic heart failure.

Correct Answer: A

Rationale: In this scenario, the correct answer is A) Refer to community programs that assist in smoking cessation. Smoking is a significant modifiable risk factor for cardiovascular disease. By referring the patient to smoking cessation programs, the nurse can address a crucial risk factor and support the patient in making lifestyle changes to improve cardiovascular health. Option B, teaching about the impact of family history on cardiovascular risk, is important for raising awareness. However, addressing smoking cessation, a modifiable risk factor, takes precedence in the discharge plan. Option C, educating about the need for a change in antihypertensive therapy, is not the most immediate intervention needed. The patient's blood pressure is within an acceptable range, and smoking cessation would have a more significant impact on cardiovascular risk reduction. Option D, assisting in reducing stress associated with cardiovascular risk, is important for overall well-being. However, addressing smoking cessation directly impacts a major risk factor and should be the priority in the discharge plan. Educationally, this case highlights the importance of prioritizing interventions based on modifiable risk factors to improve patient outcomes. It emphasizes the role of nurses in promoting lifestyle changes and providing support to patients in managing their cardiovascular health effectively.

Correct Answer: B

Rationale: In this scenario, the correct answer is option B, the 45-year-old with constrictive cardiomyopathy who developed acute dyspnea and agitation about 1 hour before the shift change. This patient should be assessed first because acute dyspnea and agitation are signs of respiratory distress and potential cardiac decompensation, which require immediate attention to prevent further deterioration. Option A, the 26-year-old with heart failure caused by congenital mitral stenosis scheduled for balloon valvuloplasty later today, can be assessed after addressing the patient in distress due to the acuity of the situation. Option C, the 56-year-old who had a coronary angioplasty and stent placement yesterday and complains of occasional chest pain, is stable post-procedure and can be assessed after the patient in distress is attended to. Option D, the 77-year-old with a post-operative temperature elevation after coronary artery bypass grafting, requires assessment for potential infection or other post-operative complications but can wait until the patient in acute distress is evaluated and stabilized. In an educational context, this question emphasizes the prioritization of patient care based on the urgency of the situation. It highlights the importance of recognizing and responding promptly to signs of acute distress in patients with cardiovascular conditions to ensure optimal outcomes. Prioritization skills are crucial for healthcare professionals to provide safe and effective care in fast-paced clinical settings.

Correct Answer: B

Rationale: The correct answer is B) Inferior vena cava. The inferior vena cava is the largest vein in the human body and carries deoxygenated blood from the lower extremities and abdominal organs back to the heart. This vein enters the right atrium of the heart proximally. Option A) Pulmonary artery is incorrect because it carries deoxygenated blood from the heart to the lungs. Option C) Pulmonary vein is incorrect because it carries oxygenated blood from the lungs to the heart. Option D) Superior vena cava is incorrect because it carries deoxygenated blood from the upper body parts to the heart. Understanding the anatomy and function of major blood vessels is crucial in comprehending the circulation of blood throughout the body. The knowledge of the inferior vena cava being the largest vein and its specific role in returning deoxygenated blood from the lower extremities is fundamental in understanding cardiovascular physiology. This information is essential for healthcare professionals, especially those in fields like cardiology, nursing, and emergency medicine.