The nurse is discharging a client to home with a new diagnosis of atrial fibrillation.. The nurse explains that which of the following is the most important symptoms to report to the physician?

Correct Answer: A

Rationale: The correct answer is A: Irregular pulse. Atrial fibrillation is characterized by an irregular heartbeat, which can lead to serious complications like blood clots and stroke. Reporting an irregular pulse to the physician is crucial for prompt evaluation and management. Fever (B) is not typically associated with atrial fibrillation. Fatigue (C) is a common symptom but not as urgent as an irregular pulse. Hemoptysis (D) is coughing up blood and is not directly related to atrial fibrillation.

Correct Answer: A

Rationale: The correct answer is A: Oliguria. In a patient with heart failure, Lasix is given to promote diuresis and reduce fluid overload. Oliguria, or decreased urine output, indicates that the Lasix is not effectively removing excess fluid from the body. This is a crucial assessment as it may suggest worsening heart failure or possible renal insufficiency. Explanation for why other choices are incorrect: B: Decrease in blood pressure - This could be an expected effect of Lasix, as it helps reduce fluid volume, leading to decreased blood pressure. C: Absence of crackles - This indicates that there is a reduction in pulmonary congestion, which is a desired effect of Lasix. D: Polydipsia - This refers to increased thirst, which may be a side effect of Lasix but does not necessarily indicate treatment failure.

Correct Answer: C

Rationale: The correct answer is C because placing electrodes with contacts on their anterior and posterior surfaces ensures better conduction of electricity from the heart to the monitor. This allows for a more accurate reading of the patient's heart activity. Option A is incorrect as changing electrode pads periodically does not necessarily improve conduction. Option B is incorrect as ribs are not excellent conductors of electricity. Option D is incorrect as placing electrodes further apart does not help improve conduction but may instead result in poor signal quality.

Correct Answer: A

Rationale: The correct answer is A: Phenylephrine. It is a vasoconstrictor that increases blood pressure by constricting blood vessels. This makes it effective in managing mild to moderate hypotension by raising blood pressure. Amiodarone (B) is an antiarrhythmic drug, not used for hypotension. Ibutilide (C) is used for atrial fibrillation/flutter, not hypotension. Milrinone (D) is a phosphodiesterase inhibitor used for heart failure, not hypotension. Therefore, A is the correct choice for managing hypotension.

Correct Answer: A

Rationale: The correct answer is A: For congestive heart failure. Milrinone is a phosphodiesterase inhibitor that helps improve cardiac contractility and output, making it a suitable treatment for congestive heart failure. It is used in patients with reduced ejection fraction and symptoms of heart failure. Choices B, C, and D are incorrect because milrinone is not typically used for hypertension, cardiac arrhythmias, or bradycardia. It is important for the nurse to understand the specific indications for milrinone to ensure safe and effective administration to the client.