When caring for a patient following a cardiac catheterization with coronary angiography, which of the following findings would be of most concern to the nurse?

Correct Answer: C

Rationale: In this scenario, the correct answer is C) Absence of pedal pulses distal to the insertion site. This finding is of most concern because it indicates a potential complication of the cardiac catheterization procedure, such as impaired circulation to the lower extremities. This could be a sign of arterial occlusion, thrombosis, or vascular damage, which are serious issues requiring immediate intervention to prevent further complications like tissue ischemia or necrosis. Option A) Swelling at the catheter insertion site is a common and expected finding post-cardiac catheterization and is not usually a cause for immediate concern unless it is excessive, accompanied by severe pain, or signs of infection. Option B) Development of raised wheals on the patient's trunk is more likely related to an allergic reaction or a side effect of medication given during the procedure, which should be addressed but may not be as urgent as the absence of pulses. Option D) Patient assessment of pain at the insertion site as 4 on a 10 point scale is subjective and can be managed with appropriate pain relief measures. While pain assessment is important, the absence of pulses indicates a more critical issue requiring immediate attention. Educationally, understanding the potential complications of cardiac catheterization and the importance of monitoring for vascular complications is crucial for nurses caring for patients post-procedure. Recognizing and responding promptly to signs of impaired circulation can prevent serious consequences and improve patient outcomes.

Correct Answer: C

Rationale: The correct answer is option C) Explain that his decreased activity level may cause constipation. Rationale: 1. Correct Answer Explanation: It is important to educate the elderly patient about the potential risk of constipation due to decreased activity levels. Elderly individuals often experience reduced bowel motility, which can lead to constipation. By explaining this risk, the patient can understand the rationale behind the medication and how it can help prevent constipation despite not currently experiencing issues. This empowers the patient to make informed decisions about their health. 2. Incorrect Answers Explanation: A) Documenting the medication as 'refused' without addressing the patient's concerns does not promote patient education or engagement in their care. B) Mixing the medication with food and administering it without addressing the patient's misconceptions does not address the underlying issue and may lead to non-compliance in the future. D) Simply reinforcing the physician's order without providing rationale or addressing the patient's concerns does not effectively engage the patient in their care or promote understanding. Educational Context: In a Med-Surg Cardiovascular setting, patient education is crucial for promoting adherence to treatment plans and improving outcomes. Understanding the rationale behind prescribed medications helps patients take an active role in their care. Providing tailored education based on individual patient needs, such as addressing concerns about medication necessity, supports holistic patient-centered care. Effective communication and patient education are key skills for healthcare providers to ensure optimal patient outcomes and satisfaction.

Correct Answer: A

Rationale: The most immediate implication for the patient's care in this scenario is Option A, which states that the arterial line indicates a blood pressure of 190/112. This finding is concerning due to the elevated blood pressure, which could indicate potential complications such as hypertension, risk of bleeding, or inadequate perfusion to vital organs. Option B, stating sinus rhythm with frequent PACs, is important but not as immediately critical as an elevated blood pressure. While frequent PACs may require monitoring and further assessment, they are not as urgent as managing elevated blood pressure. Option C, the patient not responding to verbal stimulation, is also significant but does not pose an immediate threat to the patient's physiological stability compared to uncontrolled hypertension. Option D, the patient's urine output being 100 mL of amber urine, is an important parameter to monitor for kidney function but does not require immediate intervention like the elevated blood pressure. Educationally, this question highlights the importance of prioritizing assessments in post-operative care, emphasizing the need to address critical issues promptly to ensure patient safety and optimal outcomes. Understanding the significance of vital signs and their implications on post-operative management is crucial for healthcare providers in the PACU setting.

Correct Answer: D

Rationale: In a client with cardiomyopathy, dyspnea (Option D) may be the first abnormal sign detected. Dyspnea, or shortness of breath, is a common early symptom due to the heart's reduced ability to pump effectively, leading to fluid buildup in the lungs. This can occur before other signs like ascites (Option A), which is fluid accumulation in the abdomen, heart murmur (Option B), or chest pain (Option C). Educationally, understanding the early signs of cardiomyopathy is crucial for healthcare providers to initiate timely interventions and prevent complications. By recognizing dyspnea as a potential early indicator, nurses and other healthcare professionals can intervene promptly, conduct further assessments, and collaborate with the healthcare team to provide appropriate care and support to the client. This emphasizes the importance of comprehensive assessment skills and knowledge of cardiovascular conditions in providing quality patient care.

Correct Answer: A

Rationale: The correct answer is A) Balloon valvuloplasty. Balloon valvuloplasty is used cautiously or not at all in elderly clients with aortic stenosis because the stretching involved in the procedure may fracture the calcified aortic valve, which is common in older clients with this condition. Option B) Cardiac catheterization is not the best choice because it is a diagnostic procedure used to visualize the heart's blood vessels and structures, not to treat aortic stenosis directly. Option C) Coronary artery bypass grafting is a surgical procedure used to bypass blocked coronary arteries, not to treat aortic stenosis. Option D) Valvular heart surgery may be used to replace or repair heart valves, but in elderly clients with aortic stenosis and calcified valves, balloon valvuloplasty is a less invasive option. Educationally, it is important for healthcare providers to understand the implications of different treatment options for elderly clients with aortic stenosis. This knowledge helps in making informed decisions regarding the most appropriate interventions based on individual patient factors, such as age, comorbidities, and the condition of the aortic valve.