You are teamed with an LPN/LVN in caring for a group of patients on the cardiac unit. Which action by the LPN/LVN indicates you need to intervene immediately?

Correct Answer: A

Rationale: In this scenario, the correct action by the LPN/LVN that requires immediate intervention is option A, assisting a patient to the bathroom 30 minutes after a coronary arteriogram. This is concerning because after a coronary arteriogram, it is crucial to maintain bed rest for a specified period to prevent complications such as bleeding from the insertion site or dislodging of the clot. Moving the patient too soon can lead to serious consequences. Option B is not the most concerning because checking a patient's blood pressure before administering nitroglycerin is a standard practice to ensure it is safe to give the medication. Option C shows appropriate action by returning a patient to bed when there is a significant increase in heart rate during ambulation, which could indicate cardiovascular compromise. Option D, bringing breakfast to a patient scheduled for an echocardiogram, is not ideal but does not pose an immediate risk to the patient's health. In an educational context, it is essential for healthcare providers to understand the importance of following specific protocols and guidelines post-cardiac procedures to ensure patient safety and prevent complications. This scenario highlights the critical nature of timing in patient care and the need for vigilant monitoring to prevent adverse events in cardiac patients.

Correct Answer: C

Rationale: In the context of cardiovascular health, a classic sign of ischemia is chest pain or angina. Ischemia refers to inadequate blood supply to a specific part of the body, usually due to blockage or constriction of blood vessels. Chest pain is a common symptom of myocardial ischemia, where the heart muscle does not receive enough oxygen-rich blood. This can be a warning sign of an impending heart attack. Option A: This option is incorrect because it does not provide any information related to ischemia or its classic signs. Option B: This option is incorrect because it does not address the specific symptom associated with ischemia, which is chest pain. Option D: This option is incorrect as it does not describe a classic sign of ischemia. It is crucial for healthcare providers to recognize classic signs of ischemia promptly to provide appropriate interventions and prevent further complications. Educational Context: Understanding the classic signs of ischemia is essential for healthcare professionals, especially those working in cardiology or emergency care settings. Recognizing these signs promptly can lead to timely interventions and improved patient outcomes. Educators should emphasize the importance of knowing these signs through case studies, simulations, and real-life scenarios to enhance students' clinical reasoning and decision-making skills in managing cardiovascular conditions.

Correct Answer: C

Rationale: In this scenario, the correct answer is C) Bradycardia. When administering quinidine, a nurse should observe for bradycardia in a client with a valvular disorder of the heart because quinidine is an antiarrhythmic medication that can slow down the heart rate. This adverse effect is important to monitor as it can lead to further complications in a client with a pre-existing valvular disorder. Option A) Ringing of the ears is not typically associated with quinidine administration but can be a side effect of other medications like aspirin or certain antibiotics. Option B) Stiff neck is not a common adverse effect of quinidine. Option D) Bluish discoloration of the palms is not a known side effect of quinidine and would not be a typical symptom to observe in this context. Educationally, understanding the potential adverse effects of medications used in cardiovascular disorders is crucial for nurses to provide safe and effective care to their patients. Monitoring for these adverse effects can help prevent complications and improve patient outcomes. It is important for nurses to be knowledgeable about the medications they administer and to closely monitor patients for any signs of potential adverse reactions.

Correct Answer: B

Rationale: The correct answer is B) Troponin. Troponin is considered the gold standard laboratory test in identifying heart damage from an acute myocardial infarction because it is a cardiac-specific biomarker released into the bloodstream when there is damage to the heart muscle. Troponin levels rise within a few hours of a heart attack and remain elevated for an extended period, making it a reliable indicator of cardiac injury. Option A) Myoglobin is an early marker for myocardial infarction but lacks specificity for cardiac muscle damage, as it can also be elevated in skeletal muscle injury. Option C) Creatine kinase (CK) is an enzyme found in the heart, brain, and skeletal muscle. While CK can be elevated in myocardial infarction, it is less specific to the heart compared to troponin. Option D) Aspartate aminotransferase (AST) is an enzyme found in various tissues, including the heart and liver. Elevated AST levels can indicate heart or liver damage, but it is not as specific to cardiac injury as troponin. Educationally, understanding the significance of troponin as the gold standard for identifying heart damage in myocardial infarction is crucial for healthcare providers working in cardiovascular care. It helps in accurate and timely diagnosis, monitoring, and management of patients presenting with chest pain or suspected heart attacks. This knowledge enhances patient outcomes by guiding appropriate treatment interventions based on reliable biomarker levels.

Correct Answer: A

Rationale: The correct answer is A) Stage 2 hypertension. In this scenario, the client's blood pressure reading of 160/90 falls into the Stage 2 hypertension category according to the American Heart Association guidelines. Stage 2 hypertension is characterized by a systolic pressure of 140 mmHg or higher and a diastolic pressure of 90 mmHg or higher. This level of hypertension indicates a significantly elevated blood pressure that requires intervention to prevent complications such as heart disease, stroke, and kidney damage. Option B) Prehypertension is incorrect because the client's blood pressure reading exceeds the range for prehypertension, which typically falls between 120-139/80-89 mmHg. Option C) Stage 1 hypertension is also incorrect as the client's blood pressure exceeds the criteria for Stage 1 hypertension, which is defined as a systolic pressure of 130-139 mmHg or a diastolic pressure of 80-89 mmHg. Option D) Hypertensive heart disease is not the correct answer as it refers to a condition where long-standing high blood pressure leads to complications in the heart, such as left ventricular hypertrophy or heart failure. While the client may be at risk for hypertensive heart disease if their hypertension is not managed, the blood pressure reading provided does not specifically indicate this condition. Educationally, understanding the classification of hypertension levels is essential for healthcare professionals to accurately assess and manage patients' blood pressure readings. Recognizing the various stages of hypertension helps guide treatment decisions and interventions to reduce the risk of complications associated with high blood pressure. Regular monitoring and appropriate management of hypertension are crucial in promoting cardiovascular health and preventing adverse outcomes.