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ECCO: Caring for Patients with
Cardiovascular Disorders Part 2
Questions and Answers Already Passed
A patient reports ripping chest pain that radiates to the neck, and shortness of breath. Which interventions should the nurse anticipate? ✔✔NOT - Decrease BP by 50% in 24 hrs
NOT - Prepare pt for CT scan with contrast
NOT - Administer dyslipidemia agents
- Titrate antihypertensives to MAP 60-65 mm Hg
A nurse observes a patient's jugular venous distention, tachycardia, and elevated CVP. ECHO identifies a large pericardial effusion and onset of atrial collapse. What intervention should the nurse initially anticipate? ✔✔Prepare for pericardiocentesis
You note a wide pacemaker spike followed by a wide QRS complex and a T wave with the opposite deflection on a patient with a temporary transcutaneous pacemaker. ✔✔- Palpate for a pulse corresponding with the QRS
A patient has a transvenous temporary pacemaker in place at a rate of 70 and mA of 5. The patient's rhythm is junctional with a rate of 55. No pacemaker spikes are noted on the ECG. Which is initially indicated? ✔✔- Increase the mA (output)
NOT - Increase the mV on the sensitivity dial
- Change the batteries
- Increase the pacemaker rate
NOT increase mA
Which should the nurse include in preparing a patient for an electrophysiology study? ✔✔- " You will be sedated for the procedure"
Which of these can indicate carotid artery stenosis? ✔✔neurologic dysfunction lasting 1-2 hours
Which are required to assist before and during pericardiocentesis? ✔✔NOT - position flat in bed
NOT - Attach EKG alligator clamp for lead 1 to needle
NOT - Record vital signs every 15 minutes
A patient with a recent MI reports stabbing chest pain that increases with deep breathing and is relieved by leaning forward. SpO2 is 94%. Which should the nurse initially anticipate? ✔✔NOT pericardiocentesis
NOT steroids
NOT Nitro
A nurse notes bradycardia in a patient admitted with subarachnoid hemorrhage and vomiting. What medications may increase the patient's risk of sudden cardiac death? ✔✔- Antibiotics or Antidysrhythmics
What should be the nurse's priorities in caring for a patient after surgical repair of a thoracic Type A dissection? ✔✔- Manage hypertension aggressively to prevent rupture
- Monitor for signs of cardiac ischemia
What should a nurse's priorities be in caring for a patient post-carotid endarterectomy? ✔✔- Assess cranial nerve functioning
- Assess mental alertness and awareness
- Monitor for hypertension or hypotension
A new nurse asks why it is important to check the pacing threshold on a patient with a temporary transcutaneous pacemaker. The best response is, "We need to..." ✔✔- Know the amount of energy needed to trigger depolarization
A patient with repair of the descending aorta is at risk for which of the following? ✔✔- Spinal ischemia
NOT - Renal Artery Stenosis
NOT - Mitral Stenosis
NOT - Unstable Angina
A nurse finds a patient unresponsive and without a palpable pulse. Which of the following assessments is an indication for defibrillation? ✔✔- Ventricular fibrillation
NOT - Asystole
NOT - Cyanosis
NOT - Pulse Ox below 80
Which patient has indications for synchronized cardioversion? A patient with: ✔✔YES - Supraventricular tachycardia with chest pain (Unstable pts)
- Ventricular Tachycardia with BP 100/60 (unstable pts)
NOT - Sinus Bradycardia with mental status changes
- Atrial Fibrillation with a history of VTE (unresponsive to medical management)
Which of the following is an accurate statement about temporary transcutaneous pacing? ✔✔It is indicated for symptomatic bradycardia unresponsive to meds
A patient with a history of cocaine use reports headache, blurred vision, severe chest pain, nausea, and vomiting. Vital signs are: BP 214/136, HR 106, RR 24. Which priority is initially indicated? ✔✔- Administration of Nitroprusside (Nipride)
The initial symptoms of a patient with myocarditis have been stabilized. What additional treatment should the nurse anticipate? ✔✔- Administer antibiotic or anti fungal meds
- Monitor for worsening heart failure
- Monitor HR, BP, and PsO2 during pt activity
NOT - Enforce bed rest for 24 to 36 hrs
A patient with a history of CAD reports sudden, steady abdominal pain. The nurse finds faintly palpable pedal pulses bilaterally, right popliteal BP 94/46 (62), and left 87/38 (54). What should the nurse do next? ✔✔- Evaluate medications for bleeding risk
NOT- Perform passive leg-raise maneuver
NOT - Request order for chest x-ray
NOT - Monitor intra-abdominal pressure
A patient reports sudden onset of chest pain, and dyspnea. Which assessment would differentiate whether the cause is ACS or pericarditis? ✔✔- ACS chest pain doesn't alter when pts changes position
- Pericarditis chest pain increases with inspiration
- ACS pain not usually accompanied by fever
All but headache
NOT - Assure SYNC switches is activated
