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Chapter 19: Care of Patients with Cardiac Disorders deWit: Medical-Surgical Nursing: Concepts & Practice, 3rd EditionMULTIPLE CHOICE1. The nurse is caring for a patient with suspected right-sided heart failure. Which manifestation best supports this potential diagnosis? a. Wheezingb. Orthopneac. Edemad. PallorANS: C Right-sided heart failure leads to edema from systemic backup. Wheezing, orthopnea, and pallor are indicative of left-sided failure.PTS: 1 DIF: Cognitive Level: Comprehension REF: 426, Table 19-2 OBJ: 1 (theory) TOP: Heart Failure: Right Side KEY: Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation 2. The nurse is caring for a patient with a history of left-sided congestive heart failure (CHF). Which finding leads the nurse to suspect that the patient could be experiencing an acute exacerbation of this condition? Left-sided heart failure causes increased pressure on the lungs and may manifest in wheezing. A tight and shiny abdomen is consistent with ascites, a manifestation of right-sided CHF. Sluggish pupillary reaction is consistent with a neurologic problem, and an irregularly irregular heart rate is consistent with a cardiac arrhythmia like atrial fibrillation.PTS: 1 DIF: Cognitive Level: Application REF: 426, Table 19-2 OBJ: 1 (theory) TOP: CHF: Signs KEY: Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation 3. The statement indicates that the nurse’s teaching about the purpose of an implanted cardioverter-defibrillator (ICD) has been successful? All statements are accurate, but the question asks about the purpose of the ICD.
ICDs are devices indicated for patients with repeated episodes of life-threatening dysrhythmias and for some patients with cardiomyopathy. This device monitors the heartbeat and provides an electrical shock similar to that delivered in cardiac defibrillation or cardioversion when a life-threatening rhythm is detected. Most ICDs have the ability to pace as well as defibrillate. The patient is warned to avoid exposure to strong magnetic fields such as: microwave towers, transformers and electrical transmitters, electrical generators, handheld security devices at airports, and arc welding equipment. The patient should not lean over the alternator of a running car or boat motor. A magnetic field will temporarily inactivate the device. Moving away from the magnetic source will restore normal function.
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Cardiology, Morphine, Nursing Process Step, Acute Pulmonary edema, Med Surg Cardio