Question

Six week after you start working with a patient with cardiac diagnosis he admits that he has been under a lot of stress during exercise stress testing he rubs his chest and says that he feels really heavy on his chest right now you feel his pulse and note that his skin is slightly diaphoretic and that he is agitated and appears to be anxious what is the first action you are going to do.

Sit or lie down

Check vital signs

Continue stress testing

Ask whether he has NTG tablets

A nurse is caring for a client who had an angiogram (cardiac cath) two hours ago. Which of the following findings would be essential for the nurse to follow up?

1. Apical pulse = 109 beats per minute
2. Blood urea nitrogen (BUN), 19 mg/dL
3. Decrease in respiratory rate from 21 to 18 over the past two hours.
4. BP increase from 97/54 mm Hg to 115/60 mm Hg over the past 2 hours.

A male patient diagnosed with cad has had the following laboratory results total cholesterol 240mg/dl HDL 35mg/dl LDL 112 mg/dl and Triglycerides 178 mg/dl which lab values are of concern at this time.

LDL

HDL

Triglycerides

All of the lab values

The day after a 60-yr-old patient has open reduction and internal fixation (ORIF) for an open, displaced tibial fracture, the nurse identifies the priority nursing diagnosis as.
a. activity intolerance related to deconditioning.
b. risk for constipation related to prolonged bed rest.
c. risk for impaired skin integrity related to immobility.
d. risk for infection related to disruption of skin integrity

An 82-year-old widow, arrives by ambulance to the ER .the patient was found lying on the bedroom floor, incontinent of urine and stool, with complaints of pain in her right hip Her daughter reports a past medical history of hypertension, angina, and osteoporosis. On examination, you see an elderly woman, approximately 100 pounds, holding her right thigh. You note shortening of the right leg with external rotation and a large amount of swelling at the proximal thigh and right hip. M.C. is oriented to person only and is confused about place and time, but she is able to say that her “leg hurts so bad.” M.C.'s vital signs (VS) are 90/65, 120,24, 97.5° F (36.4° C); her Spo2 is 89%. She is profoundly dehydrated. Preliminary diagnosis is a fracture of the right hip. Based on her history and your initial assessment what priority interventions would you expect to be initiated. Select all that apply

Oxygen by nasal cannula

Start an IV

Monitor lung sounds and vs

Reposition/internally rotate the hip

Get a thorough report from the patient

Answer 1

1.The correct answer is option A that is make the patient sit or lie down because it is the first step to do in the above mentioned condition option B and D are the next steps to do after making the patient comfortable. Option C is incorrect because continuing with the stress test may affect the patients condition in the above mentioned situation.

2.In the above mentioned situation option A is a warning sign of bleeding after angiogram so it is the correct answer. Other options option C and D shows normal range of vital signs. BUN value has no significance in the initial hours of angiogram.

3.In the given laboratory value the concerned value is HDL because a value of 35mg/dl is in a high risk category. LDL and triglycerides are in desirable range. Option B is correct.

4.In the mentioned scenario high risk for infection is the priority diagnosis as the patient had under gone a major surgery. Option D is correct. Other options have only next priorities.

5.The priority intervention is start an IV cannula, because there is chance for bleeding and collapse. So option B is correct. The other options A, c, E comes as next priorities. Option D is a wrong statement in the given situation.