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NCLEX Cardiac

Subjects : nclex, health-sciences, nursing

Instructions:

Answer 50 questions in 15 minutes.
If you are not ready to take this test, you can study here.
Match each statement with the correct term.
Don't refresh. All questions and answers are randomly picked and ordered every time you load a test.

This is a study tool. The 3 wrong answers for each question are randomly chosen from answers to other questions. So, you might find at times the answers obvious, but you will see it re-enforces your understanding as you take the test each time.

1. What is cardiac tamponade? Common causes?
A fluid accumulation in the pericardial space that compromises cardiac function. It is considered a medical emergency and is a hemodynamic consequence of blood or excess fluid accumulation in the pericardial sac. Common causes are surgical or traumat
Pulmonary edema
This noninvasive test takes 24 hours and causes no discomfort. Electrodes are applied to your body - you need to log your activities for a 24 hour period (walking - sleeping - urinating - physical symptoms - and medications). Don't tamper with the mo
When not visable - place the patient in the left lateral position - ask them to exhale fully and stop breathing for a few seconds.

2. What should be done is a patient on anticoagulants suffers from epistaxis for more than 15 mins?
Posterior nasal packing to stop the blood flow. The LPN CAN DO THIS!
A patient on sildenafil (Viagra) - Cealis - or Levitra bc these drugs together can cause very low blood pressure and heart attack.
After a sheath removal to apply consistent pressure and prevent bleeding. (Ex: after swan ganz removal).
When a large air bubble blocks blood flow from the right ventricle into the pulmonary artery.

3. How does the blood flow through the heart? (valves?)
Right atrium - TRICUSPID VALVE (tissue) - right ventricle - PULMONIC VALVE (paper) - lungs - left atrium - MITRAL VALVE (My) - left ventricle - AORTIC VALVE (Assets). Tissue PAPER MY ASSETS!
Correct her and tell her that the (+) lead goes on the left and the (-) lead goes on the right side.
Protamine Sulfate
Vitamin K (aqua myphiton)

4. What is the treatment for someone with right sided HF? How do you know working?
Spasms of the arterioles in finger/toes (digits of hands/feet may fall off). Tx: stop smoking - avoid stress & cold - use a vasodilator (calcium channel blocker). No skiing or butcher for career.
Decrease in weight - diuretics (watch K loss) - aldactone (k sparing but check renal fx) - inderal (do Not give to asthma patients or diabetic patients) - more exercise - no smoking - and decreased Na intake.
Inspect pulses on chest - inspect the internal jugular veins - palpate the apical pulse - palpate the carotid arteries - and auscultate the heart sounds.
Diuretic & Digoxin (dig increases force of contraction and increases perfusion). Know working if client is peeing (kidney perfusion) and more alert!

5. What should be done immediately for someone with PE?
An enlarged space indicates fluid accumulation in the pericardial sac.
It will take 5 mins and he/she should remain quiet for about 1 minute without talking or moving.
Administer 100% O2 - left trendelenburg position - heparin administered - and oral warfarin started (give heparin and warfarin together for at least 5 days).
The internal jugular veins (external are less reliable).

6. What should you always assume with a patient who has a central line placed and is experiencing SOB?
Varicose veins - elevate legs - weight reduction - brawny in color - ted hose - topical steroids - ulcers - and skin color changes.
ST segment elevation (STEMI)
Air embolism
Check all junctions frequently to make sure secure - especially before patient gets out of bed - and always use tubing with twist lock connections.

7. What is the nursing care associated with chemical stress tests (persantine stress test)?
Explain procedure - stress importance of reporting symptoms. INSTRUCT The PATIENT NO TO EAT DRINK OR SMOKE AT LEAST 1 HOUR BEFORE The TEST. EVALUATE PATIENTS HISTORY FOR ANY CARDIAC CONDITIONS OR MEDICATIONS THAT MAY INTERFERE WITH The TEST!!! (No va
Lower HOB - place patient supine - assess LOC - open airway - assess breathing - get ambu bag - put on gloves - connect tubing from O2 source - adjust flow to 10 to 15 liters. First RESCUER: PLACE APEX of MASK OVER BRIDGE of NOSE And BASE BETWEEN LOW
One large emboli (smaller=better)
Don't interfere!

8. What is the correct way to insert an oropharyngeal airway?
Used to look at vessels. A local anesthetic is injected and a catheter is inserted into a vessel in the area and advanced as necessary. A contrast medium is injected into the vessel than a series of xrays follow. Any flushing sensation/nausea/ or unu
The damaged portion of the aorta is removed and is repaired with a synthetic graft.
Gently insert the oropharyngeal airway by turning it upside down (into U shape) and slide it into the mouth. As continue to insert rotate it so the ends of the U turn downward into an arch shape after it transverses the oral cavity and approaches the
Open up blood vessels

9. What should you teach someone after they have had a pacemaker placed?

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10. What does an Allen's test determine?
Used to look at vessels. A local anesthetic is injected and a catheter is inserted into a vessel in the area and advanced as necessary. A contrast medium is injected into the vessel than a series of xrays follow. Any flushing sensation/nausea/ or unu
Thromboanglitis obliterans/ Buerger's disease= inflammatory process of arterial wall - veins - and nerves where they become blocked. It is associated with smoking/tobacco use.
The internal jugular veins (external are less reliable).
Whether the patients ulnar and radial arteries are patent.

11. What is important to remember when removing a CVC from a patient?
Activity intolerance
Use sterile gloves and aseptic technique - clean skin over port with alcohol or iodine - insert a 21 or 22 gauge HUBER needle (noncoring - won't break apart) attached to syringe or tubing into the middle of the port until rigid back of port is palpab
One large emboli (smaller=better)
Have the patient use the val salva maneuver when the line is being removed (bear down/hold breath) to prevent air from entering where the line was and causing a PE.

12. What can result from left sided heart failure if left untreated?
Give furosemide (lasix) 40-60 mg IV - O2 administration - morphine sulfate 3-5 mg IV - have patient sit up with feet lowered (decreases venous return to the heart) - nitroglycerin given sublingual or IV - and rotating tourniquets (can reduce intratho
Paroxysmal nocturnal dyspnea - elevated pulmonary capillary wedge pressure - BLOOD TINGED SPUTUM - cough - orthopnea - exertional dyspnea - cyanosis.
Vascular - artery disease causing fluid to back up into the lungs.
Pulmonary edema

13. What are examples of calcium channel blockers?
Verapamil (calan) - diltiazem (cardizem) - nifedipine (procardia) - amlodipine (norvasc).
PTT. Normal= 30 sec. If on anticoagulants it should be between 1 1/2 to 2 1/2 x the normal value. For PTT= 45-75 sec.
RAndI= Razor - electric - Aspirin - NO - Needles - small gauge - Decrease - needle sticks - and Injury- protect from. No percodan or NSAIDS - no open toed shoes.
(1st) Assess LOC - (2nd) if unconscious= begin CPR - and (3rd) Notify physician.

14. Who would most likely have peripheral venous disease?
Fifth left intercostal space medial to the midclavicular line.
If feel more than 3 shocks in a row or develop signs of infection at the site.
Arterial pulse: 60-90 - Amplitude: 4+=strong and bounding - Edema: 0=none - Reflex 2+
Old truck driver or someone on bed rest or with pelvic trauma.

15. What is superior vena cava syndrome?
D/C the med and call the doctor.
A complication from a venous access device or port. It is a blockage of the superior vena cava preventing superior blood flow from reaching the heart.
Stand behind the victim - wrap arms around waist (IF PREGNANT WRAP ABOVE The BABy) - make a fist with one had and place thumb against abdomen midline - grasp fist with other hand - press into victims abdomen with quick upward thrusts.
Having the patient supine is ideal but any position is acceptable so long as in same position for each monitoring session - locate clean and dry sensor sites on the neck (in line with earlobe) and thorax (midaxillary at xiphoid process) - connect lea

16. When would a nurse use an external femoral artery compression device?
Using both gloved hands - apply firm pressure just above the skin puncture site and over the hematoma to compress the area. Wait at least 15 mins before removing pressure and reassessing the site. Then notify the health care provider.
After a sheath removal to apply consistent pressure and prevent bleeding. (Ex: after swan ganz removal).
The damaged portion of the aorta is removed and is repaired with a synthetic graft.
It is noninvasive. You must not eat - smoke - or drink alcohol for 3 hours before the test. WEAR COMFORTABLE SHOES And LOOSE LIGHTWEIGHT SHORTS OR SLACKS - YOU MAY GET AN INJECTION of THAllIUM - after your blood pressure and ECG are monitored for 10-

17. What should you know about your recovery period after having an implantable cardioverter defibrillator (ICD)?
Pallor - diaphoresis - tachypnea - severe tearing chest pain radiating to back - PULSES In ARMS Are STRONG BUT LEG PULSES Are WEAK - low SP02.
Pericardial friction rub - chest pain (sharp and aggravated with breathing) - abnormal EKG findings - possible fever and tachycardia.
Stop What they are doing - sit down and rest - if prescribed nitroglycerin tablets place one under tongue - if it still remains take another tablet in 5 mins - and if still in pain take another after an additional 5 mins - if still pain after 3 table
For the first month post op - do not lift more than 10 or 15 lbs. And avoid excessive pushing - pulling - or twisting.

18. Should the tubing for a venous access port be included under the dressing site?

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19. What are coumadin and heparin used for?
It is a sterile procedure so both nurse and patient should wear a mask - arrange sterile field - remove dressing - assess the catheter insertion site for infection - put on sterile gloves - clean the site moving outwardly in a circular motion - apply
To inhibit thrombus and clot formation.
Pericardial friction rub: A high pitched squeaking or grating sound during cardiac contraction. It is typically best heard when the patient sits - leans forward - and breaths out.
Gently insert the oropharyngeal airway by turning it upside down (into U shape) and slide it into the mouth. As continue to insert rotate it so the ends of the U turn downward into an arch shape after it transverses the oral cavity and approaches the

20. What is more harmful a lot of little emboli or one large emboli?
One large emboli (smaller=better)
Right sided heart failure
A hematoma= bleeding into the soft tissue surrounding the femoral artery access site.
Stand behind the victim - wrap arms around waist (IF PREGNANT WRAP ABOVE The BABy) - make a fist with one had and place thumb against abdomen midline - grasp fist with other hand - press into victims abdomen with quick upward thrusts.

21. What should you do if the patient you are applying cardiac monitor electrodes to is hairy?
Clip the hair to allow good contact between the electrodes and the skin (DONT SHAVE).
Fat - Air - DVT - or Amniotic
It is a sterile procedure so both nurse and patient should wear a mask - arrange sterile field - remove dressing - assess the catheter insertion site for infection - put on sterile gloves - clean the site moving outwardly in a circular motion - apply
BIRTH CONTROL PILL (LEADING CAUSE of HTN In YOUNG WOMEN-45=STILL YOUNG) - BLACK Male (then white male - than black female - then white female) - obesity - smoking - stress - high Na diet - lack of exercise - age - sex - race - or noncompliance.

22. What nursing interventions are associated with a pt. experiencing ventricular fibrillation?
Limit the size of the infarction is the goal. Treatment= thrombolytic therapy (tPA) initiated within 6 hours of the first symptoms= standard treatment.
BIRTH CONTROL PILL (LEADING CAUSE of HTN In YOUNG WOMEN-45=STILL YOUNG) - BLACK Male (then white male - than black female - then white female) - obesity - smoking - stress - high Na diet - lack of exercise - age - sex - race - or noncompliance.
(1ST) BEGIN CARDIOPULMONARY RESUSCITATION (The PT. Is DYING) And NotIFY PHYSICIAN (2ND).
Identify the highest point of pulsation and measure from this point to the sternal angle. A measurement of greater than 3 cm= an elevated venous pressure.

23. What is a major complication of central line placement?
Use sterile gloves and aseptic technique - clean skin over port with alcohol or iodine - insert a 21 or 22 gauge HUBER needle (noncoring - won't break apart) attached to syringe or tubing into the middle of the port until rigid back of port is palpab
Chest pain or discomfort that occurs when your heart doesn't get enough blood and oxygen. Stable: the feeling comes and goes at expected times. Unstable: the pattern of your pain has changed (longer - hurts more - etc.)
Maintain BED REST
Pneumothorax and will end up with chest tube to help reinflate lung.

24. What is the maintenance for venous access port that isn't being regularly used?
Hematuria (tea or coca cola colored) - nosebleeds - gingival bleeding (no medicated mouth wash - flossing - or lemon glycerin swabs) - and bruising (assess for abuse w/o caregiver).
All People Enjoy Time Magazine= Aortic - Pulmonic - ERB's point - Tricuspid - and Mitral/Apex. P(2) E (3) T (4) MA (5) (locations)
Must be flushed 1x/month with heparin and between treatments.
Limit the size of the infarction is the goal. Treatment= thrombolytic therapy (tPA) initiated within 6 hours of the first symptoms= standard treatment.

25. What is the normal value for arterial pulse? Pulse amplitude? Edema? Reflex?
This noninvasive test takes 24 hours and causes no discomfort. Electrodes are applied to your body - you need to log your activities for a 24 hour period (walking - sleeping - urinating - physical symptoms - and medications). Don't tamper with the mo
Use sterile gloves and aseptic technique - clean skin over port with alcohol or iodine - insert a 21 or 22 gauge HUBER needle (noncoring - won't break apart) attached to syringe or tubing into the middle of the port until rigid back of port is palpab
Arterial pulse: 60-90 - Amplitude: 4+=strong and bounding - Edema: 0=none - Reflex 2+
Stop What they are doing - sit down and rest - if prescribed nitroglycerin tablets place one under tongue - if it still remains take another tablet in 5 mins - and if still in pain take another after an additional 5 mins - if still pain after 3 table

26. What will be the treatment for an acute episode of life threatening tamponade?
Positive Homan's sign (calf tenderness on dorsiflexion of the foot).
A clinician will perform echocardiogram guided pericardiocentesis with a needle or catheter to remove excess fluid in the pericardial sac.
Have the patient use the val salva maneuver when the line is being removed (bear down/hold breath) to prevent air from entering where the line was and causing a PE.
Lung disease

27. What are the signs and symptoms of left sided HF?
Fatigue - JVD - Increased peripheral venous pressure - ascites - anorexia/complaints of GI distress - cyanosis - and dependent edema.
The symptoms improve when the patient is sitting in upright position that promotes drainage but worsen with the client is lying down.
Ask patient to make a tight fist - using your index and middle fingers compress both the radial and ulnar arteries to obstruct blood flow to hand - ask pt to relax hand (hand and palm should appear blanched bc flow stopped) - release pressure on ulna
Paroxysmal nocturnal dyspnea - elevated pulmonary capillary wedge pressure - BLOOD TINGED SPUTUM - cough - orthopnea - exertional dyspnea - cyanosis.

28. What do calcium channel blockers do?
SOB - dyspnea - anxiousness - diaphoresis - cool/clammy skin - distended neck veins - mental status changes - narrowed pulse pressure - hypotension - and faint or muffled heart sounds.
Open up blood vessels
Ask patient to make a tight fist - using your index and middle fingers compress both the radial and ulnar arteries to obstruct blood flow to hand - ask pt to relax hand (hand and palm should appear blanched bc flow stopped) - release pressure on ulna
Fifth left intercostal space medial to the midclavicular line.

29. What should you watch for with PICC lines that have been in place for 6 months?
Decreased tissue perfusion. Tx: clot busting treatment must start within 6 hours.
Air answers (open junctions)
Rapid ventricular rate with no relationship to atrial activity and QRS complex is wide and bizarre.
4th left intercostal space lower sternal border

30. What are the S&S of superior vena cava syndrome?
Feeling of fullness in head - tightness around shirt collar - or rings/jewelry that suddenly seem tight - swelling in face - hands - arms - and swollen/cyanotic lips - dyspnea - coughing - hoarseness - chest pain - hemotysis - visable collateral ches
Verapamil (calan) - diltiazem (cardizem) - nifedipine (procardia) - amlodipine (norvasc).
(S1 - S2) Third left intercostal space
GI - neuro - and cardiac. S&S= yellow/green vision - N&V - bradycardia - and anorexia.

31. What are the steps for infant 1&2 rescuer CPR?
NO NSAIDS or ASA.
International Normalized Ratio measures blood clotting time and compares it to normal values. 1.0=normal. Most people on anticoagulants are 2-3.
It is calculated by checking the brachial BP and the ankle BP. The ankle systolic pressure is divided by the brachial systolic. The NA can perform. 0.97-1 is normal anything below indicates ischemia.
Check for response - activate ERS - open airway head tilt chin lift - check breathing (5-10 sec) - give 2 breaths (1 sec) with visible chest rise - checks brachial pulse (5-10 sec) - locates CPR finger position - deliver 1st cycle of compressions (30

32. What needs to be held during the placement of a femoral artery compression device?
ST segment elevation (STEMI)
Fatigue - JVD - Increased peripheral venous pressure - ascites - anorexia/complaints of GI distress - cyanosis - and dependent edema.
Decreased tissue perfusion. Tx: clot busting treatment must start within 6 hours.
NO NSAIDS or ASA.

33. What should you teach your patient about a cardiac catheterization?
Ask patient to make a tight fist - using your index and middle fingers compress both the radial and ulnar arteries to obstruct blood flow to hand - ask pt to relax hand (hand and palm should appear blanched bc flow stopped) - release pressure on ulna
Leg pain that is brought on by exercise and relieved by rest. It is characteristic of peripheral artery occlusion/ arterial insufficiency. It is dull or cramp like and consistently occurs in the same area of the leg and with same amount of distance.
The physician injects a local anesthetic into the site - inserts a catheter - and threads it through the artery into the left side of the heart or through a vein into the right side of the heart to your lungs. Next - a dye is injected which may cause
PTT. Normal= 30 sec. If on anticoagulants it should be between 1 1/2 to 2 1/2 x the normal value. For PTT= 45-75 sec.

34. What are signs and symptoms of an MI?
A nosebleed
Crushing chest pain that lasts 30 mins or longer and may radiate to the neck - shoulders - or jaw - diaphoresis - nausea - and SOB.
A drop in systolic BP greater than 12 mm Hg during inspiration indicating a compromise.
A patient on sildenafil (Viagra) - Cealis - or Levitra bc these drugs together can cause very low blood pressure and heart attack.

35. What is characteristic of ventricular fibrillation?
Steroid treatment or a pregnant woman who is retaining water.
Totally disorganized - chaotic pattern - and no discernible waves or complexes.
IV LIDOCAINE BOLUS (50-100 mg) followed by an IV lidocaine drip (suppresses ventricular activity).
Diuretic & Digoxin (dig increases force of contraction and increases perfusion). Know working if client is peeing (kidney perfusion) and more alert!

36. What should you do when applying a femoral artery compression device?
A NON INVASIVE doppler exam of the heart via the thorax to detect cardiac tamponade.
Stroke - renal or heart failure - paraplegia secondary to compromised blood flow - or death from aortic rupture.
Assess and mark the location of the dorsalis pedis and posterior tibial pulses in affected leg - wash hands and put on sterile gloves - gown - and mask - position device - check circulation and make sure good pedal pulse is present - IMMEDIATELY REPO
Stop What they are doing - sit down and rest - if prescribed nitroglycerin tablets place one under tongue - if it still remains take another tablet in 5 mins - and if still in pain take another after an additional 5 mins - if still pain after 3 table

37. Which type of patient shouldn't take nitrates?
Steroid treatment or a pregnant woman who is retaining water.
The arteries have narrowed - decreased O2 to tissues= hypoxia to cells.
A patient on sildenafil (Viagra) - Cealis - or Levitra bc these drugs together can cause very low blood pressure and heart attack.
Check all junctions frequently to make sure secure - especially before patient gets out of bed - and always use tubing with twist lock connections.

38. What should be immediately done for a patient experiencing digoxin toxicity?
0.5-2.0 ng/ml
Stop the medication - address the factors that may have precipitated the event. If life threatening Digibind ay be indicated.
High pitched sounds like S1 and S2 (pericardial friction rubs - aortic/mitral regurgitation murmurs). DIAPH(high)ragm
A monitor with four dual electrodes that are applied to the patients neck and thorax.

39. What is characteristic of premature ventricular contractions?
Used to look at vessels. A local anesthetic is injected and a catheter is inserted into a vessel in the area and advanced as necessary. A contrast medium is injected into the vessel than a series of xrays follow. Any flushing sensation/nausea/ or unu
Premature beats that are not preceded by a P- wave - QRS is wide and bizarre - and the T wave of the premature beat is generally large and in the opposite direction of the QRS.
Spasms of the arterioles in finger/toes (digits of hands/feet may fall off). Tx: stop smoking - avoid stress & cold - use a vasodilator (calcium channel blocker). No skiing or butcher for career.
(1st) Assess the client for signs of decreased cardiac output and Notify the physician (2nd).

40. What is cardioversion?

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41. Where should you place your stethescope to find the mitral (apex) valve?
Right atrium - TRICUSPID VALVE (tissue) - right ventricle - PULMONIC VALVE (paper) - lungs - left atrium - MITRAL VALVE (My) - left ventricle - AORTIC VALVE (Assets). Tissue PAPER MY ASSETS!
High pitched sounds like S1 and S2 (pericardial friction rubs - aortic/mitral regurgitation murmurs). DIAPH(high)ragm
Fifth left intercostal space medial to the midclavicular line.
All People Enjoy Time Magazine= Aortic - Pulmonic - ERB's point - Tricuspid - and Mitral/Apex. P(2) E (3) T (4) MA (5) (locations)

42. What should you do immediately for someone experiencing anticoagulant induced epistaxis?
Close the open catheter lumen with the clamp - and place the pt on their left side in trendelenburg to move the air embolus away from the pulmonic valve. If you hear a churning sound in his chest (a classic sign of air embolus) and the patient starts
It is calculated by checking the brachial BP and the ankle BP. The ankle systolic pressure is divided by the brachial systolic. The NA can perform. 0.97-1 is normal anything below indicates ischemia.
Don a protective gown - gloves - and goggles - call Dr - hand pt. emesis basin and raise the HOB 45* (at this angle he can spit out blood and prevent N&V/aspiration - have another nurse firmly press on his nose just below bony part (apply pressure at
Poorly controlled hypertension

43. What should you do to treat pulmonary edema?
Air answers (open junctions)
Changing the way that you live is the first step. STOP SMOKING!!!! <30% FAT In DIET (don't avoid all fat) - lose weight - exercise - limit salt intake - nitro - Angioplasty (stent insertion) or CABG.
(1st) Assess the client for S&S of decreased cardiac output and Notify physician (2nd).
Give furosemide (lasix) 40-60 mg IV - O2 administration - morphine sulfate 3-5 mg IV - have patient sit up with feet lowered (decreases venous return to the heart) - nitroglycerin given sublingual or IV - and rotating tourniquets (can reduce intratho

44. What are the 2 types of pacemakers?
PTT. Normal= 30 sec. If on anticoagulants it should be between 1 1/2 to 2 1/2 x the normal value. For PTT= 45-75 sec.
When they occur >6 per minute or occurring 2 or more in a row (bigeminy or trigeminy=on way out).
Demand: Works PRN (when HR goes below predetermined rate) or Fixed: beats constantly at predetermined rate so no matter what heart does still beats at same rate.
Clip the hair to allow good contact between the electrodes and the skin (DONT SHAVE).

45. What should you observe for in someone on bleeding precautions?
CPR should be done. No defibrillation bc no rhythm to shock (heart already depolarized).
Explain procedure - stress importance of reporting symptoms. INSTRUCT The PATIENT NO TO EAT DRINK OR SMOKE AT LEAST 1 HOUR BEFORE The TEST. EVALUATE PATIENTS HISTORY FOR ANY CARDIAC CONDITIONS OR MEDICATIONS THAT MAY INTERFERE WITH The TEST!!! (No va
Hematuria (tea or coca cola colored) - nosebleeds - gingival bleeding (no medicated mouth wash - flossing - or lemon glycerin swabs) - and bruising (assess for abuse w/o caregiver).
RAndI= Razor - electric - Aspirin - NO - Needles - small gauge - Decrease - needle sticks - and Injury- protect from. No percodan or NSAIDS - no open toed shoes.

46. What is the treatment for myocardial infarction?
Using both gloved hands - apply firm pressure just above the skin puncture site and over the hematoma to compress the area. Wait at least 15 mins before removing pressure and reassessing the site. Then notify the health care provider.
Used to look at vessels. A local anesthetic is injected and a catheter is inserted into a vessel in the area and advanced as necessary. A contrast medium is injected into the vessel than a series of xrays follow. Any flushing sensation/nausea/ or unu
MONA=Magnesium sulfate - O2 - Nitroglycerin - Aspirin (mona has a heart so EKG also if select all that apply).
Diuretic & Digoxin (dig increases force of contraction and increases perfusion). Know working if client is peeing (kidney perfusion) and more alert!

47. What is you see an NA placing cardiac monitor electrodes on a patient. She is placing (-) on the left and (+) on the right what should you do?
Trendelenburg position for insertion. Pt holds breath to prevent air from entering sinus tract.
Correct her and tell her that the (+) lead goes on the left and the (-) lead goes on the right side.
Anxiousness - restlessness - tachycardia - tachypneic - 90% SP02 - dyspnea - substernal pain - coughing - hemoptysis - and fever.
A monitor with four dual electrodes that are applied to the patients neck and thorax.

48. What should you teach your patient about an abdominal ultrasonography?
MONA=Magnesium sulfate - O2 - Nitroglycerin - Aspirin (mona has a heart so EKG also if select all that apply).
Decreased tissue perfusion. Tx: clot busting treatment must start within 6 hours.
Used to detect an abdominal aortic aneurysm. This noninvasive test takes 15 to 30 mins. They apply conductive gel to your abdomen and move a transducer over abdomen to scan blood vessels. Sound waves bouncing off anatomic structures are translated in
International Normalized Ratio measures blood clotting time and compares it to normal values. 1.0=normal. Most people on anticoagulants are 2-3.

49. What causes essential/primary hypertension?
NO TED HOSE - NO SHEETS/BLANKETS - NO COMPRESSION DEVICES - (TEACH NO OPEN TOES SHOES). Lambs wool is okay!
Idiopathic
In the first 72 hours!!!!!
Posterior nasal packing to stop the blood flow. The LPN CAN DO THIS!

50. What should be done immediately if a pulmonary embolism is suspected?
D/C the med and call the doctor.
Close the open catheter lumen with the clamp - and place the pt on their left side in trendelenburg to move the air embolus away from the pulmonic valve. If you hear a churning sound in his chest (a classic sign of air embolus) and the patient starts
GI - neuro - and cardiac. S&S= yellow/green vision - N&V - bradycardia - and anorexia.
Stop What they are doing - sit down and rest - if prescribed nitroglycerin tablets place one under tongue - if it still remains take another tablet in 5 mins - and if still in pain take another after an additional 5 mins - if still pain after 3 table