Test your basic knowledge |

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 are the nursing interventions for a patient in complete heart block?
(1st) Assess the client for S&S of decreased cardiac output and Notify physician (2nd).
(1st) Assess the client for signs of decreased cardiac output and Notify the physician (2nd).
NO because it isn't sterile so keep out.
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.)

2. What should you do frequently for someone with a central line to help prevent pulmonary emboli?
Check for response - activate ERS and AED - open airway with head tilt chin lift - checking breathing (5-10 sec) - give 2 breaths (1 sec each) - check carotid pulse (5-10 sec) - locate CPR hand position - deliver first cycle of compressions (30 compr
Check all junctions frequently to make sure secure - especially before patient gets out of bed - and always use tubing with twist lock connections.
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
No magnets (cell phone 6 inches away from) - DO Not DRINK CAFFEINATED BEVERAGES - DO Not ENGAGE In ROUGH ACTIVITIES (FOOTBAll OR WRESTLING) - and no tight clothing over site.

3. What is the antidote for heparin?
Protamine Sulfate
Need for follow up blood tests - Need to take oral warfarin for at least 3 months - and to reduce current risk encourage weight loss - smoking cessation - and regular exercise.
Check all junctions frequently to make sure secure - especially before patient gets out of bed - and always use tubing with twist lock connections.
D/C the med and call the doctor.

4. What is the normal value for arterial pulse? Pulse amplitude? Edema? Reflex?
Arterial pulse: 60-90 - Amplitude: 4+=strong and bounding - Edema: 0=none - Reflex 2+
Low pitched sounds such as S3 and S4 and the murmur of mitral stenosis. BEL(low)L
Lung disease
Feeling warm (fire) or tin can taste is expected and will pass.

5. What is INR?
File toe nails - if have new shoes only wear 2 hrs/day d/t neuropathy can't feel if problem. To decrease pain of claudication massage legs to increase circulation.
Chronic arteriosclerotic disease.
International Normalized Ratio measures blood clotting time and compares it to normal values. 1.0=normal. Most people on anticoagulants are 2-3.
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

6. What will a leg with arterial insufficiency look like?
D/C the med and call the doctor.
Cardiac tamponade (fluid in pericardial space) and thickening/scarring of the pericardial sac (constrictive pericarditis and possible RHF).
Crushing chest pain that lasts 30 mins or longer and may radiate to the neck - shoulders - or jaw - diaphoresis - nausea - and SOB.
Hair loss - muscle mass loss - pallor when elevated - dependent rubor - and prolonged cap refill time.

7. What is the treatment for someone with right sided HF? How do you know working?
Diuretic & Digoxin (dig increases force of contraction and increases perfusion). Know working if client is peeing (kidney perfusion) and more alert!
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
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!
Varicose veins - elevate legs - weight reduction - brawny in color - ted hose - topical steroids - ulcers - and skin color changes.

8. Where is the aortic valve landmark on the chest?
Administer 100% O2 - left trendelenburg position - heparin administered - and oral warfarin started (give heparin and warfarin together for at least 5 days).
Second right intercostal space
PT. Normal= 12 sec. If on anticoagulants it should be between 1 1/2 to 2 1/2 x the normal value. For PT= 18-30 sec.
(1st) Assess the client for S&S of decreased cardiac output and Notify physician (2nd).

9. What is an aortic dissection?

Warning: Invalid argument supplied for foreach() in /var/www/html/basicversity.com/show_quiz.php on line 183

10. What should you know about your recovery period after having an implantable cardioverter defibrillator (ICD)?
For the first month post op - do not lift more than 10 or 15 lbs. And avoid excessive pushing - pulling - or twisting.
Rapid ventricular rate with no relationship to atrial activity and QRS complex is wide and bizarre.
A patient on sildenafil (Viagra) - Cealis - or Levitra bc these drugs together can cause very low blood pressure and heart attack.
Whether the patients ulnar and radial arteries are patent.

11. How is the Allen's test done?
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
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
Awake and alert: IV lidocaine bolus and drip Unconscious - hypotensive - or S&S of angina/CHF: Direct current cardioversion and IV Lidocaine bolus and drip.
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

12. What are the S&S of pulmonary embolism?
The arteries have narrowed - decreased O2 to tissues= hypoxia to cells.
A life threatening emergency that involves a tear in the aorta's intimal layer allowing blood to flow through a false lumen creating a hematoma or false aneurysm.
A central line placed that measures the right atrial pressure. Normal= 4-10 cm of H20.
Anxiousness - restlessness - tachycardia - tachypneic - 90% SP02 - dyspnea - substernal pain - coughing - hemoptysis - and fever.

13. What should you tell a patient who developed a hematoma in the hospital and is being discharged?
Pulse before and after giving.
They may feel a slight stinging under there tongue when they are dissolving - and they should get a HA (if no HA may not be good bc the pills only last for 6 months). Keep with you at all times.
To report to her healthcare provider if she feels a large bump in her groin - if she has groin pain unrelieved by acetaminophen - or if she develops numbness - tingling - etc. in the affected leg.
Nitrates - Beta blockers - and Calcium channel blockers

14. What are the steps to perform the heimlich maneuver?
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.
IV LIDOCAINE BOLUS (50-100 mg) followed by an IV lidocaine drip (suppresses ventricular activity).
NO because it isn't sterile so keep out.
D/C the med and call the doctor.

15. What should you suspect for someone who post cardiac cath and percutaneous coronary intervention reporting feeling a pop in her left groin followed by a saturated dressing - swelling around site - palpable 2 inch fullness - and a bruit is present?
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.
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
Air answers (open junctions)
A hematoma= bleeding into the soft tissue surrounding the femoral artery access site.

16. When should a patient call 911 after having an implantable cardioverter defibrillator (ICD) placed?
Keep clean and dry for 72 hours - DON'T LIFT The ELBOW OR ARM ON The INCISION SIDE FOR FOUR WEEKS (CAN'T BRUSH HAIR OR TEECH BC PULLS CAN ROLL MARBLES) - DON'T LIFT PUSH OR PULL MORE THAN 10 LBS FOR FOUR WEEKS - take pulse and wt each day - CAll CARD
If you feel lightheaded - dizzy - or heart palpitations but feel no shock from the ICD.
Left sternal border
It is a noninvasive test that takes 15 mins. Electrodes are applied to sites on your body. You must lie still - relax - and breathe normally and remain quiet. Talking or moving distorts the images

17. What is pulsus paradoxus?
Nitrates - Beta blockers - and Calcium channel blockers
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.
When not visable - place the patient in the left lateral position - ask them to exhale fully and stop breathing for a few seconds.
A drop in systolic BP greater than 12 mm Hg during inspiration indicating a compromise.

18. What could happen without immediate intervention for a hematoma?
GI - neuro - and cardiac. S&S= yellow/green vision - N&V - bradycardia - and anorexia.
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
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 patient may suffer significant blood loss or femoral nerve compression.

19. For what disease should you do the Allen's test?

Warning: Invalid argument supplied for foreach() in /var/www/html/basicversity.com/show_quiz.php on line 183

20. Which type of patient shouldn't take nitrates?
A patient on sildenafil (Viagra) - Cealis - or Levitra bc these drugs together can cause very low blood pressure and heart attack.
When they occur >6 per minute or occurring 2 or more in a row (bigeminy or trigeminy=on way out).
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.)
No magnets (cell phone 6 inches away from) - DO Not DRINK CAFFEINATED BEVERAGES - DO Not ENGAGE In ROUGH ACTIVITIES (FOOTBAll OR WRESTLING) - and no tight clothing over site.

21. What is the treatment for premature ventricular contractions?
A nosebleed
Second Left intercostal space
IV LIDOCAINE BOLUS (50-100 mg) followed by an IV lidocaine drip (suppresses ventricular activity).
Limit the size of the infarction is the goal. Treatment= thrombolytic therapy (tPA) initiated within 6 hours of the first symptoms= standard treatment.

22. What are the steps for infant 1&2 rescuer CPR?
CPR should be done. No defibrillation bc no rhythm to shock (heart already depolarized).
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.
Maintain BED REST
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

23. In What time period is the greatest risk of sudden death from an MI?
In the first 72 hours!!!!!
Fourth or fifth intercostal space at or medial to the midclavicular line.
Correct her and tell her that the (+) lead goes on the left and the (-) lead goes on the right side.
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.

24. Where should you place your stethescope to find the tricuspid valve?
Vitamin K (aqua myphiton)
4th left intercostal space lower sternal border
Inspect pulses on chest - inspect the internal jugular veins - palpate the apical pulse - palpate the carotid arteries - and auscultate the heart sounds.
Second right intercostal space

25. What is pericarditis?
NO because it isn't sterile so keep out.
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.
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.
An inflammation of the pericardium. It may result in MI.

26. What is the most common cause of arterial insufficiency?
To report to her healthcare provider if she feels a large bump in her groin - if she has groin pain unrelieved by acetaminophen - or if she develops numbness - tingling - etc. in the affected leg.
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.
Chronic arteriosclerotic disease.
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.

27. What signals an elevated venous pressure based on the internal jugular veins?
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.
Second left intercostal space
Patient who are unable to tolerate exercise stress testing.
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.

28. Where should you place your stethescope to find the pulmonic valve?
Second Left intercostal space
Pulse before and after giving.
Pulmonary edema
Thromboanglitis obliterans/ Buerger's disease= inflammatory process of arterial wall - veins - and nerves where they become blocked. It is associated with smoking/tobacco use.

29. What should you do when applying a femoral artery compression device?
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
The symptoms improve when the patient is sitting in upright position that promotes drainage but worsen with the client is lying down.
RAndI= Razor - electric - Aspirin - NO - Needles - small gauge - Decrease - needle sticks - and Injury- protect from. No percodan or NSAIDS - no open toed shoes.
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

30. Where do the internal jugular veins lie?
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 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-
It will take 5 mins and he/she should remain quiet for about 1 minute without talking or moving.
Deep in the sternomastoid muscle - so look for pulsations in the soft tissue surrounding that area.

31. For which heart sounds should the diaphragm be used?
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
High pitched sounds like S1 and S2 (pericardial friction rubs - aortic/mitral regurgitation murmurs). DIAPH(high)ragm
(1ST) BEGIN CARDIOPULMONARY RESUSCITATION (The PT. Is DYING) And NotIFY PHYSICIAN (2ND).

32. What type of surgery is done for an aortic dissection?
The damaged portion of the aorta is removed and is repaired with a synthetic graft.
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.
Only for a few hours
IV LIDOCAINE BOLUS (50-100 mg) followed by an IV lidocaine drip (suppresses ventricular activity).

33. What is cardioversion?

Warning: Invalid argument supplied for foreach() in /var/www/html/basicversity.com/show_quiz.php on line 183

34. What makes the symptoms of superior vena cava syndrome better? Worse?
After a sheath removal to apply consistent pressure and prevent bleeding. (Ex: after swan ganz removal).
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.
The symptoms improve when the patient is sitting in upright position that promotes drainage but worsen with the client is lying down.
One large emboli (smaller=better)

35. How long is contrast media in the body?
It is an elective procedure - where the client is awake - it is synchronized with 'QRS' - the patient is sedated - a consent form must be signed prior to - they are placed on an EKG monitor - and they are shocked with 50-200 Joules.
Poorly controlled hypertension
An inflammation of the pericardium. It may result in MI.
Only for a few hours

36. What causes secondary hypertension?
ST segment elevation (STEMI)
In fatty areas or over major muscles - large breasts - or bony prominences.
Steroid treatment or a pregnant woman who is retaining water.
A monitor with four dual electrodes that are applied to the patients neck and thorax.

37. What should be done during the insertion of both a CVP catheter and a swan ganz catheter?
Trendelenburg position for insertion. Pt holds breath to prevent air from entering sinus tract.
Arterial pulse: 60-90 - Amplitude: 4+=strong and bounding - Edema: 0=none - Reflex 2+
Nitrates - Beta blockers - and Calcium channel blockers
A hematoma= bleeding into the soft tissue surrounding the femoral artery access site.

38. When should bleeding precautions be implemented?
A drop in systolic BP greater than 12 mm Hg during inspiration indicating a compromise.
They may feel a slight stinging under there tongue when they are dissolving - and they should get a HA (if no HA may not be good bc the pills only last for 6 months). Keep with you at all times.
Crushing chest pain that lasts 30 mins or longer and may radiate to the neck - shoulders - or jaw - diaphoresis - nausea - and SOB.
When: using anticoagulants - liver disease - decrease in platelets (less than 150 -000) - hemophilia - using thrombolytic meds - DIC - CA - HIV - chemo - bone marrow problems - and ASA/NSAIDS.

39. What are the proper steps to changing a central venous catheter dressing?
(1st) Assess LOC - (2nd) if unconscious= begin CPR - and (3rd) Notify physician.
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
When not visable - place the patient in the left lateral position - ask them to exhale fully and stop breathing for a few seconds.
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.

40. What places someone at risk for an aortic dissection?
ICG is a noninvasive way to collect hemodynamic data for assessing patients with heart failure - hypertension - or dyspnea.
Lower left sternal border
Fatigue - JVD - Increased peripheral venous pressure - ascites - anorexia/complaints of GI distress - cyanosis - and dependent edema.
Poorly controlled hypertension

41. When would a nurse use an external femoral artery compression device?
Idiopathic
Varicose veins - elevate legs - weight reduction - brawny in color - ted hose - topical steroids - ulcers - and skin color changes.
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!
After a sheath removal to apply consistent pressure and prevent bleeding. (Ex: after swan ganz removal).

42. What should you do to treat pulmonary edema?
The patient may suffer significant blood loss or femoral nerve compression.
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
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
All People Enjoy Time Magazine= Aortic - Pulmonic - ERB's point - Tricuspid - and Mitral/Apex. P(2) E (3) T (4) MA (5) (locations)

43. What should you always assume with a patient who has a central line placed and is experiencing SOB?
NO TED HOSE - NO SHEETS/BLANKETS - NO COMPRESSION DEVICES - (TEACH NO OPEN TOES SHOES). Lambs wool is okay!
Left sternal border
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.)
Air embolism

44. What should you do if you are going to ventilate someone with an ambu bag?
Include rest periods prior to any activity.
Used in an emergency (Vfib/defib) - used with Vfib or Vtach - NO CARDIAC OUTPUT - client is unconscious - EKG monitor - NO CONSENT NEEDED - begin with 200 Joules and up to 360.
It usually occurs when your heart is working harder (ex: exercising - eating large meal - or feeling stress. Also very hot or cold weather).
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

45. What should be checked in a patient on a beta blocker?
Pulse before and after giving.
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
All People Enjoy Time Magazine= Aortic - Pulmonic - ERB's point - Tricuspid - and Mitral/Apex. P(2) E (3) T (4) MA (5) (locations)
Varicose veins - elevate legs - weight reduction - brawny in color - ted hose - topical steroids - ulcers - and skin color changes.

46. What is characteristic of premature ventricular contractions?
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.
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.
A central line placed that measures the right atrial pressure. Normal= 4-10 cm of H20.
Put on gloves - remove the previous application paper and use a tissue to remove all ointment from the site to prevent overdose - squeeze the prescribed ointment in a thin layer onto a clean ruled application paper - choose an unused site on the ches

47. What is the treatment for a patient in complete heart block?
In the first 72 hours!!!!!
Clip hair if necessary - abrade the skin (use abrader pads or fine sandpaper and lightly rub skin using 2 or 3 brisk strokes - improves tracings) - dry skin if necessary - and attach the lead wires to the electrodes before you apply them to the patie
(1st) Assess the client for signs of decreased cardiac output and Notify the physician (2nd).
Temporary or permanent transvenous PACEMAKER INSERTION - and if the client is symptomatic and showing S&S of decreased cardiac output - GIVE ATROPINE.

48. What should be done immediately if a pulmonary embolism is suspected?
Vascular - artery disease causing fluid to back up into the lungs.
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
No clearly defined or measurable P waves and an irregular - irregular ventricular response.
The damaged portion of the aorta is removed and is repaired with a synthetic graft.

49. How should you palpate the apical pulse?
When not visable - place the patient in the left lateral position - ask them to exhale fully and stop breathing for a few seconds.
Pallor - diaphoresis - tachypnea - severe tearing chest pain radiating to back - PULSES In ARMS Are STRONG BUT LEG PULSES Are WEAK - low SP02.
When they occur >6 per minute or occurring 2 or more in a row (bigeminy or trigeminy=on way out).
Rapid ventricular rate with no relationship to atrial activity and QRS complex is wide and bizarre.

50. What should the plan of care include for a diagnosis of activity intolerance r/t right sided HF?
The patient may suffer significant blood loss or femoral nerve compression.
Pneumothorax and will end up with chest tube to help reinflate lung.
Include rest periods prior to any activity.
It will take 5 mins and he/she should remain quiet for about 1 minute without talking or moving.