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. How do you prepare a patient for Impedance cardiography monitoring?
A clinician will perform echocardiogram guided pericardiocentesis with a needle or catheter to remove excess fluid in the pericardial sac.
Air answers (open junctions)
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
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.

2. What is the necessary lab value to evaluate while a patient is on heparin? What is the normal value?
Air answers (open junctions)
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.
Elderly - hypothyroidism - renal dysfunction - dehydration - HYPOKALEMIA - hypomagnesemia - or hypercalcemia. Patients with abnormal potassium levels have a higher risk because hypokalemia makes the heart more sensitive to digoxin.
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.

3. What could happen without immediate intervention for a hematoma?
The patient may suffer significant blood loss or femoral nerve compression.
A hematoma= bleeding into the soft tissue surrounding the femoral artery access site.
Stroke - renal or heart failure - paraplegia secondary to compromised blood flow - or death from aortic rupture.
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

4. Which type of patient shouldn't take nitrates?
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
NO TED HOSE - NO SHEETS/BLANKETS - NO COMPRESSION DEVICES - (TEACH NO OPEN TOES SHOES). Lambs wool is okay!
Clip the hair to allow good contact between the electrodes and the skin (DONT SHAVE).
A patient on sildenafil (Viagra) - Cealis - or Levitra bc these drugs together can cause very low blood pressure and heart attack.

5. What should you observe for in someone on bleeding precautions?
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).
Second Left intercostal space
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.
Must be flushed 1x/month with heparin and between treatments.

6. What is the proper way to access and implanted venous access port (IVAP) (Mediport)?

7. What should you do immediately for someone experiencing anticoagulant induced epistaxis?
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
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
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.
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.

8. What is labile hypertension?
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.
Verapamil (calan) - diltiazem (cardizem) - nifedipine (procardia) - amlodipine (norvasc).
BP is elevated or decreased depending on activity.
Administer 100% O2 - left trendelenburg position - heparin administered - and oral warfarin started (give heparin and warfarin together for at least 5 days).

9. What activity should a patient with pericarditis - who is undergoing treatment - be allowed?
Rapid ventricular rate with no relationship to atrial activity and QRS complex is wide and bizarre.
Maintain BED REST
Pulmonary edema
Include rest periods prior to any activity.

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

11. What is characteristic of premature ventricular contractions?
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.
Second left intercostal space
4th left intercostal space lower sternal border
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.

12. What landmarks should you be looking for on someone's chest?
An inflammation of the pericardium. It may result in MI.
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
Aortic valve - Pulmonic valve - right ventricle - tricuspid valve - and apex or mitral valve.
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.

13. What is the treatment for premature ventricular contractions?
4th left intercostal space lower sternal border
Don't interfere!
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.
IV LIDOCAINE BOLUS (50-100 mg) followed by an IV lidocaine drip (suppresses ventricular activity).

14. What is defibrillation?
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.
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.
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 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.

15. Where should you place your stethescope to find the tricuspid valve?
4th left intercostal space lower sternal border
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.
Limit the size of the infarction is the goal. Treatment= thrombolytic therapy (tPA) initiated within 6 hours of the first symptoms= standard treatment.
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-

16. What is the treatment for a pt. with ventricular tachycardia?
MONA=Magnesium sulfate - O2 - Nitroglycerin - Aspirin (mona has a heart so EKG also if select all that apply).
Direct current cardioversion and digoxin/propranolol (inderal).
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.
It usually occurs when your heart is working harder (ex: exercising - eating large meal - or feeling stress. Also very hot or cold weather).

17. What will the Transthoracic echocardiograph (TTE) show that will indicate cardiac tamponade?
NO TED HOSE - NO SHEETS/BLANKETS - NO COMPRESSION DEVICES - (TEACH NO OPEN TOES SHOES). Lambs wool is okay!
An enlarged space indicates fluid accumulation in the pericardial sac.
Administer 100% O2 - left trendelenburg position - heparin administered - and oral warfarin started (give heparin and warfarin together for at least 5 days).
Trendelenburg position for insertion. Pt holds breath to prevent air from entering sinus tract.

18. Where do the internal jugular veins lie?
Deep in the sternomastoid muscle - so look for pulsations in the soft tissue surrounding that area.
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.
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.
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.

19. What does the device for impedance cardiography consist of?
A monitor with four dual electrodes that are applied to the patients neck and thorax.
Pericardial friction rub - chest pain (sharp and aggravated with breathing) - abnormal EKG findings - possible fever and tachycardia.
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.
Varicose veins - elevate legs - weight reduction - brawny in color - ted hose - topical steroids - ulcers - and skin color changes.

20. What usually triggers angina pain?
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.
It usually occurs when your heart is working harder (ex: exercising - eating large meal - or feeling stress. Also very hot or cold weather).
Steroid treatment or a pregnant woman who is retaining water.
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

21. What should be taught upon discharge for someone going home on coumadin as a result of a PE?
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)
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.
Varicose veins - elevate legs - weight reduction - brawny in color - ted hose - topical steroids - ulcers - and skin color changes.

22. What should you do prior to placing cardiac monitor electrodes on the skin (4 things)?
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
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.
A nosebleed
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

23. What should you do frequently for someone with a central line to help prevent pulmonary emboli?
BP is elevated or decreased depending on activity.
Check all junctions frequently to make sure secure - especially before patient gets out of bed - and always use tubing with twist lock connections.
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
One at a time to assess the pulse amplitude and contour.

24. What are the treatments/ S&S of peripheral venous disease?
(1ST) BEGIN CARDIOPULMONARY RESUSCITATION (The PT. Is DYING) And NotIFY PHYSICIAN (2ND).
Positive Homan's sign (calf tenderness on dorsiflexion of the foot).
Varicose veins - elevate legs - weight reduction - brawny in color - ted hose - topical steroids - ulcers - and skin color changes.
IV LIDOCAINE BOLUS (50-100 mg) followed by an IV lidocaine drip (suppresses ventricular activity).

25. What is the treatment for atrial fibrillation?
(S1 - S2) Third left intercostal space
Aortic valve - Pulmonic valve - right ventricle - tricuspid valve - and apex or mitral valve.
Limit the size of the infarction is the goal. Treatment= thrombolytic therapy (tPA) initiated within 6 hours of the first symptoms= standard treatment.
Direct current cardioversion and digoxin/propranolol (inderal).

26. How should you palpate the apical pulse?
The internal jugular veins (external are less reliable).
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.
When not visable - place the patient in the left lateral position - ask them to exhale fully and stop breathing for a few seconds.
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

27. What nursing interventions are associated with a pt. experiencing ventricular fibrillation?
To inhibit thrombus and clot formation.
Totally disorganized - chaotic pattern - and no discernible waves or complexes.
Rapid ventricular rate with no relationship to atrial activity and QRS complex is wide and bizarre.
(1ST) BEGIN CARDIOPULMONARY RESUSCITATION (The PT. Is DYING) And NotIFY PHYSICIAN (2ND).

28. What is the nursing care associated with chemical stress tests (persantine stress test)?
Fourth or fifth intercostal space at or medial to the midclavicular line.
To inhibit thrombus and clot formation.
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
NO NSAIDS or ASA.

29. What are signs and symptoms of an MI?
Crushing chest pain that lasts 30 mins or longer and may radiate to the neck - shoulders - or jaw - diaphoresis - nausea - and SOB.
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.
When a large air bubble blocks blood flow from the right ventricle into the pulmonary artery.
ICG is a noninvasive way to collect hemodynamic data for assessing patients with heart failure - hypertension - or dyspnea.

30. What should you not allow if a patient has a negative Allen's test?
No radial artery punctures if negative
If feel more than 3 shocks in a row or develop signs of infection at the site.
Varicose veins - elevate legs - weight reduction - brawny in color - ted hose - topical steroids - ulcers - and skin color changes.
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.

31. What type of EKG change indicates MI?
MRI is painless - you must remain still inside a small/noisy space. If you are claustrophobic you may need sedation. Remove all jewelry and other metal objects. If you have any shrapnel - a pacemaker - or any surgically implanted joints - pins - clip
ST segment elevation (STEMI)
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-
In the first 72 hours!!!!!

32. How is the arterial brachial index (ABI) calculated? Who should perform this? What is normal?
Decreased tissue perfusion. Tx: clot busting treatment must start within 6 hours.
Fatigue - JVD - Increased peripheral venous pressure - ascites - anorexia/complaints of GI distress - cyanosis - and dependent edema.
No radial artery punctures if negative
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.

33. What is characteristic of ventricular tachycardia?
When a large air bubble blocks blood flow from the right ventricle into the pulmonary artery.
Diuretic & Digoxin (dig increases force of contraction and increases perfusion). Know working if client is peeing (kidney perfusion) and more alert!
RAndI= Razor - electric - Aspirin - NO - Needles - small gauge - Decrease - needle sticks - and Injury- protect from. No percodan or NSAIDS - no open toed shoes.
Rapid ventricular rate with no relationship to atrial activity and QRS complex is wide and bizarre.

34. What should you know about your recovery period after having an implantable cardioverter defibrillator (ICD)?
If you feel lightheaded - dizzy - or heart palpitations but feel no shock from the ICD.
(1st) Assess the client for S&S of decreased cardiac output and Notify physician (2nd).
For the first month post op - do not lift more than 10 or 15 lbs. And avoid excessive pushing - pulling - or twisting.
A NON INVASIVE doppler exam of the heart via the thorax to detect cardiac tamponade.

35. For which heart sounds should the bell be used?
Low pitched sounds such as S3 and S4 and the murmur of mitral stenosis. BEL(low)L
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.
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.
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

36. What should you teach your patient about an electrocardiogram (ECG)?
In the first 72 hours!!!!!
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
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
Cardiac tamponade (fluid in pericardial space) and thickening/scarring of the pericardial sac (constrictive pericarditis and possible RHF).

37. What is a major complication of central line placement?
Vitamin K (aqua myphiton)
The arteries have narrowed - decreased O2 to tissues= hypoxia to cells.
Pneumothorax and will end up with chest tube to help reinflate lung.
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

38. What should you teach your patient about MRI?
MRI is painless - you must remain still inside a small/noisy space. If you are claustrophobic you may need sedation. Remove all jewelry and other metal objects. If you have any shrapnel - a pacemaker - or any surgically implanted joints - pins - clip
Patient who are unable to tolerate exercise stress testing.
ST segment elevation (STEMI)
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.)

39. Where should you place your stethescope to find the aortic valve?
Second Right intercostal space.
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.
Left sternal border
Air embolism

40. What should you teach someone about iodine?
BP is elevated or decreased depending on activity.
Vascular - artery disease causing fluid to back up into the lungs.
Arterial pulse: 60-90 - Amplitude: 4+=strong and bounding - Edema: 0=none - Reflex 2+
Feeling warm (fire) or tin can taste is expected and will pass.

41. What are the signs and symptoms of left sided HF?
Old truck driver or someone on bed rest or with pelvic trauma.
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
A patient on sildenafil (Viagra) - Cealis - or Levitra bc these drugs together can cause very low blood pressure and heart attack.
Paroxysmal nocturnal dyspnea - elevated pulmonary capillary wedge pressure - BLOOD TINGED SPUTUM - cough - orthopnea - exertional dyspnea - cyanosis.

42. When would a nurse use an external femoral artery compression device?
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
Thromboanglitis obliterans/ Buerger's disease= inflammatory process of arterial wall - veins - and nerves where they become blocked. It is associated with smoking/tobacco use.
After a sheath removal to apply consistent pressure and prevent bleeding. (Ex: after swan ganz removal).
Positive Homan's sign (calf tenderness on dorsiflexion of the foot).

43. What is the treatments for hypertension?
Direct current shock (defibrillation) and IV anti - arrhythmic drugs (lidocaine - Procainamide - and Bretylium).
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.
D/C the med and call the doctor.
The damaged portion of the aorta is removed and is repaired with a synthetic graft.

44. For which heart sounds should the diaphragm be used?
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.
NO because it isn't sterile so keep out.
High pitched sounds like S1 and S2 (pericardial friction rubs - aortic/mitral regurgitation murmurs). DIAPH(high)ragm
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.

45. What should you teach a patient regarding discharge after a DVT?

46. What is the most common cause of arterial insufficiency?
Low pitched sounds such as S3 and S4 and the murmur of mitral stenosis. BEL(low)L
MRI is painless - you must remain still inside a small/noisy space. If you are claustrophobic you may need sedation. Remove all jewelry and other metal objects. If you have any shrapnel - a pacemaker - or any surgically implanted joints - pins - clip
Lung disease
Chronic arteriosclerotic disease.

47. How is the Allen's test done?
Totally disorganized - chaotic pattern - and no discernible waves or complexes.
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
BP is elevated or decreased depending on activity.
Low pitched sounds such as S3 and S4 and the murmur of mitral stenosis. BEL(low)L

48. What are the two common complications of pericarditis?
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.
Cardiac tamponade (fluid in pericardial space) and thickening/scarring of the pericardial sac (constrictive pericarditis and possible RHF).
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.
When a large air bubble blocks blood flow from the right ventricle into the pulmonary artery.

49. What are the nursing interventions for a patient in atrial fibrillation?
Feeling warm (fire) or tin can taste is expected and will pass.
(1st) Assess the client for signs of decreased cardiac output and Notify the physician (2nd).
The arteries have narrowed - decreased O2 to tissues= hypoxia to cells.
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.

50. What disease can cause right sided heart failure?
Lung disease
To inhibit thrombus and clot formation.
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.
Only for a few hours