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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 would make someone more at risk for digoxin toxicity?
Nitrates - Beta blockers - and Calcium channel blockers
The symptoms improve when the patient is sitting in upright position that promotes drainage but worsen with the client is lying down.
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.
A central line placed that measures the right atrial pressure. Normal= 4-10 cm of H20.

2. How is the Allen's test done?
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.
Correct her and tell her that the (+) lead goes on the left and the (-) lead goes on the right side.
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
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

3. What is epistaxis?
A nosebleed
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
Inspect pulses on chest - inspect the internal jugular veins - palpate the apical pulse - palpate the carotid arteries - and auscultate the heart sounds.
D/C the med and call the doctor.

4. Where is the aortic valve landmark on the chest?
Second right intercostal space
Patient who are unable to tolerate exercise stress testing.
Exercise and use graduated compression devices as directed - don't stand for long period of time - to avoid dislodging blood clots don't rub or massage your legs.
If you feel lightheaded - dizzy - or heart palpitations but feel no shock from the ICD.

5. What should you teach your patient about an electrocardiogram (ECG)?
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 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
Diuretic & Digoxin (dig increases force of contraction and increases perfusion). Know working if client is peeing (kidney perfusion) and more alert!
When they occur >6 per minute or occurring 2 or more in a row (bigeminy or trigeminy=on way out).

6. If 2 liters of fluid is left in the pericardial sac (cardiac tamponade) and goes untreated what could it cause?
Second left intercostal space
Right sided heart failure
Aortic valve - Pulmonic valve - right ventricle - tricuspid valve - and apex or mitral valve.
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.

7. What should you remember while taking care of someone with a peripheral arterial occlusion?
NO TED HOSE - NO SHEETS/BLANKETS - NO COMPRESSION DEVICES - (TEACH NO OPEN TOES SHOES). Lambs wool is okay!
Idiopathic
Nitrates - Beta blockers - and Calcium channel blockers
Constipation or MAY CAUSE ANKLES TO SWELL (call healthcare provider).

8. What is Deep Vein Thrombosis (DVT)?
Air embolism
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.
A disease in which thrombi trap blood in the deep veins of the pelvis and legs.
Lowers BP and makes heart beat stronger. SE: flushed face.

9. What should you teach your patient about an exercise ECG (stress test)?
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-
A NON INVASIVE doppler exam of the heart via the thorax to detect cardiac tamponade.
A hematoma= bleeding into the soft tissue surrounding the femoral artery access site.
One at a time to assess the pulse amplitude and contour.

10. Which type of patient shouldn't take nitrates?
Lower left sternal border
A patient on sildenafil (Viagra) - Cealis - or Levitra bc these drugs together can cause very low blood pressure and heart attack.
When a large air bubble blocks blood flow from the right ventricle into the pulmonary artery.
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

11. What should you explain to the patient about an impedance cardiography test?
It will take 5 mins and he/she should remain quiet for about 1 minute without talking or moving.
Cannot
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.
Correct her and tell her that the (+) lead goes on the left and the (-) lead goes on the right side.

12. What are coumadin and heparin used for?
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
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
After a sheath removal to apply consistent pressure and prevent bleeding. (Ex: after swan ganz removal).
To inhibit thrombus and clot formation.

13. What is cardiac tamponade? Common causes?
(S1 - S2) Third left intercostal space
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
Aortic valve - Pulmonic valve - right ventricle - tricuspid valve - and apex or mitral valve.
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.

14. What can result from left sided heart failure if left untreated?
Pulmonary edema
RAndI= Razor - electric - Aspirin - NO - Needles - small gauge - Decrease - needle sticks - and Injury- protect from. No percodan or NSAIDS - no open toed shoes.
A disease in which thrombi trap blood in the deep veins of the pelvis and legs.
Patient who are unable to tolerate exercise stress testing.

15. What should be checked in a patient on a beta blocker?
Pulse before and after giving.
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
Chronic arteriosclerotic disease.
The symptoms improve when the patient is sitting in upright position that promotes drainage but worsen with the client is lying down.

16. What should be done is a patient on anticoagulants suffers from epistaxis for more than 15 mins?
The damaged portion of the aorta is removed and is repaired with a synthetic graft.
Posterior nasal packing to stop the blood flow. The LPN CAN DO THIS!
Totally disorganized - chaotic pattern - and no discernible waves or complexes.
It will take 5 mins and he/she should remain quiet for about 1 minute without talking or moving.

17. For which heart sounds should the bell be used?
A central line placed that measures the right atrial pressure. Normal= 4-10 cm of H20.
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.
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).
Low pitched sounds such as S3 and S4 and the murmur of mitral stenosis. BEL(low)L

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

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19. What is characteristic of ventricular tachycardia?
Rapid ventricular rate with no relationship to atrial activity and QRS complex is wide and bizarre.
Temporary or permanent transvenous PACEMAKER INSERTION - and if the client is symptomatic and showing S&S of decreased cardiac output - GIVE ATROPINE.
Elevated legs - anticoagulation therapy (aggressive: generally IV heparin) - Be alert for signs of PE.
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.

20. What is the treatment for premature ventricular contractions?
NO TED HOSE - NO SHEETS/BLANKETS - NO COMPRESSION DEVICES - (TEACH NO OPEN TOES SHOES). Lambs wool is okay!
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
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.
IV LIDOCAINE BOLUS (50-100 mg) followed by an IV lidocaine drip (suppresses ventricular activity).

21. What should be immediately done for a patient experiencing digoxin toxicity?
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
When not visable - place the patient in the left lateral position - ask them to exhale fully and stop breathing for a few seconds.
An enlarged space indicates fluid accumulation in the pericardial sac.
Stop the medication - address the factors that may have precipitated the event. If life threatening Digibind ay be indicated.

22. How does the blood flow through the heart? (valves?)
Feeling warm (fire) or tin can taste is expected and will pass.
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!
In the first 72 hours!!!!!
Check all junctions frequently to make sure secure - especially before patient gets out of bed - and always use tubing with twist lock connections.

23. What is the necessary lab value to evaluate while a patient is on heparin? What is the normal value?
Elevated legs - anticoagulation therapy (aggressive: generally IV heparin) - Be alert for signs of PE.
Decreased tissue perfusion. Tx: clot busting treatment must start within 6 hours.
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.
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

24. What is the normal value for arterial pulse? Pulse amplitude? Edema? Reflex?
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.
CPR should be done. No defibrillation bc no rhythm to shock (heart already depolarized).
Stroke - renal or heart failure - paraplegia secondary to compromised blood flow - or death from aortic rupture.
Arterial pulse: 60-90 - Amplitude: 4+=strong and bounding - Edema: 0=none - Reflex 2+

25. How should you palpate the apical pulse?
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
Pulse before and after giving.
When not visable - place the patient in the left lateral position - ask them to exhale fully and stop breathing for a few seconds.
An inflammation of the pericardium. It may result in MI.

26. 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
A NON INVASIVE doppler exam of the heart via the thorax to detect cardiac tamponade.
In fatty areas or over major muscles - large breasts - or bony prominences.
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

27. How do you prepare a patient for Impedance cardiography monitoring?
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
Cardiac tamponade (fluid in pericardial space) and thickening/scarring of the pericardial sac (constrictive pericarditis and possible RHF).
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.
Positive Homan's sign (calf tenderness on dorsiflexion of the foot).

28. What should you teach your patient about a cardiac catheterization?
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
NO TED HOSE - NO SHEETS/BLANKETS - NO COMPRESSION DEVICES - (TEACH NO OPEN TOES SHOES). Lambs wool is okay!
Second left intercostal space
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.

29. What is the treatment for someone with right sided HF? How do you know working?
INTERVENE: to control edema and decrease pain patient should be on bed rest with legs elevated six inches above heart level.
Diuretic & Digoxin (dig increases force of contraction and increases perfusion). Know working if client is peeing (kidney perfusion) and more alert!
(1st) Assess the client for signs of decreased cardiac output and Notify the physician (2nd).
High pitched sounds like S1 and S2 (pericardial friction rubs - aortic/mitral regurgitation murmurs). DIAPH(high)ragm

30. What should you teach your patient about a holter monitor?

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31. What is the goal of treatment for an MI? Treatment?
(1st) Assess LOC - (2nd) if unconscious= begin CPR - and (3rd) Notify physician.
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.
Limit the size of the infarction is the goal. Treatment= thrombolytic therapy (tPA) initiated within 6 hours of the first symptoms= standard treatment.
RAndI= Razor - electric - Aspirin - NO - Needles - small gauge - Decrease - needle sticks - and Injury- protect from. No percodan or NSAIDS - no open toed shoes.

32. A femoral artery compression device ______be assigned to an NA?
Don't interfere!
Cannot
Fourth or fifth intercostal space at or medial to the midclavicular line.
NO NSAIDS or ASA.

33. What does plan of care include?
When a large air bubble blocks blood flow from the right ventricle into the pulmonary artery.
Elevated legs - anticoagulation therapy (aggressive: generally IV heparin) - Be alert for signs of PE.
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.
Steroid treatment or a pregnant woman who is retaining water.

34. What will the Transthoracic echocardiograph (TTE) show that will indicate cardiac tamponade?
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
Posterior nasal packing to stop the blood flow. The LPN CAN DO THIS!
An enlarged space indicates fluid accumulation in the pericardial sac.
Anxiousness - restlessness - tachycardia - tachypneic - 90% SP02 - dyspnea - substernal pain - coughing - hemoptysis - and fever.

35. What is the antidote for coumadin?
Difficulty breathing - pain in midchest and shoulder - pale - nausea - and light headedness.
Positive Homan's sign (calf tenderness on dorsiflexion of the foot).
Pneumothorax and will end up with chest tube to help reinflate lung.
Vitamin K (aqua myphiton)

36. What condition can cause left sided heart failure?
When a large air bubble blocks blood flow from the right ventricle into the pulmonary artery.
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.
Vascular - artery disease causing fluid to back up into the lungs.
(1ST) BEGIN CARDIOPULMONARY RESUSCITATION (The PT. Is DYING) And NotIFY PHYSICIAN (2ND).

37. 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?
Second right intercostal space
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.
All People Enjoy Time Magazine= Aortic - Pulmonic - ERB's point - Tricuspid - and Mitral/Apex. P(2) E (3) T (4) MA (5) (locations)
Correct her and tell her that the (+) lead goes on the left and the (-) lead goes on the right side.

38. When would a nurse use an external femoral artery compression device?
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
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.
After a sheath removal to apply consistent pressure and prevent bleeding. (Ex: after swan ganz removal).
Cardiac tamponade (fluid in pericardial space) and thickening/scarring of the pericardial sac (constrictive pericarditis and possible RHF).

39. Where do the internal jugular veins lie?
Deep in the sternomastoid muscle - so look for pulsations in the soft tissue surrounding that area.
No radial artery punctures if negative
Second left intercostal space
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

40. What causes secondary hypertension?
Steroid treatment or a pregnant woman who is retaining water.
A patient on sildenafil (Viagra) - Cealis - or Levitra bc these drugs together can cause very low blood pressure and heart attack.
Cardiac tamponade (fluid in pericardial space) and thickening/scarring of the pericardial sac (constrictive pericarditis and possible RHF).
Pneumothorax and will end up with chest tube to help reinflate lung.

41. What should you teach someone about iodine?
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
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
Feeling warm (fire) or tin can taste is expected and will pass.
Hair loss - muscle mass loss - pallor when elevated - dependent rubor - and prolonged cap refill time.

42. Where should you place your stethescope to find the ERB's Point?
ICG is a noninvasive way to collect hemodynamic data for assessing patients with heart failure - hypertension - or dyspnea.
Direct current shock (defibrillation) and IV anti - arrhythmic drugs (lidocaine - Procainamide - and Bretylium).
Pulmonary edema
(S1 - S2) Third left intercostal space

43. What landmarks should you be looking for on someone's chest?
Open up blood vessels
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
Aortic valve - Pulmonic valve - right ventricle - tricuspid valve - and apex or mitral valve.
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.

44. Test ending in Gram=?
Anxiousness - restlessness - tachycardia - tachypneic - 90% SP02 - dyspnea - substernal pain - coughing - hemoptysis - and fever.
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
Iodine
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

45. What should happen if someone converts to asystole/flatline?
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.
CPR should be done. No defibrillation bc no rhythm to shock (heart already depolarized).
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.
Elevated legs - anticoagulation therapy (aggressive: generally IV heparin) - Be alert for signs of PE.

46. 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
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
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
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.

47. When should a patient call their doctor after having an implantable cardioverter defibrillator (ICD) placed?
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.
No radial artery punctures if negative
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.
If feel more than 3 shocks in a row or develop signs of infection at the site.

48. What is a therapeutic digoxin level?
0.5-2.0 ng/ml
ST segment elevation (STEMI)
Arterial pulse: 60-90 - Amplitude: 4+=strong and bounding - Edema: 0=none - Reflex 2+
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.

49. What is the most common cause of arterial insufficiency?
Inspect pulses on chest - inspect the internal jugular veins - palpate the apical pulse - palpate the carotid arteries - and auscultate the heart sounds.
NO TED HOSE - NO SHEETS/BLANKETS - NO COMPRESSION DEVICES - (TEACH NO OPEN TOES SHOES). Lambs wool is okay!
Chronic arteriosclerotic disease.
You need to maintain use of those devices continually except when the patient is ambulating - bathing - or during physical therapy or skin assessment.

50. What are the S&S associated with right sided heart failure?
A drop in systolic BP greater than 12 mm Hg during inspiration indicating a compromise.
Fatigue - JVD - Increased peripheral venous pressure - ascites - anorexia/complaints of GI distress - cyanosis - and dependent edema.
It will take 5 mins and he/she should remain quiet for about 1 minute without talking or moving.
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.