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NURS 6201 Exam 2 Content: Heart Failure and Dysrhythmias Questions With Complete Solutions
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NURS 6201 Exam 2 Content: Heart Failure and Dysrhythmias Questions With Complete Solutions
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NURS 6201 Exam 2 Content: Heart Failure and Dysrhythmias Questions With Complete Solutions A patient presents with Jugular Venous Distention (JVD), peripheral edema, and fatigue. Based on this initial assessment data, which of the following manifestations of heart failure do you expect them to have? (select only one) A. Frothy, serosanguineous sputum B. Bilateral crackles C. Ascites D. Confusion hhCorrect Answers hhC. (Ascites) is correct. Based on the data given, this patient is suffering from right -sided heart failure. Options A, B, and D all describe manifestations o f left -Sided heart failure, which results in pulmonary edema and, ultimately, hypoxia. Ascites is the result of fluid backing up into the abdomen because the right side of the heart is not pumping effectively. There are many different drugs for treating chronic heart failure, but a common adverse effect of almost all these drugs is.... hhCorrect Answers hhHypotension (especially orthostatic hypotension). A patient placed on Losartan for treatment of heart failure requires education regarding adverse effect s of this medication. Which of the following adverse effects would the nurse include as part of the education? (Select All That Apply) A. Angioedema B. Hyperkalemia C. Intractable cough D. Hypotension hhCorrect Answers hhA, B, and D are correct. Losartan is an Angiotensin Receptor Blocker. It blocks angiotensin II, resulting in vasodilation and increased sodium and water excretion (by blocking aldosterone). Although ARBs carry a reduced risk of angioedema relative to ACE -Is, it is still a potential problem. ARBs do not cause the intractable cough characteristic of ACE -
Is. What labs are important to monitor for a patient placed on ACEs, ARBs, or Aldosterone antagonists? (Note: Aldosterone antagonists are also known as potassium -sparing diuretics) hhCorrect Ans wers hhRenal function and serum potassium levels are critical to monitor in patients on any of these drugs. Remember that the kidneys are responsible for 90% of potassium excretion and these are potassium -sparing drugs. Any drop any renal function could hav e disastrous effects. A nurse is teaching a patient on potential adverse effects of beta -
blockers for the treatment of heart failure. Which of the following points should the nurse include? (Select all that apply) A. Worsening of HF symptoms B. Fatigue C. Bradycardia D. Hypotension hhCorrect Answers hhA-D are correct. These are all potential adverse effects of beta -blocker therapy. Recall that beta-blockers block SNS stimulation of the heart. This reduces HR and contractility, which may actually worsen sympt oms of HF if the patient is fluid overloaded. For D, just remember that practically all chronic HF drugs cause hypotension. A patient with heart failure has a persistent fluid overload that's resistant to diuretic therapy. What is a non -pharmacological intervention that can reduce their fluid overload? hhCorrect Answers hhUltrafiltration (aquapheresis) is an option for patients with FVE that is resistant to diuretics. It can rapidly remove excess fluid and sodium while maintaining hemodynamic stability. If the patient's kidneys are wrecked, hemodialysis is another option. A recently graduated nurse notices that their patient admitted for Acute Decompensated Heart Failure is prescribed Milrinone, a positive inotropic drug. Concerned, she asks her nurse prec eptor if this was a mistake. How should the preceptor respond? A. "Good catch! The provider probably meant to prescribe a beta-blocker" B. "Milrinone is used for chronic heart failure patients to increase blood pressure" C. "Milrinone is used for short -term treatment of cardiogenic shock in patients with ADHF. It can temporarily boost cardiac output, but comes with serious adverse effects". D. "Milrinone is never used for heart failure, we use dopamine instead". hhCorrect A nswers hhC is correct. Positive inotropic drugs are not typically used for chronic HF, but they are helpful in short -term treatment of ADHF. The adverse effects are nasty, including dysrhythmias, thrombocytopenia, and hepatotoxicity.
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