A client has undergone a right femoral cardiac catheterization. What nursing action is the priority following the procedure?

Complete a neurovascular check of the affected extremity.

Perform passive range of motion.

Assess the gag reflex prior to feeding the client.

Keep the client in high Fowler's position.

Answer and Explanation

The Correct Answer is A

A. Complete a neurovascular check of the affected extremity: Neurovascular assessment ensures that blood flow and nerve function are intact post-procedure. Complications such as arterial occlusion or hematoma can cause ischemia or nerve damage, making this the priority.

B. Perform passive range of motion: This is not a priority and may not be appropriate immediately post-catheterization as movement of the extremity can increase the risk of bleeding.

C. Assess the gag reflex prior to feeding the client: This applies to clients recovering from sedation during procedures like endoscopy, not cardiac catheterization.

D. Keep the client in high Fowler's position: This is contraindicated post-cardiac catheterization, as elevating the head too much can increase pressure at the puncture site and lead to bleeding.

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Correct Answer is A

Explanation

A. First-degree heart block: A prolonged PR interval greater than 0.20 seconds, as seen in this case, indicates first-degree heart block, which is a delay in conduction at the AV node.

B. Second-degree heart block. Second-degree heart block is characterized by some PR intervals being prolonged with occasional dropped beats (non-conducted P waves).

C. Bundle branch block. Bundle branch block causes a wide QRS complex (greater than 0.12 seconds), which is not seen here.

D. Sinus arrhythmia. Sinus arrhythmia involves changes in heart rate due to respiratory cycles, not prolonged PR intervals.

A. Hold the medication and notify the HCP B. Administer the medication as ordered. C. Prepare to administer vitamin K (AquaMephyton). D. Assess the client for abnormal bleeding. E. Fat embolism

Correct Answer is B

Explanation

A. Hold the medication and notify the HCP: This is unnecessary. An INR of 2.7 is within the therapeutic range for a client with a mechanical valve replacement (2.5 to 3.5). No intervention is required.

B. Administer the medication as ordered: The INR of 2.7 is within the desired therapeutic range for clients on warfarin with mechanical valve replacements, so the nurse should proceed with the prescribed dose.

C. Prepare to administer vitamin K (AquaMephyton): Vitamin K is used to reverse the effects of warfarin if the INR is too high (usually greater than 5).

D. Assess the client for abnormal bleeding: While important, this is not the first action. The INR is within the therapeutic range, so the priority is to administer the medication.

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A client has undergone a right femoral cardiac catheterization. What nursing action is the priority following the procedure?

Nursing Test Bank

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