A client with a long history of poorly-managed left-sided heart failure complains of decreased urine output. Lab results show anemia and elevated serum creatinine levels. Based on these findings, which condition should the nurse suspect the client is experiencing?

Pleural effusion

Myocardial infarction

Cardiorenal syndrome

Heparin-induced thrombocytopenia (HIT)

Answer and Explanation

The Correct Answer is C

A. Pleural effusion may be a complication of heart failure but does not directly explain the decreased urine output and elevated serum creatinine.

B. Myocardial infarction would present with different symptoms, such as chest pain, rather than decreased urine output and elevated creatinine.

C. Cardiorenal syndrome refers to the interdependence of the heart and kidneys, where chronic heart failure leads to worsening kidney function, causing symptoms like decreased urine output and elevated serum creatinine.

D. Heparin-induced thrombocytopenia (HIT) is related to the use of heparin and presents with low platelet counts, not decreased urine output and elevated creatinine.

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Correct Answer is D

Explanation

A. NSTEMI would present with elevated troponin levels indicating myocardial injury, which is not the case here.

B. Stable angina occurs predictably with exertion and is relieved by rest or nitroglycerin.

C. STEMI is characterized by ST-elevation on the ECG and elevated troponin levels, indicating significant myocardial injury.

D. Unstable angina presents with chest pain that occurs at rest or with minimal exertion and is not predictable. The presence of T-wave inversion and normal troponin levels is consistent with this diagnosis.

A. Administer furosemide 40 mg via IV push once. B. Begin an IV infusion of normal saline (NS) at 150 mL/hr. C. Administer digoxin 0.25 mg via IV push NOW. D. Monitor daily weights. E. Call a code STEMI. F. Monitor strict intake and output. G. Prepare the client for an echocardiogram. H. Prepare the client for a radiofrequency catheter ablation.

Correct Answer is ["A","D","F","G"]

Explanation

A. Administering furosemide 40 mg via IV push once is appropriate for treating fluid overload, as evidenced by pitting edema and crackles in the lungs, common in heart failure.

B. An IV infusion of normal saline (NS) at 150 mL/hr is not appropriate for this client as it can exacerbate fluid overload and worsen heart failure symptoms.

C. Administering digoxin 0.25 mg via IV push NOW may be indicated, but considering the client's low pulse rate (55/min), caution is necessary due to the risk of digoxin toxicity and bradycardia.

D. Monitoring daily weights is crucial for assessing fluid balance in heart failure patients and detecting any changes in fluid status.

E. Calling a code STEMI is not appropriate as the client does not exhibit signs of a STEMI; troponin levels are not elevated, and there is no indication of an acute myocardial infarction.

F. Monitoring strict intake and output helps in managing fluid balance and ensuring accurate assessment of the client's fluid status.

G. Preparing the client for an echocardiogram is appropriate to assess cardiac function and evaluate the severity of heart failure.

H. Radiofrequency catheter ablation is not indicated for this client as it is typically used to treat arrhythmias, not heart failure or fluid overload.

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A client with a long history of poorly-managed left-sided heart failure complains of decreased urine output. Lab results show anemia and elevated serum creatinine levels. Based on these findings, which condition should the nurse suspect the client is experiencing?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is D

Explanation

Correct Answer is ["A","D","F","G"]

Explanation

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