A nurse is admitting a client who reports chest pain.

Exhibits

The nurse is preparing the client for the cardiac catheterization (coronary angiography). Which of the following actions should the nurse take? (Select all that apply.)

Mark the surgical site with an "X

Ask the client about their last food and fluid intake

Educate the client that they will need to keep their leg straight for 6 hours after the procedure.

Ask the client about their prescribed, over the counter, and herbal medication use

Begin prophylactic heparin therapy prior to the procedure

Answer and Explanation

Correct Answer : B,D

A. Marking the surgical site with an "X" is not typically done for cardiac catheterization. Instead, the healthcare provider may mark the site if necessary, but this is usually done by the surgeon or interventional cardiologist.

B. Asking about food and fluid intake is crucial because the client will need to be NPO (nothing by mouth) for several hours before the procedure to reduce the risk of aspiration during sedation or anesthesia.

C. Educating the client about keeping their leg straight after the procedure is necessary, but this typically occurs after the procedure, not before. This helps prevent complications such as bleeding or clot formation at the insertion site.

D. Asking about prescribed, over-the-counter, and herbal medications is important because certain medications, especially anticoagulants and blood thinners, need to be stopped before the procedure to minimize the risk of bleeding during catheterization.

E. Prophylactic heparin therapy may be ordered by the provider, but it is not typically administered by the nurse before the procedure unless specifically ordered.

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Correct Answer is C

Explanation

A. AST and ALT are liver enzymes, primarily used to assess liver function, not directly related to monitoring heparin therapy.

B. Prothrombin time (PT) is used to monitor warfarin therapy, not heparin. Heparin therapy is typically monitored with aPTT, whereas warfarin is monitored with PT/INR.

C. Heparin is an anticoagulant that works by inhibiting clotting factors, and the aPTT is used to monitor its effectiveness. The aPTT measures the time it takes for blood to clot and helps ensure the heparin dose is therapeutic without causing excessive bleeding. The typical therapeutic range for aPTT on heparin therapy is 1.5 to 2.5 times the normal value.

D. INR is used to monitor warfarin therapy, not heparin. Heparin does not affect INR levels.

A. Decrease in LDL cholesterol from last visit. B. Generalized muscle aches. C. Nausea when taking the medication on an empty stomach D. Clear, light yellow urine output

Correct Answer is B

Explanation

A. A decrease in LDL cholesterol is a desired effect of simvastatin and does not indicate a problem.

B. Generalized muscle aches are a significant concern for patients on statin medications, such as simvastatin. This can be indicative of a serious side effect called rhabdomyolysis, a condition where muscle tissue breaks down and can lead to kidney damage. This should be communicated to the healthcare provider immediately for further evaluation and possible discontinuation of the medication.

C. Nausea when taking the medication on an empty stomach is a common side effect and may be addressed with guidance on when to take the medication.

D. Clear, light yellow urine is normal and does not require further action.

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A nurse is admitting a client who reports chest pain. Exhibits The nurse is preparing the client for the cardiac catheterization (coronary angiography). Which of the following actions should the nurse take? (Select all that apply.)

Nursing Test Bank

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Explanation

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A nurse is admitting a client who reports chest pain.

Exhibits

The nurse is preparing the client for the cardiac catheterization (coronary angiography). Which of the following actions should the nurse take? (Select all that apply.)