A nurse is assessing a client who has restrictive cardiomyopathy (RCM). Which of the following statements should the nurse cue in the client?
Thickening of the walls of the ventricles.
Stretching of the ventricles.
Thickening of the ventricular walls and septum.
When the ventricular tissue becomes fibrous and fatty.
The Correct Answer is D
Choice A reason:
Thickening of the walls of the ventricles is not typically associated with restrictive cardiomyopathy (RCM). This condition is more characteristic of hypertrophic cardiomyopathy (HCM), where the heart muscle becomes abnormally thick, making it harder for the heart to pump blood. In RCM, the walls of the ventricles are usually not thickened but become rigid due to fibrosis or infiltration, which restricts the heart’s ability to fill with blood during diastole.
Choice B reason:
Stretching of the ventricles is more commonly seen in dilated cardiomyopathy (DCM), not restrictive cardiomyopathy. In DCM, the heart’s ventricles become enlarged and weakened, which impairs the heart’s ability to pump blood efficiently. RCM, on the other hand, involves stiffening of the ventricular walls without significant dilation.
Choice C reason:
Thickening of the ventricular walls and septum is a hallmark of hypertrophic cardiomyopathy (HCM), not restrictive cardiomyopathy. In HCM, the thickened walls can obstruct blood flow and lead to various complications. RCM is characterized by the stiffening of the ventricular walls due to fibrosis or infiltration, which restricts diastolic filling.
Choice D reason:
When the ventricular tissue becomes fibrous and fatty is the correct description of restrictive cardiomyopathy (RCM). In RCM, the heart’s ventricles become stiff and less elastic due to fibrosis (scarring) or infiltration by abnormal substances, such as amyloid proteins. This rigidity impairs the heart’s ability to fill properly during diastole, leading to symptoms of heart failure
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason:
Serum phosphate levels are not the primary concern in the management of diabetes insipidus (DI). While phosphate levels are important for overall health, they do not directly relate to the condition or its treatment with desmopressin. DI primarily affects water balance and sodium levels in the body.
Choice B reason:
Serum calcium levels, although important, are not the most critical lab value to monitor in a client with DI receiving desmopressin. Calcium levels are crucial for bone health and various metabolic functions, but they do not directly reflect the effectiveness or complications of desmopressin therapy.
Choice C reason:
Serum sodium levels are the most important lab value to monitor in a client with DI receiving desmopressin. DI causes an imbalance in water regulation, leading to excessive urination and potential dehydration. Desmopressin helps to reduce urine output and maintain water balance, but it can also lead to water retention and hyponatremia (low sodium levels). Monitoring serum sodium is crucial to prevent complications such as seizures, confusion, and other neurological symptoms associated with hyponatremia.
Choice D reason:
Blood urea nitrogen (BUN) levels are useful in assessing kidney function and hydration status, but they are not the primary concern in the management of DI with desmopressin. While BUN levels can provide valuable information about renal function, they do not directly indicate the effectiveness or potential complications of desmopressin therapy.
Correct Answer is B
Explanation
Choice A Reason:
Monitoring blood glucose levels is crucial for managing diabetes, but in the context of hyperosmolar hyperglycemic syndrome (HHS), recognizing the signs and symptoms is more critical. HHS is a serious condition characterized by extremely high blood sugar levels without significant ketoacidosis. Early recognition of symptoms such as extreme thirst, frequent urination, confusion, and weakness can prevent complications and prompt timely medical intervention.
Choice B Reason:
Recognizing signs and symptoms of HHS is the most important topic to prioritize. HHS can develop gradually and may be life-threatening if not identified and treated promptly. Patients and caregivers need to be aware of the warning signs to seek immediate medical attention. Symptoms include severe dehydration, altered mental status, and very high blood glucose levels. Educating patients on these signs ensures they can act quickly to prevent severe outcomes.
Choice C Reason:
Administering insulin correctly is essential for managing diabetes, but it is not the top priority in the context of HHS education. While proper insulin administration helps control blood glucose levels, the immediate concern in HHS is recognizing the condition’s onset. Once HHS is identified, insulin administration becomes part of the treatment plan, but early detection is key to preventing severe complications.
Choice D Reason:
Understanding the importance of hydration is important because dehydration is a significant component of HHS. Patients with HHS often experience severe dehydration due to high blood glucose levels leading to osmotic diuresis. Educating patients on maintaining adequate hydration can help manage their condition and prevent the onset of HHS. However, recognizing the symptoms of HHS remains the top priority.
Choice E Reason:
Managing diet and nutrition is a fundamental aspect of diabetes care, but it is not the primary focus when dealing with HHS. While a balanced diet helps maintain stable blood glucose levels, the immediate concern in HHS is identifying and responding to the condition’s symptoms. Once HHS is recognized and treated, dietary management becomes part of the long-term care plan.
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