A nurse is caring for a client 4 hr following a cardiac catheterization. Which of the following actions should the nurse take?

Elevate the head of the bed 45".

Keep the affected leg slightly flexed.

Keep the client NPO for 4 hr.

Have the client lie flat in bed.

Answer and Explanation

The Correct Answer is D

Correct answer: D

A. Elevate the head of the bed 45": Do not elevate the head of the bed more than 15 degrees. Elevating the head of the bed can increase the risk of bleeding from the insertion site.

B. Keep the affected leg slightly flexed: The affected leg should be kept straight to prevent movement at the insertion site, which can cause bleeding

C. Keep the client NPO for 4 hr: There is typically no need to keep the client NPO for an extended period after a cardiac catheterization. However, individual protocols may vary, and the nurse should follow the specific instructions provided by the healthcare provider.

D. Have the client lie flat in bed: After a cardiac catheterization, it is important to keep the client lying flat to prevent bleeding or hematoma formation at the catheter insertion site. This position helps to maintain pressure on the insertion site, particularly if the catheter was inserted through the femoral artery.

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Correct Answer is C

Explanation

A. Administer enteric-coated acetaminophen: Acetaminophen is not typically used to address the symptoms described by the client, such as pain in the jaw, back, and shoulder, shortness of breath, and nausea. Moreover, an enteric-coated form of acetaminophen is not likely to address the acute symptoms.

B. Administer ibuprofen: Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) and may not be appropriate for the reported symptoms, especially if they are indicative of a cardiac event.

C. Obtain an EKG: This is the correct answer. The client's symptoms, including pain in the jaw, back, and shoulder, shortness of breath, and nausea, are concerning for a possible cardiac event, such as a myocardial infarction (heart attack). An electrocardiogram (EKG) is a crucial diagnostic tool to assess for cardiac abnormalities and should be done promptly.

D. Maintain oxygen saturations greater than or equal to 92%: While maintaining adequate oxygen saturation is important in various clinical situations, the client's symptoms, especially when associated with potential cardiac issues, warrant an immediate EKG to assess for cardiac abnormalities.

A. Excessive thrombosis and bleeding B. Increased clotting factors C. Progressive increase in platelet production D. Immediate sodium and fluid retention

Correct Answer is A

Explanation

A. Excessive thrombosis and bleeding

Disseminated Intravascular Coagulation (DIC) is a complex and serious condition characterized by widespread activation of the coagulation cascade, leading to both excessive clot formation (thrombosis) and simultaneous consumption of clotting factors and platelets, resulting in bleeding. DIC can occur as a secondary complication to various conditions such as sepsis, trauma, or obstetric complications.

B. Increased clotting factors: In DIC, there is consumption and depletion of clotting factors, not an increase.

C. Progressive increase in platelet production: Platelet production does not increase in DIC; instead, there is consumption and decreased platelet count.

D. Immediate sodium and fluid retention: DIC is not associated with immediate sodium and fluid retention; instead, it is characterized by fluid loss due to bleeding.

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