A nurse is caring for a client who just had a cardiac catheterization. Which of the following nursing interventions should the nurse include in the client's plan of care? (Select all that apply.)

Measure the client's vital signs every 4 hr.

Place the client in high-Fowler's position.

Keep the client's affected extremity straight.

Ensure bedrest is maintained for the prescribed time.

Check peripheral pulses in the affected extremity.

Answer and Explanation

Correct Answer : C,D,E

A. Vital signs should be monitored more frequently than every 4 hours immediately after cardiac catheterization, often every 15 minutes initially.
B. The client should be positioned supine or with minimal elevation to avoid stress on the catheter insertion site, not in high-Fowler’s position.
C. Keeping the affected extremity straight helps prevent bleeding and dislodgement of the vascular closure.
D. Bedrest for the prescribed time is essential to promote hemostasis and prevent complications.
E. Checking peripheral pulses ensures adequate circulation and detects possible vascular complications early.

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Correct Answer is C

Explanation

A. Nitroglycerin is used to relieve chest pain but primarily during the acute phase for vasodilation.
B. Aspirin helps prevent clot progression but does not manage pain or anxiety.
C. Morphine is effective in managing pain and anxiety after the initial phase of MI and helps reduce myocardial oxygen demand.
D. Metoprolol (a beta-blocker) reduces heart rate and myocardial workload but is not primarily for pain and anxiety management.

A. Administer pain medication. B. Clean and dress the wound. C. Administer IV fluids. D. Administer a tetanus booster.

Correct Answer is C

Explanation

A. Pain medication is important but secondary to stabilizing the client’s circulation.
B. Cleaning and dressing the wound is essential but should follow fluid resuscitation in major burns.
C. Administering IV fluids is the priority to prevent hypovolemic shock due to fluid loss from burn injuries.
D. A tetanus booster is important but not the immediate priority in emergency care.

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A nurse is caring for a client who just had a cardiac catheterization. Which of the following nursing interventions should the nurse include in the client's plan of care? (Select all that apply.)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is C

Explanation

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Correct Answer is C

Explanation

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