The nurse is assessing a client's cardiovascular status within the comprehensive health history. What should the nurse include in this section of the assessment? (Select all that apply.)
Blood pressure pattern
Dyspnea
Vision Acuity
Peripheral Edema
Constipation
Correct Answer : A,B,D
A. Blood pressure pattern: Blood pressure patterns are crucial for assessing cardiovascular health as they indicate potential issues like hypertension or hypotension, which are related to heart function.
B. Dyspnea: Dyspnea (difficulty breathing) is important in a cardiovascular assessment as it can be a sign of heart failure or other cardiac conditions affecting respiratory function.
C. Vision Acuity: While vision acuity is important for overall health, it is not directly related to cardiovascular assessment and does not provide information about heart or vascular health.
D. Peripheral Edema: Peripheral edema (swelling in the limbs) can be a sign of heart failure or other circulatory problems, making it relevant for cardiovascular assessment.
E. Constipation: Although constipation can affect overall health, it is not typically included in a cardiovascular assessment as it does not provide direct information about cardiovascular status.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. "When was the last time you experienced a fever?": This question pertains to the assessment of body temperature, which is part of the vital signs but not the "fifth vital sign."
B. "Do you consider yourself a happy person?": This question focuses on emotional well-being, not the "fifth vital sign."
C. "Do you monitor your blood pressure regularly?": This pertains to blood pressure monitoring, which is one of the vital signs but not the "fifth vital sign."
D. "Are you experiencing any pain right now?": Pain is often referred to as the "fifth vital sign" and is assessed to understand a patient's overall health and comfort.
Correct Answer is C
Explanation
Rationale:
A. Fever: While fever might be a symptom of infection, it is not specific to inner ear infections.
B. Headache: This can be a symptom associated with inner ear infections, but vertigo is a more specific concern.
C. Vertigo: Inner ear infections often cause vertigo (dizziness or spinning sensations), so interventions for managing vertigo are crucial.
D. Rhinorrhea: This symptom is more commonly associated with upper respiratory infections rather than inner ear infections.
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