The nurse is preparing a patient for a cardiac angiogram today.
Which statement by the patient would prompt the nurse to notify the physician immediately?
“I have an allergy to shellfish.”
“I ate dinner yesterday at 5pm.”
“I have not taken my aspirin for one week.”
“I did not take my metformin yesterday.”
“I did not take my metformin yesterday.”
The Correct Answer is C
A rationale:
While a shellfish allergy is important information for the healthcare team to be aware of, it is not directly relevant to the cardiac angiogram procedure itself. Shellfish allergies typically involve reactions to iodine-containing contrast dyes, which are not commonly used in cardiac angiograms. The contrast dye used in cardiac angiograms is usually a gadolinium-based contrast agent, which has a different allergy profile.
It's essential to communicate any allergies to the healthcare team, but this information would not necessarily prompt an immediate notification to the physician in the context of a cardiac angiogram.
Choice B rationale:
The patient's last meal time is relevant for some procedures that require sedation or anesthesia, but it's not typically a major concern for a cardiac angiogram.
Patients are often instructed to have a light meal or snack several hours before the procedure, but an exact fasting time is not always necessary. Unless the physician has specifically ordered a strict fasting period for this patient, the nurse would not need to notify the physician immediately about a meal consumed the previous evening.
Choice C rationale:
This statement is the most concerning and would require immediate notification of the physician. Aspirin is a common antiplatelet medication that helps prevent blood clots. It's often prescribed to patients with heart disease to reduce the risk of heart attack and stroke.
Discontinuing aspirin therapy without medical guidance can increase the risk of blood clots, which could be dangerous during a cardiac angiogram. The procedure involves inserting a catheter into the heart's arteries, and there's a risk of clot formation during this process.
If a patient has not taken their aspirin as prescribed, the physician needs to be aware of this to assess the risks and benefits of proceeding with the angiogram and potentially consider alternative medications or interventions to manage the patient's clotting risk.
Choice D rationale:
Metformin is a medication used to treat type 2 diabetes. While it's important for patients to take their medications as prescribed, missing a single dose of metformin is not typically a major concern in the context of a cardiac angiogram.
The nurse would likely remind the patient to take their metformin as soon as possible, but this would not require immediate notification of the physician.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale:
B-type natriuretic peptide (BNP) is a hormone produced primarily by the ventricles of the heart in response to stretching of the heart muscle fibers. It plays a crucial role in regulating blood volume and pressure by promoting the excretion of sodium and water by the kidneys. Elevated levels of BNP in the blood are strongly suggestive of heart failure, as the heart muscle is working harder to pump blood, leading to increased BNP production.
Key points supporting A as the correct answer:
BNP is a highly sensitive and specific marker for heart failure. Studies have demonstrated its accuracy in diagnosing heart failure, even in early stages when symptoms may be subtle.
The patient's clinical presentation aligns with heart failure. Vital fatigue and shortness of breath are both classic symptoms of heart failure, resulting from the heart's inability to meet the body's demands for oxygenated blood.
Other choices are less likely based on the information provided. Pleurisy (inflammation of the lining of the lungs), cardiomyopathy (disease of the heart muscle), and valve dysfunction can all cause shortness of breath, but they would not typically lead to elevated BNP levels unless heart failure is also present.
Additional considerations:
BNP levels can be influenced by factors other than heart failure, such as age, kidney function, and certain medications. However, in the context of a patient with typical heart failure symptoms, an elevated BNP level strongly supports the diagnosis.
BNP testing is often used to guide treatment decisions in patients with heart failure. Serial BNP measurements can help assess the effectiveness of therapy and monitor for disease progression.
Correct Answer is B
Explanation
Choice A Rationale:
Repolarization is a phase in the cardiac cycle that involves the restoration of electrical charges in heart muscle cells, enabling them to prepare for the next contraction. It does not directly refer to the physical contraction and ejection of blood from the chambers.
During repolarization, the heart muscle cells regain their negative electrical charge after depolarization, which triggered the contraction.
Repolarization is essential for maintaining the heart's rhythmic electrical activity and ensuring coordinated contractions.
It does not, however, cause the chambers to become smaller and eject blood, which is the defining feature of systole.
Choice C Rationale:
Diastole is the phase of the cardiac cycle when the heart chambers relax and fill with blood. It is the opposite of systole.
During diastole, the heart muscle relaxes, allowing the chambers to passively expand and collect blood from the veins.
The atrioventricular valves (mitral and tricuspid valves) open during diastole, allowing blood to flow from the atria into the ventricles.
While diastole is crucial for ensuring adequate blood supply to the heart, it does not involve the forceful ejection of blood into circulation that characterizes systole.
Choice D Rationale:
Ejection fraction is a measurement of the heart's pumping efficiency. It represents the percentage of blood that is ejected from the left ventricle with each contraction.
A normal ejection fraction is typically between 55% and 70%.
While ejection fraction is related to systole, it is not a synonym for it. Ejection fraction is a quantitative measure of how well the heart is pumping, while systole refers to the specific phase of the cardiac cycle when contraction and ejection occur.
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