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 C
Explanation
Choice A rationale:
Metoprolol (Lopressor) is a beta-blocker that primarily affects the heart and blood vessels. It does not have a direct effect on the visual system, and therefore, it is not associated with the green-yellow halo symptom.
Common side effects of metoprolol include:
Fatigue
Bradycardia (slow heart rate)
Hypotension (low blood pressure)
Dizziness
Cold extremities
Bronchospasm (narrowing of the airways)
Diarrhea
Tinnitus (ringing in the ears)
Decreased exercise tolerance
Glucose intolerance
Masking of hypoglycemia symptoms Choice B rationale:
Enalapril (Vasotec) is an angiotensin-converting enzyme (ACE) inhibitor that primarily affects the kidneys and blood vessels. It does not have a direct effect on the visual system, and therefore, it is not associated with the green-yellow halo symptom.
The most common side effect of enalapril is a dry cough. This cough is thought to be caused by an increase in bradykinin levels, which can lead to the constriction of bronchial smooth muscle.
Choice D rationale:
Furosemide (Lasix) is a loop diuretic that primarily affects the kidneys and fluid balance. It does not have a direct effect on the visual system, and therefore, it is not associated with the green-yellow halo symptom.
Toxicity with furosemide manifests as extensions of its diuretic activity. Signs and symptoms of overdose or toxicity include:
Dehydration
Reduced blood volume
Electrolyte imbalances, particularly hypokalemia (low potassium levels) Choice C rationale:
Digoxin (Lanoxin) is a cardiac glycoside that affects the heart's electrical activity and muscle contractions. It has a narrow therapeutic index, meaning that there is a small difference between the therapeutic dose and the toxic dose.
One of the most characteristic signs of digoxin toxicity is a visual disturbance known as the "green-yellow halo sign." This symptom is thought to be caused by the inhibition of an enzyme in the retina called Na+/K+-ATPase.
Other common signs and symptoms of digoxin toxicity include:
Nausea and vomiting
Anorexia (loss of appetite)
Fatigue
Headache
Confusion
Arrhythmias (irregular heartbeats)
Correct Answer is A
Explanation
Choice A rationale:
Systole is derived from the Greek word "sustolē," meaning "contraction." This etymology directly aligns with the physiological process it describes.
During systole, the heart muscle contracts forcefully, generating the pressure necessary to propel blood out of the heart's chambers and into the circulatory system.
This phase is crucial for ensuring adequate blood flow to all tissues and organs, delivering oxygen and nutrients and removing waste products.
It's initiated by electrical signals generated by the sinoatrial node (SA node), the heart's natural pacemaker.
The electrical impulse travels through the heart's conduction system, triggering a coordinated contraction of the atria and ventricles.
Atrial systole occurs first, contributing to ventricular filling.
Ventricular systole follows, generating the powerful force that propels blood into the pulmonary artery (from the right ventricle) and the aorta (from the left ventricle).
Systolic blood pressure, the higher number in a blood pressure reading, measures the pressure in the arteries during ventricular systole.
Choice B rationale:
This choice describes diastole, the opposite phase of the cardiac cycle.
During diastole, the heart muscle relaxes, allowing the chambers to refill with blood.
Diastole is essential for proper heart function, ensuring that the heart can adequately fill with blood before the next systolic contraction.
Choice C rationale:
This choice refers to cardiac output, which is the total volume of blood pumped by the heart per minute.
Cardiac output is influenced by both heart rate and stroke volume (the amount of blood ejected from the ventricle with each contraction). Choice D rationale:
This choice describes ejection fraction, which is the percentage of blood that fills the ventricles during diastole that is then pumped out during systole.
Ejection fraction is a measure of the heart's pumping efficiency.
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