The standard policy on the cardiac unit states, “Notify the health care provider for mean arterial pressure (MAP) less than 70 mm Hg.”. Which patient should the nurse call the health care provider about?
Newly admitted patient with a BP of 150/87 mm Hg.
Patient with left ventricular failure who has a BP of 110/70 mm Hg.
Postoperative patient with a BP of 116/42 mm Hg.
Patient with a myocardial infarction who has a BP of 140/86 mm Hg.
The Correct Answer is C
The patient with a blood pressure of 116/42 mm Hg has a mean arterial pressure (MAP) of approximately 67 mm Hg, which is less than the standard policy of 70 mm Hg. This could indicate inadequate blood flow to the vital organs, necessitating notification of the healthcare provider.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale
While it’s important to inquire about an allergy to iodine in a patient who has undergone an angiogram, it’s not typically the priority for assessing and documenting for this patient after the procedure. An allergy to iodine would be more relevant before the procedure, as iodine-based contrast dye is often used during an angiogram.
Choice B rationale
Checking peripheral pulses in the affected leg is typically a priority when caring for a patient who has undergone an angiogram. This is because the procedure involves inserting a catheter into a blood vessel in the leg. Checking the peripheral pulses can help assess for potential complications such as a blood clot or decreased blood flow to the leg.
Choice C rationale
Monitoring for decreased blood pressure is important in a patient who has undergone an angiogram, but it’s not typically the priority for assessing and documenting for this patient after the procedure. While changes in blood pressure can occur after any medical procedure, other assessments such as checking peripheral pulses in the affected leg are typically more directly related to potential complications of an angiogram.
Choice D rationale
Tracking fluid intake is an important part of overall patient care, but it’s not typically the priority for assessing and documenting for a patient who has undergone an angiogram. Other assessments such as checking peripheral pulses in the affected leg are typically more directly related to potential complications of an angiogram.
Correct Answer is B
Explanation
Choice A rationale
Calcium channel blockers are primarily used to treat hypertension, angina, and certain heart arrhythmias. They work by relaxing the muscles of your heart and blood vessels. While they can affect heart rate and blood pressure, they would not typically have immediate implications for a patient presenting with intermittent chest pain.
Choice B rationale
Phosphodiesterase 5 enzyme inhibitors, such as sildenafil (Viagra), are used to treat erectile dysfunction and pulmonary arterial hypertension. These medications can interact with nitroglycerin, a common medication used to treat chest pain, to cause a severe and life-threatening drop in blood pressure. Therefore, it’s crucial to know if a patient is taking this type of medication when they present with chest pain.
Choice C rationale
Anticoagulants are used to prevent blood clots. If a patient is taking an anticoagulant, it could affect their clotting times and could be important if the patient needs surgery or if the cause of their chest pain is a clot. However, this would not typically have immediate implications for the treatment of chest pain.
Choice D rationale
Loop diuretics are strong diuretics that are used to treat edema and hypertension. They work by preventing your body from absorbing too much salt, allowing the salt to instead be passed in your urine. While important to know for overall patient care, they would not typically have immediate implications for a patient presenting with chest pain.
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