Your client: Chester Payne
Age: 78 years old

Past medical history. History of persistent atrial fibrillation, hypertension, hyperlipidemia and osteoarthrosis.
Yesterday: Client was admitted for a diagnosis of atrial fibrillation with rapid ventricular response (RVR). Later in the day, the client's heart rhythm was converted to normal sinus rhythm using intravenous medication therapy.
0900 today: Client is sitting up in the bedside recliner. Client reports "racing heartbeat" and feeling "like I can't get a good deep breath" Upon auscultation the nurse hears an irregular heart rhythm.
Assessment is as follows:
Neurological: Alert and oriented x 4
Eyes, Ear, Nose, and Throat (EENT): Normocephalic, denies sore throat, denies nasal congestion, denies vision changes. No swelling or drainage visualized.
Pulmonary: Reports some shortness of breath (SOB), no cough. Lungs sound clear in all fields. Cardiovascular: Irregular heart rhythm auscultated. Denies chest pain. Skin is warm and dry to the touch. Capillary refill > 3 seconds. 2+ bilateral lower extremity edema. Peripheral pulse 1+ equal bilaterally. Jugular vein distention (JVD) is noted
Gastrointestinal: Abdomen rounded and firm. Reports slight nausea, bowel sounds hypoactive x 4 quadrants. Reports bowel movement prior to admission.
Genitourinary: Voiding clear yellow urine without issues as per client self-report.
Musculoskeletal: Full range of motion against resistance.

What is the next action the nurse should take?

The nurse is assessing a client with right-sided heart failure. Which of the following findings should the nurse expect? Select all that apply.

Your client: Chester Payne
Age: 78 years old

Past medical history. History of persistent atrial fibrillation, hypertension, hyperlipidemia and osteoarthrosis.
Yesterday: Client was admitted for a diagnosis of atrial fibrillation with rapid ventricular response (RVR). Later in the day, the client's heart rhythm was converted to normal sinus rhythm using intravenous medication therapy.
0900 today: Client is sitting up in the bedside recliner. Client reports "racing heartbeat" and feeling "like I can't get a good deep breath" Upon auscultation the nurse hears an irregular heart rhythm.
Assessment is as follows:
Neurological: Alert and oriented x 4
Eyes, Ear, Nose, and Throat (EENT): Normocephalic, denies sore throat, denies nasal congestion, denies vision changes. No swelling or drainage visualized.
Pulmonary: Reports some shortness of breath (SOB), no cough. Lungs sound clear in all fields. Cardiovascular: Irregular heart rhythm auscultated. Denies chest pain. Skin is warm and dry to the touch. Capillary refill > 3 seconds. 2+ bilateral lower extremity edema. Peripheral pulse 1+ equal bilaterally. Jugular vein distention (JVD) is noted
Gastrointestinal: Abdomen rounded and firm. Reports slight nausea, bowel sounds hypoactive x 4 quadrants. Reports bowel movement prior to admission.
Genitourinary: Voiding clear yellow urine without issues as per client self-report.
Musculoskeletal: Full range of motion against resistance.
 

The nurse expects the doctor to order what medication(s) for this patient?

Your client was admitted for shortness of breath. A 6 second rhythm strip of their telemetry is seen here. You anticipate that the physician might order what medication to treat this dysrhythmia?

The nurse working at a community health fair is assessing risk factors for hypertension. Which client does the nurse recognize as having the greatest risk factor?

A nurse caring for a client with peripheral arterial insufficiency determined the nursing diagnosis of altered peripheral arterial insufficiency. Which intervention will be most appropriate for the client?

The telemetry monitor alarms for your client. The 6 second rhythm strip is seen here. Your first action is to:

A client is admitted for recurrent peripheral edema. On admission the patient is AAOX3, lungs are clear to auscultations. Heart rate is 88 bmp, regular rate and rhythm. Respiratory rate is 24 breaths per minute. Abdomen is soft non-tender non-distended, last BM was yesterday and was reported by the patient to be soft, normal brown color. Patient has +2 pitting edema of the bilateral hands and bilateral ankles and feet. Blood pressure is 150/82 mmHg. Pulse ox is 88% on 3 liters of oxygen by nasal cannula.
What findings in this assessment require follow-up?

A client is admitted for observation following complaints of intermittent chest pain while mowing the grass. The pain persisted for an hour following the activity. All cardiac labs, electrocardiogram, and radiologic studies were normal and the client was provided nitroglycerin for a new diagnosis of angina pectoris. Discharge education includes information that angina is most often attributable to what cause?

The nurse is assessing a client who reports pain to the left lower extremity, especially while ambulating. The discomfort is relieved with rest. Assessment findings confirm left lower leg mottling and hairlessness. Which health problem will the nurse most likely include in the planning of the client's care?

The LPN is caring for a client who was recently prescribed 20 mg of simvastatin by mouth. Which statement should the nurse include in the client's teaching session?