IGGY CH 35 - CARDIOMYOPATHY

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IGGY CH 35 - CARDIOMYOPATHY

32 terms Lip_GallagherPreview Cardiomyopathy (MNL) 12 terms holly_brock5Preview Chapte 15 terms sier An older client is diagnosed with dilated cardiomyopathy. What will the nurse most likely assess in this client?Select all that apply.

• Fatigue
• Lower extremity edema
• Syncope
• Dyspnea
• Jugular vein distention

Answer: A, B, D, E

Explanation: A) Clinical manifestations of dilated cardiomyopathy include fatigue, lower extremity edema, shortness of breath or dyspnea, and jugular vein distention. Disorders of the heart valve, arrhythmias, and blood clots may occur with disease progression. Syncope is not a manifestation of dilated cardiomyopathy.A client tells the nurse that he knows he has high blood pressure but does not want to take any medication. Which health problem is the client at risk of developing?

• Gastritis
• Diabetes
• Cardiomyopathy
• Metabolic syndrome

Answer: C

Explanation: C) Hypertension places the client at risk for development of cardiomyopathy. Hypertension has not been associated with metabolic syndrome, diabetes, or gastritis.

An older client diagnosed with cardiomyopathy reports having to rest between activities during the day. What should the nurse realize is the reason for this client's fatigue?

• Increased stroke volume
• Decreased cardiac output
• An elongated and dilated aorta
• Increased blood pressure

Answer: B

Explanation: B) Decreased cardiac output is a result of decreased efficiency and contractibility of the myocardium. Rest could be required after each activity that puts physiological stress on the heart. Less blood is pumped from the heart to the rest of the body with a decreased cardiac output, and this has a direct effect on the activity level that can be tolerated. It is unknown if the client has high blood pressure, an elongated and dilated aorta, or increased stroke volume.A client admitted with the diagnosis of cardiomyopathy becomes short of breath with ambulation and eating, and fatigued with routine care activities. The nurse would identify which of the following nursing diagnoses as being appropriate for this client?

A) Imbalanced Nutrition: Less than Body Requirements

• Deficient Knowledge
• Activity Intolerance
• Self-Care Deficit

Answer: C

Explanation: C) The client is short of breath with ambulation and eating, and fatigued with routine care activities. The nursing diagnosis of Activity Intolerance is appropriate for the client at this time. There is not enough information to determine if the client has a knowledge deficit. Shortness of breath with meals does not indicate that the client has Imbalanced Nutrition. Fatigue with routine care activities does not necessarily mean that the client has a Self-Care Deficit.The nurse identifies the diagnosis of Excess Fluid Volume as appropriate for a client with cardiomyopathy. Which interventions should the nurse emphasize when planning this client's care?Select all that apply.

• Monitor brain natriuretic peptide (BNP) level.
• Provide oxygen as prescribed.
• Assess respiratory status and lung sounds every 4 hours and as needed.
• Provide information about activity upon discharge.
• Monitor intake and output.

Answer: C, E

Explanation: C) Interventions appropriate for the nursing diagnosis of Excess Fluid Volume include assessing respiratory status and lung sounds every 4 hours and as needed and monitoring intake and output. Providing oxygen and monitoring BNP level are interventions appropriate for the diagnosis of Decreased Cardiac Output. Providing information about activity upon discharge would be appropriate for the nursing diagnosis of Activity Intolerance.

A client diagnosed with cardiomyopathy is being discharged to home. What client statement indicates discharge teaching has been effective?

• "I will exercise as much as possible, regardless of feeling weak and short of breath."
• "My pants getting tight around the waist, means I'm eating too much and should cut back on food."
• "I will eat foods containing sodium only if drinking water with them."
• "I will see the physician to discuss implanting a cardiac defibrillator next week."

Answer: D

Explanation: D) Evidence that discharge instruction is effective for a client with cardiomyopathy would be the statement "I will see the physician to discuss implanting a cardiac defibrillator next week," as sudden cardiac death can occur with this medical diagnosis. The other client statements would indicate that discharge teaching was not effective and the client needs additional instruction and follow-up.The nurse is preparing teaching for a client with hypertrophic cardiomyopathy. For which medication classification should the nurse prepare to instruct this client?

• Digitalis
• Vasodilators
• Nitrates
• Beta blocker

Answer: D

Explanation: D) Beta blockers are the drugs of choice to reduce anginal symptoms and syncopal episodes associated with hypertrophic cardiomyopathy. Vasodilators, digitalis, and nitrates are contraindicated for the client with hypertrophic cardiomyopathy.A client with cardiomyopathy receiving diuretic therapy has a urine output of 300 cc in 8 hours. What should the nurse do to assist this client?

• Assist the client to ambulate.
• This is a normal urine output and the client does not need anything.
• Notify the physician, as the client could be dehydrated.
• Measure abdominal girth as a true assessment of the client's fluid status.

Answer: C

Explanation: C) The nurse should notify the physician, because a urine output of 300 cc in 8 hours is less than 30 cc per hour. The client could be dehydrated despite having peripheral edema. This is not a normal urine output. The nurse should not assist the client out of bed to ambulate at this time. Daily weights are an objective measurement of fluid volume and not abdominal girth.A client diagnosed with cardiomyopathy asks the nurse to explain the different types of the disease. The nurse will include all except:

• Dilated.
• Restrictive.
• Hypotrophic.
• Arrythmogenic right ventricular.

Answer: C

Explanation: C) The types of cardiomyopathy include dilated, restrictive, hypertrophic, arrythmogenic right ventricular, and unclassified.

A client with cardiomyopathy is experiencing tachycardia. Which medication order does the client's nurse anticipate?

• ACE Inhibitor
• Angiotensin II receptor blocker
• Beta blocker
• Cardiac glycoside

Answer: C

Explanation: C) A client with cardiomyopathy experiencing tachycardia may take a beta blocker to lower the heart rate. ACE inhibitors and angiotensin II blockers are used to decrease blood pressure in a client with cardiomyopathy. Cardiac glycosides are used in congestive heart failure and do not assist in lowering the heart rate in a client with cardiomyopathy.A nurse is caring for a client with cardiomyopathy who has a nursing diagnosis of Activity Intolerance. The nurse plans all interventions except:

• Spacing out nursing activities so client fatigue is lessened.
• Assisting with client ADLs as necessary.
• Using passive and active range-of-motion (ROM) exercises as tolerated.
• Consulting with a physical therapist on an activity plan.

Answer: A

Explanation: A) The client who is experiencing activity intolerance should have nursing interventions implemented that encourage and preserve client energy. Assisting the client with ADLs, utilizing ROM exercises, and consulting with physical therapy are all interventions which support this nursing diagnosis. The nurse should cluster nursing activities, not space them out, in order to conserve client energy.A nurse is educating a client with cardiomyopathy about diet choices which are appropriate for the client's condition. The nurse will include all

statements except:

• "It is important to monitor your sodium intake."
• "Increasing your dietary protein helps with cardiac cell repair."
• "Here is a list of high-fat, high-cholesterol foods to avoid."
• "I have notified the dietitian regarding your condition in order to provide you with more information."

Answer: B

Explanation: B) Diet is an important part of long-term management of heart failure. It also contributes to reducing fluid retention. The nurse will instruct the client with cardiomyopathy to monitor sodium intake and to avoid high-fat, high-cholesterol food. Instructing the client to increase protein is not appropriate and is not shown effective in managing cardiomyopathy. Consulting with the dietitian is appropriate with this client. Terms (12) Hide definitions