An 88-year-old patient with heart failure has progressed to Stage D and is hospitalized for the third time in a month. The nurse will expect to discuss which topic with the patient's family?
a. Antidysrhythmic medications
b. End-of-life care
c. Heart transplantation
d. Implantable mechanical assist devices
B
Patients in Stage D heart failure have advanced structural heart disease. For eligible patients, the best long-term solution is heart transplantation, but this patient probably is not eligible, given his advanced age. End-of-life care should be discussed. Antidysrhythmic medications are not indi-cated and may make symptoms worse. An implantable mechanical assist device is used in pa-tients awaiting heart transplantation.
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A novice nurse trying actively to create a nursing identity and synthesize role into self-image formulates a personal view of praxis that includes (Select all that apply.)
a. a broader understanding of nursing. b. both reflection and specific actions. c. caring for others as a central theme. d. nursing as both an art and a science. e. performing skills without supervision.
An appropriate nursing diagnosis for a patient with hyperparathyroidism would be:
1. Impaired urinary elimination related to urinary calculi. 2. Decreased cardiac output related to heart failure secondary to hypocalcemia. 3. Risk for injury related to hypocalcemia leading to muscle spasms and convulsions. 4. Imbalanced nutrition: greater than body requirements related to increased appe-tite.
The nurse obtains a rhythm strip on a patient who has had a myocardial infarction and makes the following analysis:
no visible P waves, P-R interval not measurable, ventricular rate 162, R-R interval regular, and QRS complex wide and distorted, QRS duration 0.18 second. The nurse interprets the patient's cardiac rhythm as a. atrial flutter. b. sinus tachycardia. c. ventricular fibrillation. d. ventricular tachycardia.
The spouse of a client referred to hospice care asks why the client needs the change in services. How should the nurse respond to this question?
1. "So we can see if there's any way to improve your spouse's life." 2. "There is no need for acute care any longer." 3. "It's best for your spouse to be cared for at home." 4. "Hospice care is cheaper than acute care."