The patient's admitting 12-lead ECG shows peaked P waves. Which of the following admitting diagnoses could be responsible for this finding?
a. Mitral stenosis
b. Pulmonary edema
c. Ischemia
d. Pericarditis
B
Tall, peaked P waves occur in right atrial hypertrophy and are referred to as P pulmonale because this condition is often the result of chronic pulmonary disease. Ischemia occurs when the delivery of oxygen to the tissues is insufficient to meet metabolic demand. Cardiac ischemia in an unstable form occurs because of a sudden decrease in supply, such as when the artery is blocked by a thrombus or when coronary artery spasm occurs. If the pulmonary edema is caused by heart failure, sometimes described as hydrostatic pulmonary edema, the fluid may be in a "bat-wing" distribution, with the white areas concentrated in the hilar region (origin of the major pulmonary vessels). However, as the heart failure progresses, the quantity of fluid in the alveolar spaces increases, and the white, fluffy appearance is seen throughout the lung. Pericarditis is inflammation of the sac around the heart.
You might also like to view...
A child is being discharged from the hospital after a three-week stay following a motor vehicle collision. The mother expresses concern about caring for the child's wounds at home
She has demonstrated appropriate technique with medication administration and wound care. The priority nursing diagnosis is: 1. Knowledge Deficient related to home care. 2. Family Processes, Altered related to hospitalization. 3. Parental Anxiety related to care of the child at home. 4. Infection, risk for related to presence of healing wounds.
Which is a true statement about tuberculosis (TB) in older adults?
a. The principal threat from tuberculosis is its highly contagious nature. b. The tuberculin purified protein derivative (PPD) test is a conclusive test for TB. c. Antimicrobial drugs have made tuberculosis a thing of the past. d. Older persons, particularly those in nursing homes, are at risk for tuberculosis.
The Glasgow coma scale is a screening tool used to assess level of consciousness in three major areas. They are
a. verbal, sensation, motor. b. eye, motor, verbal. c. verbal, pain, reflexes. d. eye, pain, verbal.
What is the most appropriate initial nursing intervention, which promotes stress reduction and healthy coping in a patient who is diagnosed with a dissociative disorder?
1. Encourage the patient to increase contact with friends and family. 2. Disregard the patient's other personalities. 3. Help the patient create distance from family members who do not believe the patient is sick. 4. Determine patient's level of safety and encourage the patient to recognize triggers.