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Cardiac-Vascular Nursing

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A patient is admitted to the hospital for a carotid angiogram with stent placement. The patient’s spouse states, “I don’t want my spouse to find out there is a risk of a stroke connected with this procedure because he or she won’t sign the consent form.” The cardiac-vascular nurse’s most appropriate action is to:

 assess the patient’s level of understanding of risks, benefits, and alternatives.
 assure the patient’s spouse that the risk of stroke is minimal.
 offer the patient emotional support and reinforce the benefits of the procedure.
 perform a neurologic assessment to establish a baseline.

Cardiac-Vascular Nursing

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A patient who underwent a percutaneous, transluminal coronary angioplasty four weeks ago has a subsequent ejection fraction of 30%. The patient returns for a follow-up visit. Examination reveals lungs that are clear to auscultation and slight pedal edema. The patient’s medications are digoxin (Lanoxin), furosemide (Lasix), enalapril maleate (Vasotec), and aspirin. The patient reports a 5-lb (2.27-kg) weight gain over the past two days. The cardiac-vascular nurse’s initial action is to:

 document the weight and reassess the patient at the next session.
 inquire about the patient’s medication compliance.
 notify the patient’s physician.
 review the patient’s most recent nuclear scan.

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In an assessment for intermittent claudication, the cardiac-vascular nurse assesses for leg pain and cramping with exertion, then asks the patient:

 “Does shortness of breath accompany the leg pain?”
 “Does this same type of pain occur without activity?”
 “Is the leg pain relieved by rest?”
 “Is the leg pain relieved with elevation?”