A nurse cares for a client who has an 80 blockage of the right ...

[bobthebuilder]

A nurse cares for a client who has an 80 blockage of the right coronary artery (RCA) and is scheduled for bypass surgery. Which intervention should the nurse be prepared to implement while this client waits for surgery?
 
  a. Administration of IV furosemide (Lasix)
  b. Initiation of an external pacemaker
  c. Assistance with endotracheal intubation
  d. Placement of central venous access

Question 2

A nurse assesses a client who is recovering from a myocardial infarction. The client's pulmonary artery pressure reading is 25/12 mm Hg. Which action should the nurse take first?
 
  a. Compare the results with previous pulmonary artery pressure readings.
  b. Increase the intravenous fluid rate because these readings are low.
  c. Immediately notify the health care provider of the elevated pressures.
  d. Document the finding in the client's chart as the only action.

[ambernicolefink]

Answer to Question 1

ANS: B
The RCA supplies the right atrium, the right ventricle, the inferior portion of the left ventricle, and the atrioventricular (AV) node. It also supplies the sinoatrial node in 50 of people. If the client totally occludes the RCA, the AV node would not function and the client would go into heart block, so emergency pacing should be available for the client. Furosemide, intubation, and central venous access will not address the primary complication of RCA occlusion, which is AV node malfunction.

Answer to Question 2

ANS: A
Normal pulmonary artery pressures range from 15 to 26 mm Hg for systolic and from 5 to 15 mm Hg for diastolic. Although this client's readings are within normal limits, the nurse needs to assess any trends that may indicate a need for medical treatment to prevent complications. There is no need to increase intravenous fluids or notify the provider.