Author Question: A patient with idiopathic pulmonary arterial hypertension (IPAH) is receiving nifedipine ... (Read 107 times)

bobbie · **on:** Jun 25, 2018

A patient with idiopathic pulmonary arterial hypertension (IPAH) is receiving nifedipine (Procardia). Which assessment would best indicate to the nurse that the patient's condition is improving?

a. Blood pressure (BP) is less than 140/90 mm Hg.
b. Patient reports decreased exertional dyspnea.
c. Heart rate is between 60 and 100 beats/minute.
d. Patient's chest x-ray indicates clear lung fields.

Question 2

The nurse administers prescribed therapies for a patient with cor pulmonale and right-sided heart failure. Which assessment would best evaluate the effectiveness of the therapies?

a. Observe for distended neck veins.
b. Auscultate for crackles in the lungs.
c. Palpate for heaves or thrills over the heart.
d. Review hemoglobin and hematocrit values.

ryrychapman11 · **Reply #1 on:** Jun 25, 2018

Answer to Question 1

ANS: B
Because a major symptom of IPAH is exertional dyspnea, an improvement in this symptom would indicate that the medication was effective. Nifedipine will affect BP and heart rate, but these parameters would not be used to monitor the effectiveness of therapy for a patient with IPAH. The chest x-ray will show clear lung fields even if the therapy is not effective.

Answer to Question 2

ANS: A
Cor pulmonale is right ventricular failure caused by pulmonary hypertension, so clinical manifestations of right ventricular failure such as peripheral edema, jugular venous distention, and right upper-quadrant abdominal tenderness would be expected. Crackles in the lungs are likely to be heard with left-sided heart failure. Findings in cor pulmonale include evidence of right ventricular hypertrophy on electrocardiogram ECG and an increase in intensity of the second heart sound. Heaves or thrills are not common with cor pulmonale. Chronic hypoxemia leads to polycythemia and increased total blood volume and viscosity of the blood. The hemoglobin and hematocrit values are more likely to be elevated with cor pulmonale than decreased.