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Author Question: A patient who has chronic heart failure tells the nurse, I was fine when I went to bed, but I woke ... (Read 103 times)

darbym82

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A patient who has chronic heart failure tells the nurse, I was fine when I went to bed, but I woke up in the middle of the night feeling like I was suffocating The nurse will document this assessment finding as
 
  a. orthopnea.
  b. pulsus alternans.
  c. paroxysmal nocturnal dyspnea.
  d. acute bilateral pleural effusion.

Question 2

IV sodium nitroprusside (Nipride) is ordered for a patient with acute pulmonary edema. During the first hours of administration, the nurse will need to titrate the nitroprusside rate if the patient develops
 
  a. ventricular ectopy.
  b. a dry, hacking cough.
  c. a systolic BP <90 mm hg.
  d. a heart rate <50 beats>



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Eazy416

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Answer to Question 1

ANS: C
Paroxysmal nocturnal dyspnea is caused by the reabsorption of fluid from dependent body areas when the patient is sleeping and is characterized by waking up suddenly with the feeling of suffocation. Pulsus alternans is the alternation of strong and weak peripheral pulses during palpation. Orthopnea indicates that the patient is unable to lie flat because of dyspnea. Pleural effusions develop over a longer time period.

Answer to Question 2

ANS: C
Sodium nitroprusside is a potent vasodilator, and the major adverse effect is severe hypotension. Coughing and bradycardia are not adverse effects of this medication. Nitroprusside does not cause increased ventricular ectopy.





 

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