A nurse cares for a client who is prescribed magnetic resonance ...

[wrbasek0]

A nurse cares for a client who is prescribed magnetic resonance imaging (MRI) of the heart. The client's health history includes a previous myocardial infarction and pacemaker implantation. Which action should the nurse take?
 
  a. Schedule an electrocardiogram just before the MRI.
  b. Notify the health care provider before scheduling the MRI.
  c. Call the physician and request a laboratory draw for cardiac enzymes.
  d. Instruct the client to increase fluid intake the day before the MRI.

Question 2

A nurse assesses a client 2 hours after a cardiac angiography via the left femoral artery. The nurse notes that the left pedal pulse is weak. Which action should the nurse take?
 
  a. Elevate the leg and apply a sandbag to the entrance site.
  b. Increase the flow rate of intravenous fluids.
  c. Assess the color and temperature of the left leg.
  d. Document the finding as left pedal pulse of +1/4.

[GCabra]

Answer to Question 1

ANS: B
The magnetic fields of the MRI can deactivate the pacemaker. The nurse should call the health care provider and report that the client has a pacemaker so the provider can order other diagnostic tests. The client does not need an electrocardiogram, cardiac enzymes, or increased fluids.

Answer to Question 2

ANS: C
Loss of a pulse distal to an angiography entry site is serious, indicating a possible arterial obstruction. The pulse may be faint because of edema. The left pulse should be compared with the right, and pulses should be compared with previous assessments, especially before the procedure. Assessing color (pale, cyanosis) and temperature (cool, cold) will identify a decrease in circulation. Once all peripheral and vascular assessment data are acquired, the primary health care provider should be notified. Simply documenting the findings is inappropriate. The leg should be positioned below the level of the heart or dangling to increase blood flow to the distal portion of the leg. Increasing intravenous fluids will not address the client's problem.

[wrbasek0]

TYSM

[peter]

Thanks for the timely response, appreciate it