A client has undergone a right femoral cardiac catheterization. What nursing action is the priority following the procedure?

Complete a neurovascular check of the affected extremity.

Perform passive range of motion.

Assess the gag reflex prior to feeding the client.

Keep the client in high Fowler's position.

Answer and Explanation

The Correct Answer is A

A. Complete a neurovascular check of the affected extremity: Neurovascular assessment ensures that blood flow and nerve function are intact post-procedure. Complications such as arterial occlusion or hematoma can cause ischemia or nerve damage, making this the priority.

B. Perform passive range of motion: This is not a priority and may not be appropriate immediately post-catheterization as movement of the extremity can increase the risk of bleeding.

C. Assess the gag reflex prior to feeding the client: This applies to clients recovering from sedation during procedures like endoscopy, not cardiac catheterization.

D. Keep the client in high Fowler's position: This is contraindicated post-cardiac catheterization, as elevating the head too much can increase pressure at the puncture site and lead to bleeding.

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Correct Answer is D

Explanation

A. The client's blood pressure has decreased since the last visit. Decreased blood pressure is not a typical early sign of mitral valve stenosis.

B. The client's liver is enlarged and the abdomen is edematous. These are signs of more advanced heart failure, which can result from mitral valve stenosis but are not early indicators.

C. The client has jugular vein distention and 3+ pedal edema. Jugular vein distention and pedal edema are later signs of heart failure caused by mitral valve stenosis, not early signs.

D. The client complains of shortness of breath when walking. Shortness of breath on exertion is an early sign of mitral valve stenosis as the left atrium is unable to effectively pump blood into the left ventricle, leading to pulmonary congestion and difficulty breathing.

A. First degree heart block B. Second degree heart block C. Bundle branch block D. Sinus arrhythmia

Correct Answer is A

Explanation

A. First-degree heart block: A prolonged PR interval greater than 0.20 seconds, as seen in this case, indicates first-degree heart block, which is a delay in conduction at the AV node.

B. Second-degree heart block. Second-degree heart block is characterized by some PR intervals being prolonged with occasional dropped beats (non-conducted P waves).

C. Bundle branch block. Bundle branch block causes a wide QRS complex (greater than 0.12 seconds), which is not seen here.

D. Sinus arrhythmia. Sinus arrhythmia involves changes in heart rate due to respiratory cycles, not prolonged PR intervals.

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A client has undergone a right femoral cardiac catheterization. What nursing action is the priority following the procedure?

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