A nurse is assisting with the plan of care for a client immediately following a cardiac catheterization with coronary angiography. An arterial closure device was used to close the access site. Which of the following interventions should the nurse recommend?

Elevate the head of the bed 45 degrees.

Limit fluid intake for 4 hr after the procedure.

Have the client rest in bed for 2 hr.

Insert an indwelling urinary catheter 1 hr post procedure.

Answer and Explanation

The Correct Answer is C

A. Elevate the head of the bed 45 degrees. The head of the bed should not be elevated this high, as this can increase pressure on the arterial access site, risking bleeding or disruption of the closure device.

B. Limit fluid intake for 4 hr after the procedure. Fluids should actually be encouraged to help flush out contrast dye used during the procedure and to maintain hydration. Limiting fluids could increase the risk of renal complications.

C. Have the client rest in bed for 2 hr. Bed rest is typically required after cardiac catheterization, especially with the use of an arterial closure device. Two hours is a reasonable time for initial bed rest following the procedure.

D. Insert an indwelling urinary catheter 1 hr post procedure. A urinary catheter is not routinely required after a cardiac catheterization unless there are specific medical indications.

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Correct Answer is B

Explanation

A. 108/60 mm Hg: This is considered normal blood pressure and does not indicate hypertension.

B. 134/86 mm Hg: According to the current guidelines, stage 1 hypertension is defined as systolic 130-139 mm Hg or diastolic 80-89 mm Hg. This client's blood pressure falls into that category.

C. 164/104 mm Hg: This is classified as stage 2 hypertension, which is defined by systolic BP ≥ 140 mm Hg or diastolic BP ≥ 90 mm Hg.

D. 128/68 mm Hg: This is considered elevated blood pressure, not stage 1 hypertension. Stage 1 begins at systolic BP of 130 mm Hg.

A. Aim for a total cholesterol at 225 mg/dL. B. Maintain blood pressure at less than 140/90 mm Hg. C. Limit total fat intake to 50% of total daily calories. D. Keep body mass index (BMI) above 30.

Correct Answer is C

Explanation

A. Aim for a total cholesterol at 225 mg/dL. A total cholesterol level of 225 mg/dL is higher than the recommended target, which is typically less than 200 mg/dL. This is not an appropriate treatment goal.

B. Maintain blood pressure at less than 140/90 mm Hg. This is a reasonable goal for many clients with atherosclerosis. Keeping blood pressure below 140/90 mm Hg helps reduce the risk of further vascular damage.

C. Limit total fat intake to 50% of total daily calories. Limiting fat intake to 50% of total daily calories is excessive. The recommendation is usually around 25-35% of total daily calories from fat, with a focus on healthy fats.

D. Keep body mass index (BMI) above 30. A BMI above 30 is classified as obese, which is a risk factor for atherosclerosis. The goal is to reduce BMI to within a healthy range (18.5-24.9).

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A nurse is assisting with the plan of care for a client immediately following a cardiac catheterization with coronary angiography. An arterial closure device was used to close the access site. Which of the following interventions should the nurse recommend?

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