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 D

Explanation

A. Check for orthostatic hypotension. While important, checking for orthostatic hypotension is not the priority action in a hypertensive emergency, where rapid blood pressure reduction is necessary.

B. Assist the client to make lifestyle changes. Assisting the client with lifestyle changes is part of long-term blood pressure management but is not a priority action when administering nicardipine for acute hypertension.

C. Instruct the client to restrict sodium intake. Sodium restriction is a key component of managing hypertension but is not the priority action during an acute hypertensive crisis.

D. Monitor the client's BP every 5 minutes. In a hypertensive crisis, frequent monitoring of the client’s blood pressure is essential to ensure the medication is lowering blood pressure safely and effectively.

A. "I will sit on the side of the bed before I stand up." B. "I should weigh myself on the same day once a week." C. "I should expect to develop a slight cough while taking this medication." D. "I will not take my medicine if my heart rate is greater than 70/min."

Correct Answer is A

Explanation

A. "I will sit on the side of the bed before I stand up." Propranolol can cause orthostatic hypotension, so the client should sit on the edge of the bed before standing to avoid dizziness or falls. This statement shows correct understanding.

B. "I should weigh myself on the same day once a week." Clients taking propranolol, especially if they have heart failure, should weigh themselves daily to monitor for fluid retention. Weekly weighing is insufficient for identifying early signs of worsening heart failure.

C. "I should expect to develop a slight cough while taking this medication." A cough is more commonly associated with ACE inhibitors (such as lisinopril) rather than beta-blockers like propranolol. This statement indicates a misunderstanding.

D. "I will not take my medicine if my heart rate is greater than 70/min." Beta-blockers like propranolol are typically withheld if the heart rate is below 60 beats per minute, not when it is greater than 70. This statement shows a misunderstanding of when to hold the medication.

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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?

Nursing Test Bank

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