A nurse is planning care for a client who has hypertrophic cardiomyopathy that has not improved after pharmacologic treatment. Which of the following procedures should the nurse anticipate the health care provider ordering?
Pericardiocentesis
Septal myectomy
Pericardial window
Synchronized electrical cardioversion
The Correct Answer is B
A. Pericardiocentesis: Pericardiocentesis is a procedure used to drain fluid from the pericardial sac, typically performed in cases of pericardial effusion or cardiac tamponade. It is not indicated for the treatment of hypertrophic cardiomyopathy (HCM), which involves structural abnormalities of the heart muscle rather than pericardial fluid accumulation.
B. Septal myectomy: Septal myectomy is a surgical procedure performed to treat hypertrophic obstructive cardiomyopathy (HOCM), a subtype of hypertrophic cardiomyopathy characterized by thickening of the interventricular septum and dynamic left ventricular outflow tract obstruction. Septal myectomy involves the surgical removal of a portion of the hypertrophied septum to relieve left ventricular outflow tract obstruction and improve symptoms.
C. Pericardial window: A pericardial window is a surgical procedure used to create a communication between the pericardial sac and the pleural space, typically performed in cases of recurrent pericardial effusion or tamponade to prevent fluid re-accumulation. It is not indicated for the treatment of hypertrophic cardiomyopathy.
D. Synchronized electrical cardioversion: Synchronized electrical cardioversion is a procedure used to restore normal sinus rhythm in patients with certain types of cardiac arrhythmias, such as atrial fibrillation or atrial flutter. It is not typically indicated for the treatment of hypertrophic cardiomyopathy, although patients with HCM may develop arrhythmias as a complication.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Comply with compression therapy:
Compression therapy typically refers to the use of compression garments or devices to improve circulation and reduce swelling in the extremities, particularly in conditions such as venous insufficiency or deep vein thrombosis.
While compression therapy may be beneficial for certain circulatory disorders, it is not a standard treatment for cardiac tamponade.
Cardiac tamponade is a medical emergency characterized by the accumulation of fluid in the pericardial sac, leading to increased pressure on the heart and impaired cardiac function.
Treatment for cardiac tamponade involves prompt recognition and intervention to relieve the pressure on the heart, such as pericardiocentesis or surgical drainage of the pericardial effusion.
B. Monitor wounds on lower extremities:
Monitoring wounds on the lower extremities is essential for assessing healing, preventing complications such as infection, and promoting overall wound care.
However, monitoring wounds on the lower extremities is not directly related to the management or monitoring of cardiac tamponade.
In cardiac tamponade, the focus of monitoring is on assessing signs and symptoms of cardiac compromise, such as hypotension, tachycardia, dyspnea, and pulsus paradoxus, rather than wound care.
C. Take antiplatelet medications as ordered:
Antiplatelet medications, such as aspirin or clopidogrel, are commonly prescribed to prevent platelet aggregation and reduce the risk of thrombotic events, particularly in patients with cardiovascular disease or a history of myocardial infarction or stroke.
While antiplatelet medications may be part of the long-term management of certain cardiac conditions, they are not specific to the treatment or monitoring of cardiac tamponade.
The primary treatment for cardiac tamponade involves interventions to relieve the pressure on the heart and restore cardiac function, such as pericardiocentesis or surgical drainage of the pericardial effusion.
D. Monitor for gradual onset of symptoms:
Phase II of cardiac tamponade is characterized by a gradual onset of symptoms as the pressure within the pericardial sac increases, leading to impaired cardiac filling and decreased cardiac output.
Symptoms may include dyspnea, fatigue, orthopnea, tachycardia, and chest discomfort, which may develop gradually over time.
Early recognition of symptoms is crucial for prompt diagnosis and intervention to prevent further deterioration and improve outcomes in patients with cardiac tamponade.
Correct Answer is D
Explanation
A. "Vision changes occur when blood vessels leak fluid or blood under a portion of the retina": This statement describes a symptom of diabetic retinopathy, not open-angle glaucoma. In open-angle glaucoma, vision changes primarily result from increased intraocular pressure (IOP) due to impaired drainage of aqueous humor, not leakage of fluid or blood under the retina.
B. "Vision changes occur when the cloudy lens alters the passage of light through the eye": This statement describes a symptom of cataracts, not open-angle glaucoma. Cataracts involve clouding of the lens inside the eye, which affects the passage of light and leads to visual disturbances. Open-angle glaucoma, however, primarily affects the optic nerve and visual field due to increased intraocular pressure.
C. "Vision changes occur when retinal tissue pulls away from the blood vessels in the eye": This statement describes a symptom of retinal detachment, not open-angle glaucoma. Retinal detachment occurs when the retina detaches from the underlying layers of the eye, leading to vision changes and potentially vision loss. Open-angle glaucoma, on the other hand, primarily involves increased intraocular pressure and optic nerve damage.
D. "Vision changes occur when pressure in the eye is increased due to a decrease of aqueous humor": This statement is accurate. In open-angle glaucoma, vision changes occur due to increased intraocular pressure resulting from inadequate drainage of aqueous humor from the eye. This increased pressure can lead to damage of the optic nerve, resulting in peripheral vision loss and potentially blindness if left untreated.
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