A nurse is providing care for a group of clients who have coronary artery disease who are all scheduled for coronary artery bypass grafts (CABG). Which of the following clients is at the highest risk for complications following the surgical procedure?

A client who has coronary artery disease (CAD) and Bell's palsy

A client who has coronary artery disease (CAD) and chronic diverticulitis

A client who has coronary artery disease (CAD) and chronic allergies

A client who has coronary artery disease (CAD) and chronic obstructive pulmonary disease (COPD)

Answer and Explanation

The Correct Answer is D

A. A client who has coronary artery disease (CAD) and Bell's palsy: Bell's palsy, a condition characterized by sudden, temporary weakness or paralysis of the facial muscles, does not directly increase the risk of complications following CABG surgery. While Bell's palsy may affect facial muscle function, it typically does not impact respiratory function or cardiovascular stability during surgery.

B. A client who has coronary artery disease (CAD) and chronic diverticulitis: Chronic diverticulitis, inflammation or infection of the diverticula in the colon, is not directly related to increased risk for complications following CABG surgery. While diverticulitis may require medical management and dietary modifications, it does not typically affect cardiovascular or respiratory function during surgery.

C. A client who has coronary artery disease (CAD) and chronic allergies: Chronic allergies, while they may cause respiratory symptoms such as nasal congestion or rhinitis, are not typically associated with increased risk for complications following CABG surgery. Allergies alone are unlikely to significantly impact cardiovascular stability or respiratory function during surgery compared to conditions such as COPD.

D. A client who has coronary artery disease (CAD) and chronic obstructive pulmonary disease (COPD): A client with CAD and COPD is at the highest risk for complications following coronary artery bypass graft (CABG) surgery. COPD is a chronic respiratory condition characterized by airflow limitation and increased airway resistance, often accompanied by emphysema and chronic bronchitis. These respiratory impairments can significantly impact the client's ability to tolerate anesthesia, mechanical ventilation, and postoperative respiratory function. COPD increases the risk of complications such as atelectasis, pneumonia, exacerbation of COPD, and respiratory failure following CABG surgery.

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Correct Answer is ["D","E"]

Explanation

A. Diabetes mellitus: An inverse association between diabetes mellitus (DM) and abdominal aortic aneurysm (AAA) risk hasbeen reported. Apart from a lower AAA prevalence among patients with vsthose without DM, there isdata showing that DM may exert a protective role on aneurysmal growth in patients with small AAAs, thus decreasing the risk of rupture. As atherosclerosis has almost the same risk factors as aneurysms, the decreased AAA prevalence in patients with DM may indicate that atherosclerosis is an associated feature and not a cause of the aneurysms.

B. Total cholesterol 170 mg/dL (less than 200 mg/dL): While elevated total cholesterol is a risk factor for cardiovascular disease, it is not specifically listed as a risk factor for abdominal aortic aneurysm (AAA). However, dyslipidemia, including elevated total cholesterol levels, can contribute to the development of atherosclerosis, which is a risk factor for AAA.

C. HDL cholesterol 65 mg/dL (male greater than 45 mg/dL; female greater than 55 mg/dL): High-density lipoprotein (HDL) cholesterol levels greater than 65 mg/dL are not listed as a risk factor for abdominal aortic aneurysm (AAA). However, low levels of HDL cholesterol are associated with an increased risk of cardiovascular disease, which may indirectly contribute to the development of AAA through the promotion of atherosclerosis.

D. Smoking cigarettes: Smoking cigarettes is a significant modifiable risk factor for abdominal aortic aneurysm (AAA). Smoking damages the walls of blood vessels, promotes inflammation, and accelerates the development of atherosclerosis, increasing the risk of AAA formation and rupture.

E. Family history of aneurysm: A family history of aneurysm, particularly abdominal aortic aneurysm (AAA), is a risk factor for developing AAA. Genetic factors can predispose individuals to the development of aneurysms, and a positive family history increases the likelihood of AAA occurrence.

A. Completing hourly endotracheal suctioning B. Ensuring proper ventriculostomy transducer levels C. Monitoring volume status D. Elevating the head of the bed 15°

Correct Answer is D

Explanation

A. Completing hourly endotracheal suctioning: Hourly endotracheal suctioning is not typically indicated for a client with increased intracranial pressure (ICP). Frequent suctioning can lead to increased intrathoracic pressure and potentially compromise venous return, which may further elevate ICP. Suctioning should be performed as needed to maintain airway patency while minimizing the risk of increasing ICP.

B. Ensuring proper ventriculostomy transducer levels: Ensuring proper ventriculostomy transducer levels is important for accurate measurement of intracranial pressure (ICP) but may not directly alleviate elevated ICP. Monitoring ICP through ventriculostomy allows for timely detection of changes in ICP, which can guide interventions to manage elevated pressure levels. However, it is not a direct intervention to reduce ICP.

C. Monitoring volume status: Monitoring volume status is important in managing a client with increased intracranial pressure (ICP) as both hypovolemia and hypervolemia can impact ICP. However, monitoring volume status alone does not directly address elevated ICP. Interventions to optimize volume status, such as fluid administration or diuresis, may be implemented based on assessment findings, but they should be done cautiously to avoid exacerbating cerebral edema or altering cerebral perfusion.

D. Elevating the head of the bed 15°: Elevating the head of the bed 15° (or higher) is a crucial intervention for managing a client with increased intracranial pressure (ICP). This position helps promote venous drainage from the brain, reducing venous congestion and intracranial pressure. Elevating the head of the bed also helps prevent cerebrospinal fluid (CSF) from pooling in the brain, which can further increase ICP. Placing the client in a semi-upright position is a standard practice in managing ICP and is recommended in various clinical guidelines.

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A nurse is providing care for a group of clients who have coronary artery disease who are all scheduled for coronary artery bypass grafts (CABG). Which of the following clients is at the highest risk for complications following the surgical procedure?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which of the following are risk factors for abdominal aortic aneurysm (AAA)? (Select all that apply.)

Correct Answer is ["D","E"]

Explanation

A nurse is caring for a client who has increased intracranial pressure. Which of the following interventions should the nurse plan to include in the plan of care?

Correct Answer is D

Explanation

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