A patient with dilated cardiomyopathy has new onset atrial fibrillation that has been unresponsive to drug therapy for several days. What topic should the nurse plan to include in patient teaching?
Permanent pacemakers
Emergency cardioversion
IV adenosine (Adenocard)
Anticoagulant therapy
The Correct Answer is D
When a patient with dilated cardiomyopathy develops new onset atrial fibrillation (AF) that has been unresponsive to drug therapy, the nurse should prioritize patient education about anticoagulant therapy. Atrial fibrillation increases the risk of blood clots forming in the heart's atria due to the irregular and ineffective pumping of blood. These blood clots can potentially travel to other parts of the body, leading to serious complications such as stroke.
Anticoagulant therapy, also known as blood-thinning medication, is commonly prescribed for patients with atrial fibrillation to prevent the formation of blood clots. The most common anticoagulant prescribed for AF is warfarin or direct oral anticoagulants (DOACs) such as apixaban, rivaroxaban, dabigatran, or edoxaban. The nurse should educate the patient about the importance of taking the anticoagulant as prescribed and the need for regular monitoring of clotting times (INR for warfarin) to ensure the medication is effective and the dose is appropriate.
While other options listed in the choices may be relevant in specific situations, the priority in this case is to address the potential risk of stroke associated with atrial fibrillation and the importance of anticoagulant therapy to manage that risk effectively.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A 3 lb weight gain in a short period, especially overnight, is indicative of fluid overload in a client with end-stage kidney disease receiving hemodialysis. Hemodialysis is performed to remove excess fluid and waste products from the body. If the client is experiencing fluid overload, it means that their body is retaining more fluid than it should, and this can lead to complications such as pulmonary edema, heart failure, and other cardiovascular problems. The nurse should identify this finding as an indication of potential fluid overload and report it to the healthcare provider for further evaluation and intervention.
Correct Answer is A
Explanation
In a patient with acute decompensated heart failure (ADHF), the priority nursing assessment is to auscultate lung sounds. ADHF is characterized by the sudden worsening of heart failure symptoms, which may include pulmonary congestion and fluid accumulation in the lungs. Assessing lung sounds helps to identify signs of pulmonary edema, which is a serious complication of ADHF.
The nurse should listen for crackles or rales, which are abnormal lung sounds caused by the presence of fluid in the alveoli. These findings suggest that the patient is experiencing fluid overload and inadequate gas exchange in the lungs. Prompt recognition of pulmonary edema allows for early intervention, such as administering diuretics or other medications, to relieve fluid overload and improve respiratory function.
While the other options (B) Facial swelling, (C) Level of anxiety, and (D) Intake and output, are important assessments in a patient with heart failure, they are not the priority in a patient with manifestations of acute decompensated heart failure. The priority is to assess for signs of respiratory
distress and pulmonary congestion, as these can quickly lead to respiratory failure and life threatening complications.
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