The nurse is preparing a patient for a cardiac angiogram today.
Which statement by the patient would prompt the nurse to notify the physician immediately?
“I have an allergy to shellfish.”
“I ate dinner yesterday at 5pm.”
“I have not taken my aspirin for one week.”
“I did not take my metformin yesterday.”
“I did not take my metformin yesterday.”
The Correct Answer is C
A rationale:
While a shellfish allergy is important information for the healthcare team to be aware of, it is not directly relevant to the cardiac angiogram procedure itself. Shellfish allergies typically involve reactions to iodine-containing contrast dyes, which are not commonly used in cardiac angiograms. The contrast dye used in cardiac angiograms is usually a gadolinium-based contrast agent, which has a different allergy profile.
It's essential to communicate any allergies to the healthcare team, but this information would not necessarily prompt an immediate notification to the physician in the context of a cardiac angiogram.
Choice B rationale:
The patient's last meal time is relevant for some procedures that require sedation or anesthesia, but it's not typically a major concern for a cardiac angiogram.
Patients are often instructed to have a light meal or snack several hours before the procedure, but an exact fasting time is not always necessary. Unless the physician has specifically ordered a strict fasting period for this patient, the nurse would not need to notify the physician immediately about a meal consumed the previous evening.
Choice C rationale:
This statement is the most concerning and would require immediate notification of the physician. Aspirin is a common antiplatelet medication that helps prevent blood clots. It's often prescribed to patients with heart disease to reduce the risk of heart attack and stroke.
Discontinuing aspirin therapy without medical guidance can increase the risk of blood clots, which could be dangerous during a cardiac angiogram. The procedure involves inserting a catheter into the heart's arteries, and there's a risk of clot formation during this process.
If a patient has not taken their aspirin as prescribed, the physician needs to be aware of this to assess the risks and benefits of proceeding with the angiogram and potentially consider alternative medications or interventions to manage the patient's clotting risk.
Choice D rationale:
Metformin is a medication used to treat type 2 diabetes. While it's important for patients to take their medications as prescribed, missing a single dose of metformin is not typically a major concern in the context of a cardiac angiogram.
The nurse would likely remind the patient to take their metformin as soon as possible, but this would not require immediate notification of the physician.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale:
Atrial flutter is characterized by a rapid, regular atrial rate of around 250-350 beats per minute with a "sawtooth" pattern on the ECG. It typically presents with a 2:1 or 4:1 atrioventricular (AV) block, resulting in a ventricular rate of around 150 beats per minute or less. However, the rhythm in question does not exhibit the characteristic sawtooth pattern or rapid atrial rate of atrial flutter.
Choice B rationale:
Normal Sinus Rhythm (NSR) is the typical heart rhythm in healthy individuals. It is characterized by the following features on the ECG:
Regular rhythm: The R-R intervals (the distance between consecutive QRS complexes) are relatively constant.
Rate: The heart rate is typically between 60-100 beats per minute.
P waves: Each QRS complex is preceded by a P wave, representing atrial depolarization.
PR interval: The PR interval (the distance between the P wave and the QRS complex) is normal, measuring between 0.12-0.20 seconds.
QRS complex: The QRS complex is narrow (less than 0.12 seconds), representing normal ventricular depolarization.
ST segment: The ST segment is usually isoelectric (flat).
T wave: The T wave is typically upright, representing ventricular repolarization.
Choice C rationale:
Atrial Fibrillation (AFib) is characterized by a rapid, irregular atrial rate (usually over 400 beats per minute) with no discernible P waves on the ECG. The ventricular rate is also irregular, often ranging between 100-175 beats per minute.
However, the rhythm in question does not exhibit the characteristic irregular pattern of AFib.
Choice D rationale:
Ventricular Tachycardia (VT) is a rapid heart rhythm originating from the ventricles. It is characterized by a wide QRS complex (greater than 0.12 seconds) and a rate typically over 100 beats per minute. However, the rhythm in question does not exhibit the wide QRS complex characteristic of VT.
Correct Answer is C
Explanation
Choice A rationale:
Drowsiness and blurred vision are not common adverse effects of nitroglycerin.
While some individuals may experience mild drowsiness, it's not a primary concern.
Blurred vision is not typically associated with nitroglycerin use.
Choice B rationale:
Nervousness and paresthesia (tingling or numbness in the extremities) are not common adverse effects of nitroglycerin.
Some individuals may experience transient anxiety or nervousness, but it's not a characteristic side effect.
Paresthesia is more commonly associated with other medications or conditions.
Choice C rationale:
Throbbing headache and dizziness are the most common adverse effects of nitroglycerin.
They occur due to nitroglycerin's vasodilatory effect, which causes blood vessels to relax and widen.
This can lead to a temporary drop in blood pressure, resulting in headaches and dizziness.
The headaches are often described as throbbing or pulsating, and they typically occur in the frontal or temporal regions of the head.
Dizziness may be mild or severe, and it may be accompanied by lightheadedness or a feeling of unsteadiness.
Choice D rationale:
Tinnitus (ringing in the ears) and diplopia (double vision) are not common adverse effects of nitroglycerin.
They may occur in rare cases, but they are not typically associated with its use.
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