The patient with restrictive cardiomyopathy asks the nurse what could have caused this disorder. Which response by the nurse is most accurate?

"All patients with this disorder have a genetic defect which causes it."

"There are many theories about its development but amyloidosis in your history is a probable cause."

"You probably had a silent heart attack which caused this disorder."

"Your long-standing hypertension caused this disorder."

Answer and Explanation

The Correct Answer is B

A. "All patients with this disorder have a genetic defect which causes it.": Restrictive cardiomyopathy is not primarily a genetic disorder. While there may be rare familial forms, most cases are acquired, often secondary to systemic diseases, making this statement inaccurate and misleading.

B. "There are many theories about its development but amyloidosis in your history is a probable cause.": This is the most accurate response. Restrictive cardiomyopathy is commonly associated with infiltrative diseases such as amyloidosis, hemochromatosis, and sarcoidosis, which impair ventricular filling due to stiff, non-compliant myocardium.

C. "You probably had a silent heart attack which caused this disorder.": Silent myocardial infarctions can contribute to ischemic cardiomyopathy, typically leading to dilated, not restrictive, changes in the myocardium. They are not a primary cause of restrictive cardiomyopathy.

D. "Your long-standing hypertension caused this disorder.": Chronic hypertension more commonly leads to left ventricular hypertrophy and may contribute to diastolic heart failure, but it is not a typical cause of restrictive cardiomyopathy.

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Correct Answer is E

Explanation

A. contact the prescriber to decrease the rate of the D51/2NS during the blood transfusion: There's no need to alter the rate of maintenance fluids unless there's a fluid volume concern. Additionally, decreasing the rate would not address the need for a dedicated blood transfusion line if another lumen is available.

B. stop the D51/2NS, check the client's vitals & notify the prescriber: Stopping necessary fluids without cause may compromise fluid balance. Unless there's a compatibility issue or no other lumen, stopping the infusion is not the safest or most efficient action.

C. Fluids cannot be given through a CVC: Central venous catheters are routinely used for administering fluids, medications, and blood products, especially in critical care settings.

D. Insert a 22 gauge peripheral IV to administer the transfusion: While blood can be given through a peripheral IV, using an existing central venous catheter is safer and more efficient, especially when multiple lumens are available. Inserting a new IV unnecessarily increases infection and complication risks.

E. transfuse the unit of packed red blood cells through a separate lumen of the CVC: This is the safest and most appropriate action. Triple-lumen CVCs allow for simultaneous infusions through separate channels without mixing. Blood should be transfused through a dedicated lumen to avoid incompatibility or dilution by other fluids.

A. hypermagnesemia. B. hypocalcemia. C. hypokalemia. D. hyperglycemia.

Correct Answer is C

Explanation

A. Hypermagnesemia: Hypermagnesemia (high magnesium levels) can cause bradycardia, hypotension, and prolonged PR and QRS intervals. While it can affect cardiac rhythm, it's less commonly associated with PVCs. The client's magnesium level of 2.5 mg/dL is within the normal range (1.5-2.5 mg/dL).

B. Hypocalcemia: While the calcium level of 8.0 mg/dL is slightly low (normal: ~8.5–10.5 mg/dL), mild hypocalcemia is less commonly associated with PVCs compared to hypokalemia. It can affect cardiac contractility but is not the most likely cause of these arrhythmias.

C. Hypokalemia: The potassium level is 2.8 mEq/L, which is significantly below normal (normal: 3.5–5.0 mEq/L). Potassium is a crucial electrolyte for maintaining normal cardiac electrical activity. Hypokalemia increases myocardial excitability and can lead to various cardiac dysrhythmias and a known cause of ventricular irritability, including multifocal PVCs, and increases the risk of life-threatening arrhythmias in clients with cardiac or metabolic conditions.

D. Hyperglycemia: The glucose level of 200 mg/dL is elevated but not severely high. While it reflects poor glycemic control, it is not directly linked to the occurrence of PVCs. Electrolyte imbalances, particularly low potassium, are more arrhythmogenic.

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Potassium 2.8 mEq/L
Sodium 133 mEq/L
Chloride 90 mEq/L
Glucose 200 mg/dl
Magnesium 2.5 mg/dL
Calcium 8.0 mg/dL

The patient with restrictive cardiomyopathy asks the nurse what could have caused this disorder. Which response by the nurse is most accurate?

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Naxlex Comprehensive Predictor Exams

A client has a triple lumen subclavian central venous catheter (CVC) with D51/2NS infusing through one lumen (port) at 75 mL per hour. The nurse has an order to transfuse one unit of packed red blood cells (PRBCs). The nurse's safest action is to:

Correct Answer is E

Explanation

Correct Answer is C

Explanation

Which clinical manifestation would the nurse use to indicate that the status of an older adult patient (greater than age 75) with chronic heart failure condition is worsening?

The patient with restrictive cardiomyopathy asks the nurse what could have caused this disorder. Which response by the nurse is most accurate?

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