Question 1

The nurse is auditing the medical records of MI clients treated with thrombolytic therapy in the emergency department. The nurse knows that the ideal time for a client to be treated with thrombolytics is within ________ minutes or less for the best outcomes.
Record your answer rounding to the nearest whole number.

30

Accepted Answer

Thrombolytics are most effective when administered from 20 minutes to 12 hours after the onset of MI symptoms. Ideally, the time from presentation in the emergency department to administration of the thrombolytic agent should be 30 minutes or less. Research has demonstrated little or no therapeutic benefit if the drugs are administered 24 hours or more after the MI onset.

Question 2

The nurse preparing to discharge a client with a prescription of nitroglycerin for angina knows it is important to teach the client to contact emergency medical services if chest pain is not relieved within two to three doses of nitroglycerin or 10 to ________ minutes.
Record your answer rounding to the nearest whole number.

15

Accepted Answer

When given sublingually, nitroglycerin reaches peak plasma levels within minutes, thus quickly terminating angina pain. Chest pain that does not respond within 10 to 15 minutes after two or three doses of sublingual nitroglycerin may indicate MI, and emergency medical services (EMS) should be contacted.

Question 3

The nurse is caring for a client who is being admitted to the emergency department with severe chest pain. The healthcare provider has ordered a nitroglycerin drip. The nurse knows it is essential to ask the client about the use of erectile dysfunction drugs within the last 24 to ________ hours in order to decrease the risk of a hypotensive crisis.
Record your answer rounding to the nearest whole number.

48

Accepted Answer

Be aware that use of erectile dysfunction drugs (for example, sildenafil [Viagra], vardenafil [Levitra], or tadalafil [Cialis]) within the past 24 to 48 hours may cause profound and prolonged hypotension when nitrates are administered.

Question 4

The nurse is educating a client with hypertension on the importance of maintaining an optimal weight. The client asks the nurse how much weight loss is needed. The nurse's response is based on the knowledge that a weight loss of 11 to ________ lb produces a measurable decrease in blood pressure.
Record your answer rounding to the nearest whole number.

Accepted Answer

Therapeutic lifestyle changes should be recommended for all clients with prehypertension or HTN. Of greatest importance is maintaining optimum weight, since obesity is closely associated with dyslipidemia (abnormal serum lipid levels) and HTN. A 5- to 9-kg (11- to 20-lb) weight loss often produces a measurable decrease in blood pressure, even in clients who are obese. Combining a medically supervised weight loss program with proper nutrition can delay the progression from prehypertension to HTN.

Question 5

When reviewing the medical record of a client admitted for hypertensive emergency, the nurse realizes the client's actual admitting diagnosis should have been hypertensive crisis, because the diastolic blood pressure was greater than ________ mmHg and the client was experiencing oliguria.
Record your answer rounding to the nearest whole number.

Accepted Answer

A hypertensive emergency (HTN-E), also called hypertensive crisis, is defined as a diastolic pressure greater than 120 mmHg, with evidence of target-organ system damage. This client should have been diagnosed with hypertensive crisis.

Question 6

The nurse is administering nitroprusside in the treatment of a hypertensive crisis. The nurse will assess the client's blood pressure after 1 to ________ minutes to assess for the therapeutic effects of the medication.
Record your answer rounding to the nearest whole number.

Accepted Answer

The onset of action for this medication is 1 to 2 minutes. The nurse would assess the client for the therapeutic effects of the medication at this time.

Deck 8: Thrombolytic Therapy: Ideal Treatment Time for Mi Clients