Cardiovascular and Hematological Care Flashcards
7 cards from real CMSRN practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Cardiovascular and Hematological Care flashcards as text
A patient with a pacemaker has a paced rhythm on the monitor, but the nurse notes the patient's heart rate is 38 bpm and symptoms of dizziness. What does this indicate?
Answer: Pacemaker failure to capture
Failure to capture occurs when the pacemaker delivers a stimulus but the myocardium does not depolarize, resulting in bradycardia despite paced spikes.
Which intervention is most important when caring for a patient receiving thrombolytic therapy for acute MI?
Answer: Avoid all arterial and venous punctures at non-compressible sites
Thrombolytics cause systemic fibrinolysis; avoiding punctures at non-compressible sites reduces the risk of uncontrolled hemorrhage.
A patient with polycythemia vera is at highest risk for which complication?
Answer: Thromboembolism
The elevated red blood cell mass in polycythemia vera increases blood viscosity, dramatically raising the risk of arterial and venous thrombosis.
A nurse administers digoxin to a patient with heart failure. Before administration, the apical pulse is 52 bpm. What should the nurse do?
Answer: Hold the dose and notify the provider
Digoxin is typically held and the provider notified if the apical pulse is below 60 bpm due to its negative chronotropic effect, which can worsen bradycardia.
A patient receiving IV vancomycin develops sudden flushing, erythema, and hypotension during the infusion. This reaction is most consistent with:
Answer: Red man syndrome
Red man syndrome is a non-immune infusion reaction to vancomycin characterized by flushing and hypotension, prevented by slowing the infusion rate.
A patient with chronic heart failure has a serum sodium of 128 mEq/L. The nurse anticipates which prescribed intervention?
Answer: Fluid restriction and review of diuretic regimen
Dilutional hyponatremia in heart failure is treated with fluid restriction and optimization of diuretic therapy, not sodium replacement.
A patient with hemophilia A requires emergency surgery. Which product should the nurse anticipate administering?
Answer: Factor VIII concentrate
Hemophilia A is caused by factor VIII deficiency; surgical patients require factor VIII concentrate to prevent life-threatening hemorrhage.