CMSRN - Medical-Surgical Nursing Cardiovascular and Hematological Care Questions and Answers Flashcards
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A patient is admitted with a hemoglobin of 6.2 g/dL and is prescribed a transfusion of packed red blood cells. Which action should the nurse take first?
Answer: Verify the blood product with another licensed nurse at the bedside
Two licensed nurses must verify patient identity and blood product compatibility at the bedside before initiating a transfusion.
A nurse is monitoring a patient after a cardiac catheterization via the femoral artery. Which finding requires immediate intervention?
Answer: A rapidly expanding hematoma at the insertion site
A rapidly expanding hematoma at the femoral access site indicates possible arterial bleeding and requires immediate pressure application and physician notification.
A patient with chronic kidney disease develops normocytic normochromic anemia. Which medication should the nurse anticipate administering?
Answer: Epoetin alfa (Procrit)
Chronic kidney disease causes decreased erythropoietin production, and epoetin alfa is a synthetic erythropoietin used to stimulate red blood cell production.
During electrocardiogram (ECG) interpretation, the nurse notes ST-segment elevation in leads II, III, and aVF. Which coronary artery is most likely occluded?
Answer: Right coronary artery
ST elevation in leads II, III, and aVF indicates an inferior myocardial infarction, which is most commonly caused by right coronary artery occlusion.
A patient with a mechanical heart valve asks why warfarin is prescribed instead of a direct oral anticoagulant (DOAC). What is the most accurate response?
Answer: Warfarin is the only anticoagulant proven safe and effective for mechanical heart valves
Clinical trials have shown that DOACs are associated with increased thromboembolic and bleeding events in patients with mechanical valves, making warfarin the standard of care.
A nurse is caring for a patient in cardiogenic shock. Which hemodynamic finding is expected?
Answer: Elevated pulmonary artery wedge pressure (PAWP) and decreased cardiac output
Cardiogenic shock results from pump failure, leading to elevated PAWP due to fluid backup and decreased cardiac output from impaired contractility.