Cardiovascular and Hematological Care Flashcards

A patient reports tearing chest pain that radiates to the back and has unequal blood pressures in both arms. Which condition does the nurse suspect?

Answer: Aortic dissection

Aortic dissection classically presents with sudden tearing or ripping chest pain radiating to the back and a blood pressure differential between extremities.

Which finding is a hallmark of cardiac tamponade?

Answer: Beck's triad: hypotension, muffled heart sounds, JVD

Beck's triad (hypotension, muffled heart sounds, and JVD) results from pericardial fluid compressing the heart and impeding ventricular filling.

A post-operative patient develops a sudden onset of dyspnea, pleuritic chest pain, and tachycardia 3 days after hip replacement surgery. Which condition is most likely?

Answer: Pulmonary embolism

Pulmonary embolism is a common post-operative complication, especially after orthopedic surgery, presenting with sudden dyspnea, pleuritic pain, and tachycardia.

A patient with iron-deficiency anemia is started on oral ferrous sulfate. Which teaching point is most important?

Answer: Expect black, tarry stools as a side effect

Iron supplementation commonly causes dark or black stools, which is expected and not a sign of GI bleeding, and patients must be educated about this.

A patient with neutropenia following chemotherapy develops a fever of 38.5°C (101.3°F). What is the nurse's priority action?

Answer: Obtain blood cultures and initiate prescribed antibiotics immediately

Febrile neutropenia is a medical emergency; cultures must be drawn and broad-spectrum antibiotics started within one hour to prevent septic shock.

The nurse notes a patient's rhythm strip shows no P waves, a sawtooth baseline at 300 bpm with a ventricular rate of 75 bpm. Which rhythm is this?

Answer: Atrial flutter with 4:1 block

Atrial flutter characteristically shows a sawtooth flutter wave pattern at ~300 bpm; a 4:1 conduction ratio results in a ventricular rate of ~75 bpm.

A patient with chronic kidney disease has a hemoglobin of 8.2 g/dL. The provider orders erythropoietin-stimulating agents (ESAs). The nurse understands this medication works by:

Answer: Stimulating bone marrow to produce red blood cells

ESAs mimic endogenous erythropoietin to stimulate the bone marrow to produce red blood cells, correcting anemia of chronic kidney disease.