Heart Failure for Certified Emergency Nursing (CEN)

The triage nurse assesses an anxious and diaphoretic 54-year old man who arrives at the ED complaining of severe, left-sided pressure like chest pain, and left arm numbness. The pain began 2 hours ago and is unrelieved by rest. He has no significant medical history. After initiating cardiac monitoring, the nurse administers oxygen at 2 liters/minute and establishes an IV line of dextrose 5% in water (D5W) at a KVO rate. The patient’s vital signs are blood pressure 120/60 mmHg, pulse rate 88 beats/minute and irregular, and respirations 20 breaths/minute. The cardiac rhythm shows normal sinus rhythm with occasional unifocal premature ventricular contractions (PVCs). The triage nurse suspects that this patient is exhibiting signs of a myocardial infarction (MI) because the chest pain:

The nurse understands that the most common cause ofright ventricular failure is:

Which intervention would the nurse know to be inappropriate for a patient with left ventricularfailure?

Which statement about dopamine is true?

The physician orders an ACE inhibitor to be added to the patient’s medication regimen for treatment of congestive heart failure. The nurse understands the pharmacologic effects of ACE inhibitors to include:

Which should be the nurse’s primary goal when planning the care of a patient with an acute MI:

The 12-lead EKG demonstrates ST elevation in leads V1 through V3. The nurse interprets this as an acute MI involving the:

Which health history finding would not predispose a patient to developing an MI?

Which nursing diagnostic category is most appropriate for a patient on ACE inhibitors whose condition has been stabilized?

The physician orders Amiodarone (Cordarone) at a loading dose of 150 mg IV bolus over 10 minutes at 15 mg/min. Then a maintenance infusion of 360 mg over 6 hours at 1mg/min. Amiodarone (Cordarone) is indicated because it: