A nurse is caring for a client who just returned from a cardiac catheterization. Which of the following nursing interventions should the nurse include in the client's plan of care? (Select all that apply.)
Have the client remain in bed up to 6 hr.
Check peripheral pulses in the affected extremity.
Place the client in high-Fowler's position.
Keep the client's hip and leg extended.
Measure the client's vital signs every 4 hr.
Correct Answer : A,B,D,E
A. It is important for the client to remain in bed for a specified time (typically 4 to 6 hours) to prevent complications such as bleeding at the catheter insertion site.
B. Checking peripheral pulses in the affected extremity is crucial for assessing circulation and identifying any potential complications, such as hematoma or occlusion.
C. High-Fowler's position is not typically appropriate immediately after cardiac catheterization; the client should remain flat or with limited elevation to reduce stress on the insertion site.
D. Keeping the hip and leg extended is important to prevent flexion at the site of catheter insertion, reducing the risk of bleeding or hematoma formation.
E. Measuring vital signs is essential after a procedure like cardiac catheterization to monitor for any changes that may indicate complications; however, the frequency is typically more frequent than every 4 hours initially.
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Correct Answer is B
Explanation
A. Tricuspid atresia typically leads to decreased pulmonary blood flow due to the absence of normal blood flow to the lungs.
B. Patent ductus arteriosus results in increased pulmonary blood flow because it allows blood to flow from the aorta to the pulmonary artery, increasing the volume of blood going to the lungs.
C. Coarctation of the aorta can cause decreased blood flow to the lower body, which may not directly relate to increased pulmonary blood flow.
D. Tetralogy of Fallot is characterized by decreased pulmonary blood flow due to right ventricular outflow obstruction, making it not associated with increased pulmonary blood flow.
Correct Answer is B
Explanation
A. This option is incorrect as it does not describe the expected blood pressure difference in coarctation of the aorta.
B. Coarctation of the aorta typically presents with higher blood pressure in the upper body (arms) and lower blood pressure in the lower body (legs) due to the obstruction of blood flow distal to the aortic arch.
C. This option is incorrect because while coarctation can lead to decreased perfusion in the lower extremities, it does not typically result in decreased blood pressure in both the arms and legs simultaneously.
D. While increased blood pressure may occur in the arms, the legs would not typically show increased blood pressure in cases of coarctation.