I just took my cardiac test today. 2 questions in particular are bothering me...
1. A nurse is caring for a patient who had just had a cardiac cath performed. Which of the following assessment findings would require immediate intervention?
A. Cold extremities bilaterally
B. New onset of slurred speech.
I chose A, but everyone I have spoken to has argued that B is the correct answer. Here is my rational for why I chose A, and not B.
I know that one of the complications of a cardiac cath is a thromboembolic event. This includes a stroke, and slurred speech is a sign of a stroke. However, a patient that is undergoing a cardiac cath will be sedated. In my experience, in the immediate post-op period (which is what I am assuming this question was referring to, because of the word "JUST"), the effects of the sedative (whichever one was used) would still be apparent, and the patient's speech will be slurred.
On the other hand, I know that your priority is to assess the patient's effected leg in contrast to the unaffected leg. However, I chose B because if something had happened in the heart that caused a dysrhythmia during the cardiac cath, or if bleeding was occuring internally, Cardiac Output would be decreased, thus decreasing perfusion to the BOTH lower extremities.
2. A nurse on a Tele floor walks into a patient's room to find the patient on the bathroom floor, clutching his chest. The patient is ashen and diaphoretic. What is the FIRST thing the nurse would do?
A. Measure Sp02
B. Go check the ECG monitor
C. Call for the RRT
I chose C. Here is why.
A. If a patient is ashen, they are not receiving enough oxygen, therefor a pulse ox is not going to be very helpful in this situation
B. If I were to walk into a room with a patient lying on the floor, seemingly having a heart attack, I would not leave the room to go take a look at his ECG
C. The RRT team can be of much help in this situation.
What do you guys think?