Cardiac-Vascular Nursing (CVRN) Practice Exam

A patient who underwent a percutaneous coronary angioplasty has an ejection fraction of 30% and reports a 5-lb weight gain. What should the nurse's initial action be?

1. Document the weight and reassess the patient at the next session

2. Inquire about the patient's medication compliance

3. Notify the patient's physician

4. Review the patient's most recent nuclear scan

The correct answer is: Inquire about the patient's medication compliance

The correct initial action is to inquire about the patient's medication compliance. After undergoing a percutaneous coronary angioplasty, it is crucial to ensure the patient is adhering to prescribed medications, especially if they have an ejection fraction of 30%, which indicates significant heart dysfunction and an increased risk for complications. Weight gain in this context can suggest fluid retention, which may be exacerbated by non-compliance with diuretics or heart failure medications. Understanding the patient's adherence to their medication regimen is vital to assessing the appropriate next steps in management, as it can have immediate implications for the patient’s cardiovascular status. While documenting the weight and reassessing later may seem reasonable, it does not address the potential urgency of the situation. Notifying the physician may be necessary if the weight gain is severe or accompanied by other concerning symptoms, but the first step should focus on gathering information about the patient's current state, including medication compliance. Reviewing the most recent nuclear scan, while useful for understanding cardiac function, may not provide immediate information relevant to the current weight gain and its potential causes.