NCLEX Test-Taking Strategy Tip

Tip #4: Watch where the client is in the disease process or condition he or she is experiencing.

Examples of this are phrases such as "immediately postoperatively," "the first postoperative day," and "experienced a myocardial this morning."

Example: A client had a cardiac catheterization through the left femoral artery. During the first few hours after the cardiac catheterization procedure, which nursing action would be most important?

Rewording: What is the most important nursing care in the first few hours after a cardiac catheterization?

1. Check his temperature every 2 hours and monitor catheter insertion site for inflammation.
2. Elevate the head of his bed 90 degrees and keep affected extremity straight.
3. Evaluate his blood pressure and respriatory status every 15 minutes for 4 to 6 hours.
4. Check his pedal and femoral pulses every 15 minutes for first hour, and then every 30 minutes.

The correct answer is 4. The phrase, "during the first few hours after the procedure," is important in answering this question correctly. The danger of hemorrhage and hematoma at the puncture site is greatest during this time. The question also asks for the most important nursing care. Option 3: it is important to evaluate vital signs, but it is not required that they be evaluated every 15 minutes for 4 to 6 hours if client is stable. Option 4 is critical in the first few hours following a cardiac catheterization.

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