A client admitted to the coronary care unit with an inferior wall myocardial infarction is anxious, sweating, tachypneic, and reports midsternal chest discomfort and nausea.
Which nursing diagnosis is the priority?

This is because older adults have a reduced ability to excrete drugs and their metabolites through the kidneys, which can lead to drug accumulation and toxicity. Decreased renal function can also affect the pharmacokinetics and pharmacodynamics of many drugs, altering their absorption, distribution, metabolism, and elimination.

Choice A is wrong because reduced muscle mass does not directly affect drug metabolism or clearance, although it may affect the volume of distribution of some drugs that are highly protein-bound or lipophilic.

Choice C is wrong because slowed gastrointestinal motility does not increase the risk of adverse drug events in older adults, although it may affect the rate and extent of drug absorption.

Choice D is wrong because thinning of the layers of the skin does not affect drug metabolism or clearance, although it may increase the risk of skin infections or injuries.

Reminiscing about the spouse with significant others. This is an important need for a widowed client during the grieving period following the death of the client’s spouse because it helps them process their loss, express their emotions, and honor their memories. Reminiscing can also provide comfort, support, and meaning to the bereaved.

Choice B. Self-indulgence in order to fill the emptiness left by the spouse’s death is wrong because it can be unhealthy, addictive, or harmful to the client’s well-being. Self-indulgence may also prevent the client from coping with their grief in a constructive way.

Choice C. Reassurance that the client did all that could be expected for their spouse is wrong because it may imply that the client is responsible for their spouse’s death or that they could have prevented it.

This may increase the client’s guilt, regret, or self-blame. Reassurance should focus on the client’s strengths, resilience, and coping skills.

Choice D. Engagement in activities that will take the client’s mind off the loss of the spouse is wrong because it may suggest that the client should avoid or deny their grief.

This may interfere with the healing process and lead to unresolved or complicated grief. Engagement in activities should be balanced with time for reflection, mourning, and self-care.

Normal ranges for grief vary depending on the individual, the relationship, and the circumstances of the death. However, some general guidelines are that grief can last from a few months to several years and that it may involve physical and emotional symptoms such as trouble sleeping, loss of appetite, difficulty concentrating, crying, sadness, anger,