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?

The nurse should ask this question to support safe medication administration because the client is to receive medications that are highly teratogenic. Teratogens are substances that can cause congenital disorders and fetal abnormalities.

The nurse should avoid giving teratogenic medications to pregnant clients or clients who may become pregnant.

Choice A is wrong because the family history of cancer is not relevant to the teratogenic effects of the medications.

Choice C is wrong because the previous experience of severe side effects from a drug is not related to the risk of fetal harm.

Choice D is wrong because the allergy to any prescription or non-prescription drugs is not specific to the teratogenic potential of the medications.

The directive takes effect only if the client is incapable of personally making health care decisions. This statement demonstrates an understanding of health care proxy and care because it reflects the definition of a health care proxy as a person who can make health care decisions for the client only when the client is unable to communicate these themselves.

Choice A is wrong because the daughter does not have the authority to make all of the client’s health care decisions, only those that the client has not specified in advance or that are not covered by the living will.

Choice B is wrong because no extraordinary means, such as cardiopulmonary resuscitation, will be initiated only if the client has expressed this preference in a living will or a do-not-resuscitate order.

Choice D is wrong because the closest relative, such as the spouse, does not have to be consulted before the daughter in making health care decisions, unless the client has designated them as an alternate proxy.