A client is admitted to the telemetry unit with an episode of substernal chest pain.
His diagnostic studies reveal an elevated ST segment on the electrocardiogram (ECG) and an elevated cardiac troponin level.
What would be an appropriate initial nursing goal?
Reduce anxiety and relieve pain.
Improve myocardial oxygenation and reduce cardiac workload.
Eliminate family stressors and provide a calm environment.
Start the client on a low-sodium diet and decrease fluid intake.
The Correct Answer is B
Choice A rationale
While reducing anxiety and relieving pain are important aspects of care, they are not the primary goal for a client with an elevated ST segment on the ECG and an elevated cardiac troponin level. These findings indicate myocardial injury, which requires interventions to improve myocardial oxygenation and reduce cardiac workload.
Choice B rationale
The primary goal for a client with an elevated ST segment on the ECG and an elevated cardiac troponin level is to improve myocardial oxygenation and reduce cardiac workload. This can be achieved through medications, oxygen therapy, and bed rest.
Choice C rationale
Eliminating family stressors and providing a calm environment can contribute to reducing anxiety and promoting relaxation, but it is not the primary goal in this situation.
Choice D rationale
Starting the client on a low-sodium diet and decreasing fluid intake are interventions for managing heart failure, not for an acute myocardial injury.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
The diaphragm is not typically the location of a coarctation of the aorta. The diaphragm is a muscle that helps with breathing and separates the chest cavity from the abdominal cavity.
Choice B rationale
The bifurcation into the common iliac arteries is not typically the location of a coarctation of the aorta. The common iliac arteries are located in the lower part of the aorta and supply blood to the pelvis and legs.
Choice C rationale
The aortic valve is not typically the location of a coarctation of the aorta. The aortic valve is located between the left ventricle of the heart and the aorta.
Choice D rationale
The ductus arteriosus is the correct answer. Coarctation of the aorta often occurs near the ductus arteriosus, a blood vessel that connects the left pulmonary artery to the aorta.
Correct Answer is C
Explanation
Choice A rationale
Diltiazem does not increase the contractile force of the heart. In fact, it is classified as a negative inotrope, meaning it decreases the force of heart contractions.
Choice B rationale
While diltiazem can affect heart rhythm, it does not specifically reduce heart palpitations. Its primary effect is to slow the heart rate and relax the blood vessels.
Choice C rationale
Diltiazem is a calcium channel blocker used to manage cardiovascular conditions such as hypertension, chronic stable angina, atrial fibrillation, and Prinzmetal’s angina. It works by inhibiting the calcium influx into cardiac and vascular smooth muscle during depolarization. This results in vasodilation, or the widening of blood vessels, which can help decrease coronary artery spasms, a characteristic feature of Prinzmetal’s angina.
Choice D rationale
Diltiazem does not prevent the formation of plaque in the coronary arteries. It primarily acts to relax the blood vessels and slow the heart rate.
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