A client with a complex cardiac history is scheduled for transesophageal echocardiography. Which of the following statements, if made by the nurse, is inappropriate?

“The test will provide a detailed profile of the heart’s electrical activity.”

“I will need to start an IV in your arm before the test.”

“Your throat may be a little sore after the exam.”

“You will need to refrain from eating and drinking 6-8 hours before this test.”

Answer and Explanation

The Correct Answer is A

A. "The test will provide a detailed profile of the heart’s electrical activity."

This statement is inappropriate because transesophageal echocardiography (TEE) primarily provides detailed images of the heart's structure, such as the valves and chambers, rather than focusing on the heart's electrical activity. The assessment of electrical activity is typically associated with electrocardiography (ECG or EKG) rather than echocardiography.

B. "I will need to start an IV in your arm before the test."

This statement is appropriate. It is common for medical procedures, including TEE, to require an intravenous (IV) line for administration of medications or fluids during or after the procedure.

C. "Your throat may be a little sore after the exam."

This statement is appropriate. TEE involves inserting a probe through the esophagus, and it is common for patients to experience a sore throat afterward due to the presence of the probe.

D. "You will need to refrain from eating and drinking 6-8 hours before this test."

This statement is appropriate. It is standard practice to ask patients to fast for a specific period before TEE to minimize the risk of complications, such as aspiration, during the procedure.

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Correct Answer is D

Explanation

A. Lie in a low Fowler’s or supine position:

Lying in a low Fowler's or supine position may worsen respiratory distress and compromise oxygenation. It can reduce lung expansion and increase the work of breathing, especially in patients with pneumonia. This is not a recommended position for individuals with respiratory issues.

B. Increase oral fluids unless contraindicated:

Increasing oral fluids is generally a good practice, especially in respiratory conditions like pneumonia. It helps thin respiratory secretions, making them easier to clear. However, this alone may not address copious tracheobronchial secretions. Suctioning may be needed to effectively remove excess secretions.

C. Increase activity:

Increasing activity may be beneficial for some patients, but it might exacerbate respiratory distress in others, especially if they are already experiencing increased work of breathing. The appropriateness of increasing activity depends on the specific condition and the patient's overall stability.

D. Call the nurse for oral suctioning as needed:

This is the most appropriate choice. If the client is experiencing increased work of breathing due to copious tracheobronchial secretions, calling the nurse for oral suctioning is an intervention aimed at maintaining a clear airway and alleviating respiratory distress. Regular suctioning may be necessary to assist the client in managing secretions effectively.

A. The patient pain reflects the target heart rate has been set too high and needs to be lowered to finish the test. B. The patient’s pain reflects pericarditis and the test should be stopped. C. The patient’s pain reflects ischemia to the myocardium and the test should be stopped. D. The patient’s pain reflects that supplemental oxygen is needed to finish the test.

Correct Answer is C

Explanation

A. The patient pain reflects the target heart rate has been set too high and needs to be lowered to finish the test.

This option suggests that the chest pain is related to the target heart rate being set too high. However, chest pain during an exercise stress test is more commonly associated with myocardial ischemia rather than an inappropriate target heart rate. Lowering the target heart rate may not address the underlying issue of ischemia.

B. The patient’s pain reflects pericarditis and the test should be stopped.

Chest pain during an exercise stress test is more commonly associated with myocardial ischemia rather than pericarditis. Pericarditis is inflammation of the pericardium, and its symptoms may include chest pain that is often sharp and pleuritic. However, during an exercise stress test, the focus is on detecting cardiovascular abnormalities, and chest pain is more concerning for ischemia.

C. The patient’s pain reflects ischemia to the myocardium and the test should be stopped.

This is the most appropriate interpretation. Chest pain during an exercise stress test may indicate insufficient oxygen supply to the myocardium (ischemia). Stopping the test allows for further evaluation and appropriate intervention.

D. The patient’s pain reflects that supplemental oxygen is needed to finish the test.

Chest pain during an exercise stress test is not typically addressed by providing supplemental oxygen. Stopping the test and evaluating the cause of the chest pain is a more appropriate action.

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A client with a complex cardiac history is scheduled for transesophageal echocardiography. Which of the following statements, if made by the nurse, is inappropriate?

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Explanation

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Correct Answer is C

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