A client with angina has been prescribed nitroglycerin.
Before administering the drug, what potential adverse effects should the nurse inform the client about?

Choice A rationale:

Antipyretic action refers to the ability to reduce fever. While aspirin does have antipyretic properties, this is not the primary reason it is administered during an MI. Fever is not a characteristic symptom of MI, and reducing fever would not directly address the underlying cause of the MI, which is the formation of a blood clot in a coronary artery.

Choice B rationale:

Antiplatelet action is the ability to prevent platelets from clumping together and forming blood clots. This is the crucial mechanism by which aspirin helps in the setting of an MI.

During an MI, a blood clot forms in a coronary artery, blocking blood flow to the heart muscle. This blockage can cause severe damage to the heart muscle, leading to chest pain, shortness of breath, and potentially life-threatening complications.

Aspirin irreversibly inhibits the enzyme cyclooxygenase (COX), which is essential for platelet aggregation. By blocking COX, aspirin prevents platelets from sticking together and forming new clots. This can help to:

Limit the size of the existing clot in the coronary artery.

Prevent the formation of additional clots that could further block blood flow.

Allow for better blood flow to the heart muscle, reducing damage and improving outcomes.

Choice C rationale:

Analgesic action refers to the ability to relieve pain. While aspirin does have analgesic properties, this is not the primary reason it is administered during an MI. Pain relief is an important aspect of managing MI symptoms, but it does not directly address the underlying cause of the MI, which is the blood clot.

Choice D rationale:

Antithrombotic action is a broader term that encompasses any action that prevents or reduces blood clot formation. Aspirin's antiplatelet action is a specific type of antithrombotic action. However, it's important to note that aspirin does not directly dissolve existing clots; it primarily prevents new clots from forming.

Choice A rationale:

Incorrect. Scarring on the atria is not an indication of procedure failure in the context of the maze procedure. In fact, it's a desired outcome.

Pacemaker implantation: Not routinely indicated after the maze procedure, even if scarring is present. Pacemakers are primarily used to treat bradyarrhythmias (slow heart rhythms), not atrial fibrillation.

Choice B rationale:

Incorrect. Repeating the maze procedure is generally not considered unless there's clear evidence of recurrent atrial fibrillation despite initial scarring. Scarring formation takes time, and premature repeat procedures are often not necessary.

Consulting the care team: While collaboration is essential, consultation specifically for repeating the procedure based solely on scarring would be premature.

Choice C rationale:

Correct. The maze procedure intentionally creates scar tissue within the atria to block abnormal electrical signals that cause atrial fibrillation. Scarring disrupts the pathways that allow these signals to circulate and trigger fibrillation. Therefore, the presence of scarring is a positive finding that suggests the procedure has achieved its intended effect.

Choice D rationale:

Incorrect. Further diagnostic testing is not routinely indicated solely based on the presence of scarring after the maze procedure. Additional testing might be considered if the patient experiences recurrent atrial fibrillation or other concerning symptoms, but scarring itself does not necessitate immediate further investigation.