A nurse in an emergency department is reviewing the medical record of a client who is having an acute myocardial infarction.

Which of the following findings places the client at risk if he receives alteplase?

The correct answer is choice **D. Identify possible precipitating factors related to the infections**.

Choice D rationale:

As a charge nurse concerned about a recent increase in facility-acquired catheter infections, the first step should be to identify possible precipitating factors related to the infections. This involves conducting a thorough investigation to determine the root causes of the increased infection rates. By identifying the underlying factors, the nurse can then develop targeted interventions to address the specific issues and prevent further infections.

Choice A rationale:

While scheduling nursing staff training for infection control procedures is important, it should not be the first action taken. Before implementing training, it is crucial to identify the factors contributing to the increased infection rates to ensure that the training addresses the specific issues at hand.

Choice B rationale:

Meeting with providers to discuss measures to decrease the infections is a necessary step, but it should not be the first action. Providers need to be informed about the situation, but their input will be more valuable once the precipitating factors have been identified.

Choice C rationale:

Revising the current policy for catheter care may be necessary, but it should not be the first action. Policies should be based on evidence-based practices and tailored to address the specific issues identified through the investigation.

A client who is experiencing a panic attack has a very high level of anxiety and a diminished ability to focus. The nurse should stay with the client and remain calm and reassuring during the panic attack. This can help the client feel safe and supported, and reduce the intensity of the anxiety.

Choice A is wrong because atomoxetine is not an anti-anxiety medication, but a selective norepinephrine reuptake inhibitor (SNRI) used to treat attention deficit hyperactivity disorder (ADHD). It has no effect on reducing anxiety and can cause side effects such as insomnia, nausea, and increased blood pressure.

Choice B is wrong because encouraging the client to watch television is not a therapeutic intervention for a panic attack.
Watching television can increase the stimuli in the client’s environment, which can worsen anxiety.
The nurse should maintain an environment with low stimulation for the client experiencing a panic attack. Dim lighting, few people, and minimal distractions can assist the nurse to decrease the client’s level of anxiety.
Choice C is wrong because teaching the client how to meditate is not appropriate during a panic attack.
Meditation is a relaxation technique that can be helpful for preventing or reducing anxiety, but it requires concentration and focus, which are impaired in a panic attack. The nurse should teach the client how to meditate when the client is calm and receptive, not when the client is in crisis.