A nurse is administering digoxin to a patient.
What priority assessment needs to take place prior to administration?

A rationale:

While a shellfish allergy is important information for the healthcare team to be aware of, it is not directly relevant to the cardiac angiogram procedure itself. Shellfish allergies typically involve reactions to iodine-containing contrast dyes, which are not commonly used in cardiac angiograms. The contrast dye used in cardiac angiograms is usually a gadolinium-based contrast agent, which has a different allergy profile.

It's essential to communicate any allergies to the healthcare team, but this information would not necessarily prompt an immediate notification to the physician in the context of a cardiac angiogram.

Choice B rationale:

The patient's last meal time is relevant for some procedures that require sedation or anesthesia, but it's not typically a major concern for a cardiac angiogram.

Patients are often instructed to have a light meal or snack several hours before the procedure, but an exact fasting time is not always necessary. Unless the physician has specifically ordered a strict fasting period for this patient, the nurse would not need to notify the physician immediately about a meal consumed the previous evening.

Choice C rationale:

This statement is the most concerning and would require immediate notification of the physician. Aspirin is a common antiplatelet medication that helps prevent blood clots. It's often prescribed to patients with heart disease to reduce the risk of heart attack and stroke.

Discontinuing aspirin therapy without medical guidance can increase the risk of blood clots, which could be dangerous during a cardiac angiogram. The procedure involves inserting a catheter into the heart's arteries, and there's a risk of clot formation during this process.

If a patient has not taken their aspirin as prescribed, the physician needs to be aware of this to assess the risks and benefits of proceeding with the angiogram and potentially consider alternative medications or interventions to manage the patient's clotting risk.

Choice D rationale:

Metformin is a medication used to treat type 2 diabetes. While it's important for patients to take their medications as prescribed, missing a single dose of metformin is not typically a major concern in the context of a cardiac angiogram.

The nurse would likely remind the patient to take their metformin as soon as possible, but this would not require immediate notification of the physician.

Choice B rationale:

LDL (low-density lipoprotein) cholesterol is often referred to as "bad" cholesterol. It contributes to the buildup of plaque in the arteries, which narrows the arteries and can lead to coronary artery disease (CAD). CAD is a major risk factor for heart attack and stroke.

HDL (high-density lipoprotein) cholesterol is often referred to as "good" cholesterol. It helps to remove LDL cholesterol from the arteries and transport it back to the liver, where it can be broken down and removed from the body. Therefore, a high HDL level is protective against heart disease.

An elevated LDL level and a lowered HDL level are both associated with an increased risk of CAD. This is because the elevated LDL level contributes to plaque buildup, while the lowered HDL level means that there is less "good" cholesterol available to remove the "bad" cholesterol from the arteries.

Therefore, the statement "Increased LDL and decreased HDL increase my risk of coronary artery disease" indicates an understanding of the significance of these cholesterol levels.

Choice A rationale:

This statement is incorrect. An increased LDL level will actually increase the amount of cholesterol deposited on the artery walls.

Choice C rationale:

This statement is also incorrect. A decreased HDL level will decrease the amount of cholesterol moved away from the artery walls.

Choice D rationale:

This statement is incorrect. Increased LDL has the potential to increase, not decrease, the risk of heart disease.