A nurse is assessing a client’s pulmonary artery wedge pressure (PAWP). The nurse should recognize that an elevated PAWP indicates which of the following complications?

Choice A reason: Decreased serotonin levels are linked to depression, as serotonin regulates mood in the brain’s limbic system. Antidepressants like SSRIs increase serotonin, alleviating low mood and anhedonia, making this client a prime candidate for therapy to address neurochemical imbalances in depression.
Choice B reason: Decreased cortisol is not directly tied to depression requiring antidepressants. Cortisol dysregulation may occur in stress disorders, but antidepressants target serotonin or norepinephrine, not adrenal function, making this client less suitable for antidepressant therapy based on this imbalance.
Choice C reason: Elevated dopamine is linked to schizophrenia or mania, not depression. Antidepressants target serotonin or norepinephrine, not dopamine. This client may need antipsychotics or mood stabilizers, not antidepressants, as dopamine excess does not indicate depressive pathology requiring such therapy.
Choice D reason: Elevated thyroid levels suggest hyperthyroidism, mimicking anxiety, not depression. Antidepressants are not indicated, as treatment targets thyroid function. Depression may coexist, but thyroid correction is prioritized, making this client unsuitable for primary antidepressant therapy based on this finding.

Choice A reason: Administering oxygen is premature without assessing the cause of chest heaviness. While hypoxia may occur in aneurysm rupture, stopping exertion reduces cardiovascular demand first, prioritizing safety in a client with an abdominal aortic aneurysm at risk for rupture.
Choice B reason: Having the client sit down is the priority, as chest heaviness may signal aneurysm instability. Rest reduces aortic wall stress and oxygen demand, preventing rupture or dissection, stabilizing the client for further assessment and intervention in this high-risk condition.
Choice C reason: Checking vital signs is important but secondary to stopping exertion. Chest heaviness suggests potential aneurysm rupture, and continued ambulation risks catastrophe. Sitting the client minimizes cardiovascular stress, allowing subsequent vital sign checks to guide further actions effectively.
Choice D reason: Notifying the provider is critical but not first. Chest heaviness requires immediate cessation of activity to reduce aortic pressure. Sitting stabilizes the client, allowing data collection (e.g., vital signs) before provider notification, ensuring urgent intervention for potential aneurysm complications.