A nurse is collecting data from a client who has an acute myocardial infarction (MI). Which of the following clinical manifestations should the nurse expect to find? (Select all that apply.)
Nausea
Orthopnea
Diaphoresis
Headache
Tachycardia
Correct Answer : A,C,E
a. Nausea: Nausea is a common symptom of myocardial infarction and can be associated with autonomic nervous system activation.
b. Orthopnea: Orthopnea, difficulty breathing while lying down, is more commonly associated with heart failure, not necessarily myocardial infarction.
c. Diaphoresis: Profuse sweating or diaphoresis is a common manifestation of myocardial infarction due to sympathetic nervous system activation.
d. Headache: Headache is not a typical symptom of myocardial infarction. However, some individuals may experience atypical symptoms.
e. Tachycardia: Tachycardia (rapid heart rate) is a common response to myocardial infarction and can be associated with sympathetic nervous system stimulation in response to decreased cardiac output.
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Related Questions
Correct Answer is D
Explanation
a. Urinary retention: Dark amber, cloudy, and malodorous urine is not typically associated with urinary retention. Urinary retention usually results in a lower-than-normal urine output.
b. Urinary incontinence: Incontinence refers to the inability to control urine flow and does not directly cause changes in urine color, clarity, or odor.
c. Urinary frequency: Increased frequency of urination is not typically associated with dark amber, cloudy, and malodorous urine.
d. Urinary tract infection (UTI): Dark amber, cloudy, and foul-smelling urine are common signs of a urinary tract infection. The infection causes changes in the appearance and odor of urine due to the presence of bacteria and inflammatory cells.
Correct Answer is B
Explanation
a. Decreased calcium level: NG tube drainage is more likely to result in hypokalemia (decreased potassium) than hypocalcemia (decreased calcium).
b. Decreased potassium level: NG tube drainage, which contains stomach contents, can lead to loss of potassium. Monitoring for hypokalemia is crucial as it can result in cardiac dysrhythmias.
c. Elevated magnesium level: NG tube drainage is not typically associated with an increase in magnesium levels.
d. Elevated sodium level: NG tube drainage may contribute to sodium loss, leading to hyponatremia, rather than hypernatremia.
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