A nurse is discussing the importance of following a low-sodium diet with a client who has heart failure. Which of the following food items would be appropriate for this patient to choose?

A. Hypernatremia (elevated sodium levels) is not a common sign of Addisonian crisis. In Addisonian crisis, the lack of aldosterone leads to sodium loss, which often results in hyponatremia (low sodium levels) rather than hypernatremia. The patient might also experience dehydration and electrolyte imbalances, but hypernatremia is not typical in this scenario.
B. Fluid volume overload is not characteristic of Addisonian crisis. Instead, Addisonian crisis often leads to fluid volume deficit due to the loss of aldosterone, which impairs sodium and water retention. This can result in dehydration and low blood volume rather than fluid overload.
C. Hypokalemia (low potassium levels) is not typically associated with Addisonian crisis. In fact, the lack of aldosterone in Addisonian crisis leads to potassium retention, resulting in hyperkalemia (elevated potassium levels). Therefore, monitoring for hypokalemia is not relevant in the context of Addisonian crisis following a bilateral adrenalectomy.
D. Hypoglycemia (low blood glucose levels) is a key sign of Addisonian crisis. Cortisol plays a crucial role in glucose metabolism and maintaining blood glucose levels. With the loss of cortisol production after a bilateral adrenalectomy, patients may experience hypoglycemia, which can be a critical indicator of Addisonian crisis.

A. Cardiac catheterization is often used in the management of an acute myocardial infarction to assess the extent of coronary artery disease and to determine the need for interventions such as angioplasty and stenting. This procedure is crucial for reperfusion therapy, especially in the context of ST-elevation MI (STEMI). Given the client’s symptoms and diagnostic findings, preparing for cardiac catheterization is an appropriate order.
B. While an echocardiogram can be useful for evaluating cardiac function and determining the extent of myocardial damage, it is not typically the immediate priority in the acute management of an MI. The focus is usually on rapid reperfusion therapy and stabilizing the patient. Therefore, this option is less urgent compared to others like administering oxygen and preparing for cardiac catheterization.
C. Warfarin is an oral anticoagulant used for long-term anticoagulation management and is not typically used in the acute setting of an MI. In acute MI management, other anticoagulants such as heparin or low molecular weight heparin are preferred for immediate anticoagulation. Administering warfarin in the acute setting is not appropriate.
D. Furosemide is a diuretic used to manage fluid overload and reduce symptoms of heart failure. It is not indicated as an immediate intervention in acute MI unless there is evidence of significant fluid overload or heart failure symptoms. The client’s current presentation does not suggest an immediate need for furosemide.
E. Supplemental oxygen is important in the management of acute myocardial infarction to ensure
adequate oxygen delivery to the myocardium and to alleviate hypoxia, especially since the client’s oxygen saturation is low at 92%. Providing supplemental oxygen is a standard intervention in the acute management of MI.
F. Sublingual nitroglycerin is commonly used to relieve chest pain in myocardial infarction by causing vasodilation. However, it should be used with caution in the presence of hypotension or other contraindications. Given the client’s symptoms and high heart rate, nitroglycerin could be appropriate,
but should be carefully monitored for effects on blood pressure.
G. A clear liquid diet is not an immediate priority in the management of acute myocardial infarction. Diet modification may be considered later in the course of treatment, but it is not a critical intervention in the acute phase.