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. Pyridostigmine is primarily used in the treatment of myasthenia gravis, a different autoimmune neuromuscular disorder characterized by weakness of voluntary muscles. It works by inhibiting the

enzyme acetylcholinesterase, which increases the levels of acetylcholine at neuromuscular junctions, thereby improving muscle strength. It is not used for treating multiple sclerosis.
B. Levodopa-carbidopa is commonly used to treat Parkinson’s disease. Levodopa is converted to dopamine in the brain, and carbidopa prevents levodopa from being converted into dopamine before it reaches the brain. This combination helps manage the motor symptoms of Parkinson’s disease. It is not used for multiple sclerosis.
C. Riluzole is used primarily for the treatment of amyotrophic lateral sclerosis (ALS), a neurodegenerative disease affecting motor neurons. It works by reducing the release of glutamate, a neurotransmitter that can be toxic to nerve cells. Riluzole is not used for multiple sclerosis.
D. Interferon-beta is a disease-modifying therapy used in the treatment of multiple sclerosis. It works by modulating the immune system to reduce the frequency and severity of MS relapses. Interferon-beta can help slow the progression of disability and reduce the number of new lesions seen on MRI scans.

Client's Response to Nitroglycerin Therapy

• Unstable Angina:
o Typically, unstable angina responds well to nitroglycerin. The relief of discomfort after nitroglycerin administration suggests that the chest pain was likely related to unstable angina, as it indicates a reduction in coronary artery spasm or temporary ischemia.
• Myocardial Infarction:
o In an MI, nitroglycerin may help alleviate pain, but it does not address the underlying cause of myocardial injury. The pain relief in an MI is generally more variable and may not be as effective if there is significant myocardial damage.

2. Client's Initial Report of Manifestations

• Unstable Angina:
o The symptoms described (shortness of breath, dizziness, and discomfort in the jaw, neck, and left arm) are consistent with unstable angina, which is characterized by episodes of chest pain or discomfort at rest or with minimal exertion, often associated with transient ischemia.
• Myocardial Infarction:
o These symptoms can also be consistent with MI, especially if they are severe or persistent. However, MI often presents with more intense and prolonged pain, and the discomfort might not always resolve with rest.

3. 12 Lead EKG Report

• Unstable Angina:
o ST depression on an EKG is more commonly associated with unstable angina, which indicates transient ischemia rather than a sustained myocardial injury.
• Myocardial Infarction:
o ST depression indicates ischemia commonly in angina.

4. Troponin Results

• Unstable Angina:
o Troponin levels are typically normal in unstable angina. The client’s troponin I (0.01 ng/mL) and troponin T (0.03 ng/mL) are within the normal range, suggesting no significant myocardial injury. This is consistent with unstable angina.
• Myocardial Infarction:
o Elevated troponin levels are a key marker of myocardial injury. The normal troponin results in this case do not support an MI diagnosis, as elevated troponin levels would be expected in MI.