A nurse is discussing the use of docusate sodium (Colace) with a client who is recovering from a non-ST elevation myocardial infarction (NSTEMI). What is the rationale for administering this medication during the recovery from a myocardial infarction?
Treats hyperlipidemia to reduce the risk of new plaques
Prevents the formation of clots to reduce the risk of stroke
Prevents vagal stimulation to reduce e risk of dysrhythmias
Removes excess sodium to reduce the risk of hypertension
The Correct Answer is C
A. This statement refers to medications like statins (e.g., rosuvastatin, atorvastatin) which are used to lower cholesterol levels and reduce the risk of atherosclerosis progression. Docusate sodium does not treat hyperlipidemia or affect plaque formation directly.
B. This refers to anticoagulant medications (e.g., heparin, warfarin, direct oral anticoagulants) which are used to prevent clot formation and reduce the risk of thromboembolic events such as stroke. Docusate sodium does not have anticoagulant properties.
C. After a myocardial infarction (MI), especially in the early recovery phase, vagal stimulation can exacerbate bradycardia or contribute to dysrhythmias. Stool softeners like docusate sodium help prevent constipation, which can stimulate the vagus nerve during straining, potentially leading to vagally mediated dysrhythmias such as bradycardia or atrioventricular blocks.
D. Diuretics (e.g., furosemide, hydrochlorothiazide) are used to reduce fluid retention and lower blood pressure by increasing urine output. Docusate sodium does not remove excess sodium or affect blood pressure regulation.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Medicare does cover individuals under 65 years old who have end-stage renal disease (ESRD) and meet certain criteria.
B. There are programs that allow individuals with both Medicare and low income to qualify for Medicaid, which can help cover additional healthcare costs that Medicare may not fully cover.
C. While Medicare does provide significant coverage for healthcare services, it is not entirely free of out- of-pocket costs. Medicare Part A typically covers hospital stays, skilled nursing facility care, hospice, and some home health care services with no premiums for most people.
D. Medicare is indeed federally-funded health insurance primarily for individuals aged 65 and older. It also covers certain younger individuals with disabilities and those with ESRD.
Correct Answer is B
Explanation
A. Atrial flutter typically presents with a regular atrial rate (usually around 250-350 beats per minute) and a characteristic "sawtooth" pattern of flutter waves (F-waves) on the ECG. This condition would not present with irregular ventricular rates and is less likely based on the ECG findings described.
B. Atrial fibrillation is identified by an irregularly irregular rhythm and the absence of P-waves on the ECG, which is replaced by erratic activity.
C. Unstable angina presents with chest pain or discomfort due to reduced blood flow to the heart muscles, usually related to atherosclerotic plaque rupture or erosion. It does not cause the ECG findings described (absence of P-waves and irregular ventricular rate).
D. PACs are early atrial depolarizations that can cause palpitations but do not typically result in the absence of P-waves or irregular ventricular rates as described in the scenario.
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