A nurse is planning care for a client who is recovering from an acute myocardial infarction that occurred 3 days ago. Which of the following interventions should the nurse include?
Perform an ECG every 12 hr.
Obtain a cardiac rehabilitation consultation.
Draw a troponin level every 4 hr.
Place the client in a supine position while resting.
The Correct Answer is B
Rationale:
A. Perform an ECG every 12 hr: Frequent ECGs are typically done during the acute phase to monitor for arrhythmias, but by day 3 post-MI, continuous or as-needed monitoring is more appropriate unless new symptoms occur.
B. Obtain a cardiac rehabilitation consultation: Early involvement of cardiac rehab supports gradual activity progression, lifestyle modification, and psychosocial support, improving long-term outcomes after MI.
C. Draw a troponin level every 4 hr: Troponin testing is most useful for diagnosing and trending damage during the first 24 hours; by day 3, levels have usually peaked and are declining.
D. Place the client in a supine position while resting: Supine positioning can increase cardiac workload; a semi-Fowler's position is preferred to reduce venous return and ease breathing.
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Related Questions
Correct Answer is C
Explanation
A. "Polyuria can be caused by using antidepressants.": Antidepressants are more commonly associated with urinary retention or hesitancy rather than polyuria, so this statement reflects a misunderstanding of the typical causes.
B. "Polyuria can be caused by enlargement of the prostate gland.": Prostate enlargement usually causes urinary retention, difficulty initiating urination, or nocturia, rather than excessive urine output.
C. "Polyuria can be caused by drinking too much fluid.": Excessive fluid intake increases urine production, which is a common and direct cause of polyuria. This reflects an accurate understanding of one of the typical mechanisms leading to increased urine output.
D. "Polyuria can be caused by trauma to the lower urinary tract.": Trauma is more likely to result in hematuria, pain, or retention, not necessarily polyuria. This statement does not accurately reflect a common cause of excessive urination.
Correct Answer is D
Explanation
A. Weight gain 2.3 kg (5 lb): Mild weight gain can occur with oral contraceptive use and is generally not dangerous. This finding does not require immediate reporting.
B. Frequent nausea: Nausea is a common side effect, especially during the first few months of therapy. While bothersome, it is usually not an urgent concern unless severe or persistent.
C. Breast tenderness: Breast tenderness is a common, mild side effect of oral contraceptives and does not typically indicate a serious problem requiring immediate intervention.
D. Persistent headache: A new, persistent, or severe headache can indicate vascular complications, such as hypertension or increased risk of thromboembolism, which are serious adverse effects of oral contraceptives. This finding requires immediate reporting.
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