A nurse is preparing a class discussion on the clinical manifestations of a heart attack observed in women. Which symptoms would the nurse include as key assessment data? Select all that apply.

Choice A: African American women have the BRCA 1 and BRCA 2 gene is not the correct answer because it is not a fact but a misconception. BRCA 1 and BRCA 2 are genes that normally help prevent breast and ovarian cancer by repairing DNA damage. However, mutations in these genes can increase the risk of developing these cancers. BRCA mutations are not exclusive to African American women, but they can affect any race or ethnicity. According to the National Cancer Institute, about 12% of American white women and 10% of African American women have a BRCA mutation.

Choice B: American white women respond better to breast cancer treatment is not the correct answer because it is not a fact but a disparity. Breast cancer treatment can include surgery, radiation, chemotherapy, hormone therapy, or targeted therapy. The response to treatment can vary depending on various factors such as tumor type, stage, grade, or molecular profile. However, some studies have shown that American white women have better survival rates and outcomes than African-American women after breast cancer treatment. This disparity may be due to differences in access to care, quality of care, socioeconomic status, or biological factors.

Choice C: Breast cancer is more advanced in African American women when found is the correct answer because it is a fact and a disparity. Breast cancer is a disease that occurs when abnormal cells grow and invade the breast tissue or other parts of the body. The stage of breast cancer describes how far the cancer has spread and how serious it is. Breast cancer can be detected by screening tests such as mammograms or clinical exams such as breast self-exams. However, some studies have shown that African American women are more likely than American white women to be diagnosed with breast cancer at later stages. This disparity may be due to differences in screening rates, awareness, symptoms, or tumor biology.

Choice D: More Hispanic women smoke, which increases their risk is not the correct answer because it is not a fact but a misconception. Smoking is a risk factor for breast cancer, as it can damage the DNA of breast cells and increase the levels of hormones that stimulate cell growth. However, smoking rates are not higher among Hispanic women than other racial or ethnic groups. According to the Centers for Disease Control and Prevention, about 14% of Hispanic women smoke cigarettes compared to 16% of American white women and 14% of African American women.

Choice A: Cardiac complications are not the correct answer because they are not the main cause of the high infant mortality rate. Cardiac complications are problems that affect the heart or blood vessels of the newborn, such as congenital heart defects, arrhythmias, or heart failure. They can cause serious symptoms such as cyanosis, difficulty breathing, or poor feeding. However, they account for only about 5% of all infant deaths in the United States.

Choice B: Necrotizing enterocolitis is the correct answer because it is the main cause of the high infant mortality rate. Necrotizing enterocolitis is a condition that causes inflammation and death of the intestinal tissue of the newborn, leading to infection, perforation, or sepsis. It can cause symptoms such as abdominal distension, bloody stools, or shock. It is more common in premature or low birth weight infants and accounts for about 10% of all neonatal deaths.

Choice C: Viral infections are not the correct answer because they are not the main cause of the high infant mortality rate. Viral infections are diseases that are caused by viruses that invade the cells of the newborn, such as respiratory syncytial virus (RSV), cytomegalovirus (CMV), or herpes simplex virus (HSV). They can cause symptoms such as fever, cough, rash, or blisters. However, they account for only about 2% of all infant deaths in the United States.

Choice D: Prematurity is the correct answer because it is the main cause of the high infant mortality rate. Prematurity is a condition that occurs when a baby is born before 37 weeks of gestation, which is considered full-term. Premature babies are at risk of developing various complications such as respiratory distress syndrome, intraventricular hemorrhage, or retinopathy of prematurity. Prematurity accounts for about 35% of all infant deaths in the United States.

Choice E: Sudden infant death syndrome is the correct answer because it is the main cause of the high infant mortality rate. Sudden infant death syndrome is a condition that causes the unexpected and unexplained death of an apparently healthy baby during sleep. The exact cause of sudden infant death syndrome is unknown, but some risk factors include sleeping on the stomach, overheating, smoking exposure, or soft bedding. Sudden infant death syndrome accounts for about 15% of all infant deaths in the United States.

Choice F: Low birth weight is the correct answer because it is the main cause of the high infant mortality rate. Low birth weight is a condition that occurs when a baby is born weighing less than 2,500 grams (5 pounds 8 ounces). Low birth weight babies are at risk of developing various complications such as hypothermia, hypoglycemia, or jaundice. Low birth weight accounts for about 25% of all infant deaths in the United States.