A nurse is reinforcing teaching to a client who is postmenopausal about reducing the risk of coronary artery disease. Which of the following statements by the client indicates an understanding of the teaching?

A. "I will sit on the side of the bed before I stand up." Propranolol can cause orthostatic hypotension, so the client should sit on the edge of the bed before standing to avoid dizziness or falls. This statement shows correct understanding.

B. "I should weigh myself on the same day once a week." Clients taking propranolol, especially if they have heart failure, should weigh themselves daily to monitor for fluid retention. Weekly weighing is insufficient for identifying early signs of worsening heart failure.

C. "I should expect to develop a slight cough while taking this medication." A cough is more commonly associated with ACE inhibitors (such as lisinopril) rather than beta-blockers like propranolol. This statement indicates a misunderstanding.

D. "I will not take my medicine if my heart rate is greater than 70/min." Beta-blockers like propranolol are typically withheld if the heart rate is below 60 beats per minute, not when it is greater than 70. This statement shows a misunderstanding of when to hold the medication.

A. Neurological assessment: The neurological assessment indicates the client is alert and oriented, which is good; however, it does not require immediate follow-up.

B. Vital signs: The vital signs indicate an elevated heart rate (138/min), elevated respiratory rate (28/min), and borderline low blood pressure (96/75 mm Hg). These findings suggest potential hemodynamic instability and require immediate attention to assess the underlying cause and determine the appropriate interventions.

C. Basic Metabolic Profile (BMP) laboratory report: The BMP is largely within normal limits except for the glucose level (148 mg/dL), which is slightly elevated but not critically so. There is no urgent need for follow-up based on the BMP findings unless other symptoms arise.

D. Cardiac enzymes laboratory report: The troponin level is elevated (10.1 ng/mL), indicating myocardial injury, which requires immediate follow-up to assess the risk of acute coronary syndrome or worsening heart failure. This is a critical finding that warrants further evaluation.

E. B-natriuretic peptide (BNP) laboratory report: The BNP level is significantly elevated at 800 ng/mL, indicating worsening heart failure. This finding requires immediate follow-up to assess the client's condition and determine appropriate management strategies.

F. Respiratory assessment: The respiratory assessment shows an elevated respiratory rate (28/min) and oxygen saturation at 93% on supplemental oxygen. The presence of pink-tinged sputum may indicate pulmonary congestion or possible pulmonary edema, necessitating immediate follow-up.

G. ECG report: The ECG shows atrial fibrillation with a rapid ventricular response (RVR) at a rate of 135/min. This irregular heart rate can lead to decreased cardiac output and increased risk of thromboembolic events, requiring immediate follow-up to manage the heart rate and rhythm appropriately.