A patient is prescribed metoprolol in the treatment of stable angina.
What is the best outcome measure of decreased cardiac workload due to metoprolol for the nurse to evaluate?

Patient's heart rate is 62 and regular.

Patient is able to lie flat without reporting difficulty breathing.

Patient does not report dyspnea after climbing one flight of stairs.

Patient has weight loss of 3 lbs (1.4 kg) over 2 weeks.

Answer and Explanation

The Correct Answer is A

Choice A rationale

Metoprolol decreases cardiac workload by reducing heart rate and myocardial oxygen demand. A heart rate of 62 is within normal limits, demonstrating effective beta-blocker action and improved cardiac efficiency.

Choice B rationale

Lying flat without difficulty breathing reflects improved respiratory status, which is more related to pulmonary management, not directly indicative of reduced cardiac workload or beta-blocker efficacy.

Choice C rationale

Absence of dyspnea after climbing stairs suggests improved physical fitness but does not directly measure the cardiac effects of metoprolol, which targets heart rate reduction and myocardial oxygen use.

Choice D rationale

Weight loss is related to overall health improvement or dietary changes rather than specific effects of metoprolol, which primarily impacts heart rate and cardiac oxygen consumption.

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Correct Answer is B

Explanation

Choice A rationale

Nitroprusside is a vasodilator for hypertensive crises but is contraindicated in elevated ICP because it increases cerebral blood volume and exacerbates intracranial pressure, worsening the patient's condition.

Choice B rationale

Hypertonic saline (3%) helps reduce ICP by drawing excess fluid from brain tissue into the bloodstream through osmosis, effectively lowering intracranial pressure while maintaining cerebral perfusion.

Choice C rationale

Furosemide is a loop diuretic that reduces fluid overload but does not specifically target ICP. It is less effective in managing the osmotic balance required for intracranial pressure reduction.

Choice D rationale

Norepinephrine is a vasopressor used to treat hypotension and improve perfusion but does not lower ICP and may increase cerebral vasoconstriction, exacerbating intracranial hypertension. .

A. Avoid vigorous coughing or nose blowing. B. The ear canal will be firmly packed with a dry dressing if drainage occurs. C. Your ear canal will be irrigated with saline at room temperature. D. Bedrest with bathroom privileges is required for 24 hours.

Correct Answer is A

Explanation

Choice A rationale

Vigorous coughing or nose blowing increases pressure in the middle ear, potentially dislodging the stapes prosthesis, interfering with healing, and increasing risk of complications like vertigo or auditory damage.

Choice B rationale

Packing with dry dressing is contraindicated because it may trap moisture and increase infection risk. If drainage occurs, sterile measures are taken to assess and manage infection without creating ideal conditions for pathogens.

Choice C rationale

Irrigation of the ear canal risks introducing pathogens or disrupting the surgical area. Post-surgery, maintaining a dry environment helps reduce infection and promote proper healing.

Choice D rationale

Though bedrest may be recommended initially, prolonged immobility isn't essential unless specific complications arise. Movement minimizes risks of clot formation and encourages circulation, aiding recovery.

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A patient is prescribed metoprolol in the treatment of stable angina.What is the best outcome measure of decreased cardiac workload due to metoprolol for the nurse to evaluate?

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A patient is prescribed metoprolol in the treatment of stable angina.
What is the best outcome measure of decreased cardiac workload due to metoprolol for the nurse to evaluate?