A patient with dilated cardiomyopathy has recently developed atrial fibrillation that has been unresponsive to drug therapy for several days.

What topic should the nurse plan to include in patient teaching?

Choice A rationale
Sinus tachycardia at a rate of 110 beats/min is a normal response to exercise. During a stress test, the heart rate will naturally increase as the body’s demand for oxygen increases. A heart rate of 110 beats/min is within the expected range during moderate exercise.
Choice B rationale
An increase in blood pressure from 134/68 to 150/80 mm Hg is a normal response to exercise. During a stress test, blood pressure will naturally rise as the heart works harder to pump blood to the muscles. This increase is within the expected range during moderate exercise.
Choice C rationale
Feeling tired during a stress test on a treadmill is a normal response to exercise. Fatigue can occur as the body’s energy stores are used up during physical activity. However, if the patient reports extreme fatigue or other symptoms such as chest pain or shortness of breath, it may indicate a problem.
Choice D rationale
Inversion of T waves on the electrocardiogram during a stress test is a sign of myocardial ischemia, a condition in which the heart muscle is not getting enough oxygen. This could indicate the presence of significant coronary artery disease and is a finding that would necessitate immediate action.

Choice A rationale
Increasing glomerular filtration would result in increased urine output, not decreased venous return. This action is not directly related to the therapeutic action of nitroglycerin.
Choice B rationale
While enhancing the contractility of the myocardium would increase oxygen delivery, this is not the primary action of nitroglycerin. Nitroglycerin primarily works by dilating the blood vessels, which reduces the amount of work the heart has to do and increases the blood supply to the heart muscle.
Choice C rationale
Nitroglycerin does not produce an immediate analgesic effect. While it can relieve chest pain, it does so by increasing blood flow to the heart, not by acting as an analgesic.
Choice D rationale
Nitroglycerin increases the coronary blood supply and decreases the afterload314. By dilating the blood vessels, nitroglycerin reduces the amount of work the heart has to do and increases the blood supply to the heart muscle. This is the primary therapeutic action of nitroglycerin in alleviating chest pain.