Exhibits
Review H and P, nurse's notes, flow chart, laboratory results, and prescriptions. Complete the diagram by dragging from the choices area to specify which condition the client is most likely experiencing, two actions the PN should take to address that condition, and two parameters the PN should monitor to assess the client's progress.
The Correct Answer is []
The client’s symptoms—severe chest pain, nausea, dizziness, trembling, and diaphoresis—along with elevated troponin levels, are indicative of a myocardial infarction. Troponin is a cardiac biomarker used to diagnose myocardial infarction, and the client’s symptoms are consistent with this condition.
Actions to Take:
- Use Therapeutic Communication to Build Rapport
Effective therapeutic communication helps the client feel supported and may reduce anxiety and fear related to their condition. This approach can provide a calm environment for the client, which is crucial when managing a myocardial infarction. - Teach Coping Skills
Teaching coping skills can help the client manage anxiety and stress, which are important for recovery from a myocardial infarction. Understanding how to cope with the emotional and psychological aspects of the condition supports overall care and management.
Parameters to Monitor:
- Heart Rhythm
Monitoring heart rhythm is essential to detect any arrhythmias or complications related to myocardial infarction. Changes in heart rhythm can indicate worsening of the condition or response to treatment. - Vital Signs
Monitoring vital signs, including blood pressure and heart rate, is crucial for assessing the client’s hemodynamic status and the effectiveness of treatment. Abnormalities in vital signs can indicate worsening of the myocardial infarction or side effects of medications
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Palpating the brachial artery before inflating the blood pressure cuff is a correct technique to locate the artery and ensure accurate blood pressure measurement.
B. Counting respirations while palpating the radial pulse is a correct technique as it minimizes the risk of the client altering their breathing pattern.
C. Asking the client to relax their arm before taking the blood pressure is an appropriate step to ensure an accurate measurement.
D. Inserting a thermometer into the sublingual pocket after the client sips water can affect the accuracy of the temperature reading, as water can alter the temperature measurement.
Correct Answer is ["A","D","E"]
Explanation
A. Place the drink where the client can reach from her bed
Placing the drink where the client can easily reach it encourages regular fluid intake. Accessibility is key for clients who may be feeling weak or fatigued, especially when dealing with symptoms of illness like fever and cough. Ensuring that fluids are within reach minimizes barriers to drinking and supports better hydration efforts.
B. Encourage drinks with high sugar content
Drinks with high sugar content are not ideal for promoting adequate fluid intake. High sugar content can worsen symptoms like nausea or dehydration and may lead to increased thirst or gastrointestinal upset, which is counterproductive to encouraging fluid intake. Offering fluids with balanced electrolytes and moderate sugar content is more beneficial.
C. Only offer water or other clear drink
Offering only water or clear drinks can be too restrictive and may not meet the client's preferences or needs. While clear liquids are appropriate, incorporating a variety of fluids can improve hydration and patient satisfaction. It is beneficial to offer options that the client might find appealing.
D. Ask the client what her favorite drink is
Asking the client for her favorite drink engages her in the decision-making process and increases the likelihood of her consuming more fluids. Personal preferences can significantly affect fluid intake, and offering drinks she likes can help in achieving adequate hydration.
E. Offer both hot and cold drinks
Offering both hot and cold drinks can cater to the client’s preferences and provide comfort, which may encourage her to drink more fluids. Variety in temperature can make drinking fluids more appealing, especially if the client is feeling unwell or has specific preferences.
F. Suggest popular drinks like coffee or soda
Suggesting coffee or soda is not recommended due to their diuretic effects and potential for dehydration. Coffee and soda can also interfere with electrolyte balance and are generally not suitable for hydration in a clinical setting where the goal is to address fluid volume deficit
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