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Exhibits

The nurse is reviewing the client's medical record. Which of the following findings indicates the client's condition has improved? Select all that apply.

Echocardiogram results

Blood pressure

Urinary output

Pain level

Respiratory rate

Heart rate

Oxygenation saturation

Answer and Explanation

Correct Answer : B,D,E,F,G

Echocardiogram results would provide information about the structure and function of the heart, particularly regarding any changes in cardiac function or wall motion abnormalities that might have been detected during the acute phase. It does indicate signs of improvement.
B.   Blood pressure is an important vital sign that reflects cardiovascular status. In the context of acute coronary syndrome or myocardial infarction, a stable or improving blood pressure indicates adequate perfusion to vital organs, including the heart. A decrease in blood pressure from hypertensive levels seen earlier could indicate stabilization of the client's condition.
C.   Urinary output is a critical indicator of renal perfusion and function. During acute illness, including cardiac events, decreased urinary output can indicate poor perfusion due to decreased cardiac output or hypoperfusion. In this scenario the output is still inadequate.
D.   Pain level, specifically chest pain in the context of acute coronary syndrome, is a subjective indicator of the client's cardiac status. A reduction in pain intensity, as reported by the client, can indicate that the treatment, such as nitroglycerin for angina, is effective in relieving myocardial ischemia. Therefore, a decrease in pain level suggests improvement in the client's cardiac condition.
E.   Respiratory rate is another vital sign that reflects the client's respiratory effort and overall respiratory status. In the context of acute cardiac events, respiratory rate can increase due to pain, anxiety, or respiratory distress. A decrease in respiratory rate suggests improved respiratory comfort and potentially reduced cardiac workload, indicating improvement in the client's condition.
F.   Heart rate is a crucial vital sign that reflects cardiac workload and rhythm. In acute coronary syndrome, tachycardia is often present due to sympathetic stimulation and the body's response to myocardial ischemia. A decrease in heart rate suggests that the client's cardiac workload has decreased, possibly indicating improved myocardial perfusion and stability.
G.   Oxygen saturation reflects the amount of oxygen bound to hemoglobin in the blood, which is essential for tissue oxygenation. In acute cardiac events, hypoxemia can occur due to impaired cardiac function or respiratory compromise. Improvement in oxygen saturation indicates improved tissue oxygenation, possibly due to effective management of cardiac function or respiratory support.

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Correct Answer is C

Explanation

C. The CPM machine should be used during designated therapy sessions as prescribed by the healthcare provider. Turning it off during meals allows the client to focus on eating without interference from the machine.

A The range of motion settings on the CPM machine should be adjusted gradually according to the client's tolerance and prescribed therapy plan. Rapidly increasing the range of motion could cause discomfort, pain, or even injury to the client's knee joint. Therefore, the nurse should not increase the range of motion rapidly.

B Storing the CPM machine on the floor is not ideal because it can increase the risk of contamination or damage to the equipment. The machine should be stored on a clean, stable surface when not in use to prevent accidental damage or exposure to dirt and debris.

D. Regular checks of the CPM machine's settings are important, but every 12 hours may not be frequent enough to ensure the machine is functioning correctly and safely.

A. "Your provider wouldn't prescribe this medication if it weren't necessary." B. "Most clients feel better after taking the antibiotic." C. "If you don't take this medication, you will feel worse." D. "I will tell your provider that you do not want to take this medication."

Correct Answer is D

Explanation

A While this statement is factual, it may come off as dismissive of the client’s concerns. The client may feel that their feelings and autonomy are not being respected. It's important to provide education but also to engage the client in a conversation about their concerns.

B. While this statement is intended to provide reassurance and encouragement, it may not be accurate for all clients or situations. It could also oversimplify the client's concerns and may not address the specific reasons for their reluctance to take the medication.

C. This response emphasizes the potential consequences of not adhering to the prescribed treatment plan. It highlights the importance of the medication in managing or treating the client's condition effectively. However, it may come across as threatening or coercive, which is not conducive to building a trusting and collaborative relationship with the client.

D. This is an appropriate response as it acknowledges the client’s autonomy and concern. It indicates that the nurse respects the client’s wishes and that the client will have the opportunity to discuss their concerns further with the provider. This fosters open communication and may lead to a better understanding of the necessity of the medication.

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Exhibits The nurse is reviewing the client's medical record. Which of the following findings indicates the client's condition has improved? Select all that apply.

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Exhibits

The nurse is reviewing the client's medical record. Which of the following findings indicates the client's condition has improved? Select all that apply.