In planning care for a patient with acute myocardial infarction (AMI), which of the following should the nurse identify as the highest priority goal of care?
Stable ECG rhythm
Ability to verbalize causes and effects of CHD/CAD
Adequate relief of pain
Compliance with prescribed bedrest
The Correct Answer is C
Choice A reason : While maintaining a stable ECG rhythm is important, it is not the highest priority. The primary concern is to address life-threatening complications.
Choice B reason : Educating the patient about the causes and effects of coronary heart disease (CHD) or coronary artery disease (CAD) is important for long-term management but is not the immediate priority during acute care.
Choice C reason : Adequate relief of pain is the highest priority in the care of a patient with AMI. Pain is an indicator of ongoing ischemia and can increase the workload of the heart, thereby worsening the condition.
Choice D reason (AMI): While bedrest is part of the care plan, it is not the highest priority compared to pain relief, which has direct implications on the patient's immediate physiological status.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: Aspirin can irritate the stomach lining and increase acid reflux, worsening GERD symptoms. It is generally not recommended without consulting a healthcare provider.
Choice B reason : Mercury content in seafood is not directly linked to GERD. This statement is misleading and does not address known risk factors for GERD.
Choice C reason : Lying down after eating can indeed increase the onset of GERD as it allows stomach contents to flow back into the esophagus more easily.
Choice D reason : Alcohol and caffeine can relax the lower esophageal sphincter, allowing stomach acid to rise into the esophagus and worsen GERD symptoms. Therefore, it is advisable to avoid or reduce their intake.
Correct Answer is D
Explanation
Choice A reason: Painful and red-tinged urination could be related to kidney stones but is not directly relevant to the preparation for an intravenous pyelogram.
Choice B reason: The end of the menstrual period is not typically relevant to the preparation for an intravenous pyelogram.
Choice C reason: Drinking fluids is generally encouraged but does not need to be reported unless it is restricted before the procedure.
Choice D reason: The client's allergy to shellfish is important to report because the contrast dye used in an intravenous pyelogram may contain iodine, which can cause a reaction in people with shellfish allergies.
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