The nurse is caring for a client admitted with unstable angina. The laboratory result for the initial troponin I is elevated in this client. The nurse should recognize what implication of this assessment finding?

This result indicates muscle injury but does not specify the source.

Because the client has a history of unstable angina, this is a poor indicator of myocardial injury.

This is only an accurate indicator of myocardial damage when it reaches its peak in 24 hours.

This is an accurate indicator of myocardial injury.

Answer and Explanation

The Correct Answer is D

A. This result indicates muscle injury but does not specify the source.

This statement is partly correct. An elevated troponin I level does indicate muscle injury, specifically damage to the heart muscle. However, troponin I is highly specific to cardiac muscle, so an elevated level would indeed specify the source as cardiac or myocardial injury.

B. Because the client has a history of unstable angina, this is a poor indicator of myocardial injury.

This statement is incorrect. A history of unstable angina does not diminish the significance of an elevated troponin I level. In fact, unstable angina is itself a serious condition that can lead to myocardial injury or heart attack, and an elevated troponin I level in this context indicates ongoing or recent myocardial damage.

C. This is only an accurate indicator of myocardial damage when it reaches its peak in 24 hours.

This statement is not entirely accurate. While it is true that troponin I levels may continue to rise and peak within 12-24 hours after the onset of myocardial injury, an elevated troponin I level at any point is still a significant indicator of myocardial damage. It's essential to recognize elevated troponin I levels promptly to initiate appropriate interventions and monitor the client's cardiac status closely.

D. This is an accurate indicator of myocardial injury.

This statement is correct. An elevated troponin I level is a highly sensitive and specific marker of myocardial injury. It indicates damage to the heart muscle, which can occur due to conditions like unstable angina, heart attack (myocardial infarction), myocarditis, or other cardiac issues. Therefore, recognizing an elevated troponin I level in a client with unstable angina is crucial for proper management and further evaluation.

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Correct Answer is B

Explanation

A. "Cardiac enzymes assist in diagnosing the presence of pulmonary congestion.": Cardiac enzymes are not used to diagnose pulmonary congestion. They are specific markers used to assess damage to the heart muscle, particularly after a myocardial infarction (MI).

B. "These tests help determine the degree of damage to the heart tissues.": This statement is correct. Cardiac enzyme studies, such as troponin levels, CK-MB (creatine kinase-MB), and LDH (lactate dehydrogenase), are used to evaluate the extent of myocardial damage during and after an MI. Elevated levels of these enzymes indicate myocardial injury.

C. "These tests will enable the provider to determine the heart structure.": While cardiac imaging studies like echocardiograms or angiograms are used to assess heart structure, cardiac enzymes are primarily used to evaluate myocardial damage and not heart structure.

D. "Cardiac enzymes will identify the location of the MI.": Cardiac enzymes can indicate the presence of an MI and the extent of myocardial damage, but they do not specifically identify the location of the MI within the heart. Additional diagnostic tests, such as electrocardiograms (ECGs) and imaging studies, are often used to determine the location of the MI.

A. Work together to see how they can incorporate healthier choices into the foods enjoyed. B. Tell the client if they do not change their diet, they are going to have a myocardial infarction. C. Give the client a list of foods to choose from. D. It is okay to cheat because of the medications.

Correct Answer is A

Explanation

A. Work together to see how they can incorporate healthier choices into the foods enjoyed:

This approach emphasizes collaboration between the nurse and the client, focusing on finding ways to incorporate healthier food choices into the client's diet while considering their food preferences and cultural background. By working together, the nurse can help the client identify suitable substitutions, portion control strategies, and meal planning techniques that align with the dietary recommendations for coronary heart disease. This approach promotes active participation, empowers the client to make informed decisions, and increases the likelihood of long-term adherence to the dietary plan.

B. Tell the client if they do not change their diet, they are going to have a myocardial infarction:

This approach uses fear tactics or negative consequences to motivate behavior change, which is generally not recommended in healthcare settings. Fear-based strategies may lead to increased anxiety, stress, or resistance in the client, ultimately hindering motivation and adherence to the dietary plan. Positive reinforcement, education, and collaborative goal-setting are more effective in promoting behavior change and improving adherence to lifestyle modifications.

C. Give the client a list of foods to choose from:

Providing a list of foods can be a helpful tool in guiding food choices and promoting a balanced diet. However, this approach may not address the client's individual preferences, cultural considerations, or practical challenges in implementing dietary changes. Without personalized guidance and support, the client may struggle to navigate food options effectively and may experience difficulties in adhering to the dietary recommendations.

D. It is okay to cheat because of the medications:

Encouraging cheating or deviating from the dietary plan due to medications undermines the importance of dietary modifications in managing coronary heart disease. It is essential to emphasize the significance of following a heart-healthy diet and lifestyle, as medications alone may not be sufficient to manage the condition effectively. Providing education on medication adherence and dietary guidelines, along with ongoing support, helps reinforce the importance of consistent dietary habits in promoting cardiovascular health.

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The nurse is caring for a client admitted with unstable angina. The laboratory result for the initial troponin I is elevated in this client. The nurse should recognize what implication of this assessment finding?

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Explanation

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Correct Answer is A

Explanation

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