The nurse is caring for a diabetic client who had a Coronary Angiography two hours ago. Which of the following orders should the nurse question?
Have client lay in bed flat for 4 hours
Monitor site for bleeding and hematoma formation
Administer metformin
Administer Aspirin
The Correct Answer is C
A. Having the client lay flat for 4 hours is appropriate. After coronary angiography, bed rest is required to prevent bleeding from the arterial puncture site, especially if a femoral approach was used.
B. Monitoring the site for bleeding and hematoma formation is correct. Bleeding is a potential complication, and frequent assessment of the catheter insertion site is necessary.
C. Administering metformin should be questioned. Metformin is contraindicated within 48 hours of receiving contrast dye because of the risk of lactic acidosis, especially in clients with impaired renal function.
D. Administering aspirin is appropriate. Aspirin is commonly prescribed to prevent clot formation after a coronary procedure.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. A balloon inflation within the artery describes percutaneous coronary intervention (PCI) or angioplasty, not CABG.
B. A medication to dissolve a blood clot refers to thrombolytic therapy, which is not part of a CABG procedure.
C. Injecting dye to outline heart vessels describes a coronary angiogram, which is a diagnostic procedure but not a treatment.
D. CABG involves using a healthy artery or vein to bypass the blocked portion of a coronary artery, restoring proper blood flow to the heart muscle.
Correct Answer is D
Explanation
A. Intermittent claudication with pallor is typically associated with peripheral artery disease (PAD) rather than myocardial infarction.
B. Jugular vein distention and dependent edema are signs of right-sided heart failure, which may develop after an MI but are not classic acute MI symptoms.
C. Mid-epigastric pain and heartburn can sometimes be confused with MI symptoms, but heartburn alone is not diagnostic of an MI.
D. Diaphoresis and cool clammy skin are correct. These symptoms occur due to sympathetic nervous system activation in response to cardiac ischemia, leading to vasoconstriction, sweating, and signs of impending shock.
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