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

Answer and Explanation

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.

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Correct Answer is D

Explanation

A. Heart failure is associated with central sleep apnea, not obstructive sleep apnea (OSA), which results from airway obstruction.
B. Opioid overdose is linked to central sleep apnea, where the brain fails to send proper signals to the breathing muscles. It does not cause obstruction of the airway.
C. Brainstem injury can affect respiratory drive, but it is not a direct cause of OSA, which is due to mechanical airway obstruction.
D. Enlarged tonsils are correct. In children and adults, enlarged tonsils can block the airway, making them a common cause of OSA.

A. Weight gain B. Shortness of breath C. Pulmonary embolism D. Anorexia

Correct Answer is B

Explanation

A. Weight gain is more commonly associated with right-sided heart failure due to fluid retention and peripheral edema, not left-sided heart failure.
B. Shortness of breath (dyspnea) is correct. Left-sided heart failure causes pulmonary congestion, leading to dyspnea, orthopnea, and pulmonary edema as blood backs up into the lungs.
C. Pulmonary embolism is not a direct manifestation of left-sided heart failure. While heart failure increases the risk of clot formation, a pulmonary embolism is a separate condition.
D. Anorexia is more common in right-sided heart failure, as systemic venous congestion can lead to gastrointestinal edema and poor appetite.

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