The nurse is doing discharge teaching with a client who has coronary artery disease.

The client asks why he has to take an aspirin every day if he doesn’t have any pain.

What would be the nurse’s best response?

Choice A Rationale:

Repolarization is a phase in the cardiac cycle that involves the restoration of electrical charges in heart muscle cells, enabling them to prepare for the next contraction. It does not directly refer to the physical contraction and ejection of blood from the chambers.

During repolarization, the heart muscle cells regain their negative electrical charge after depolarization, which triggered the contraction.

Repolarization is essential for maintaining the heart's rhythmic electrical activity and ensuring coordinated contractions.

It does not, however, cause the chambers to become smaller and eject blood, which is the defining feature of systole.

Choice C Rationale:

Diastole is the phase of the cardiac cycle when the heart chambers relax and fill with blood. It is the opposite of systole.

During diastole, the heart muscle relaxes, allowing the chambers to passively expand and collect blood from the veins.

The atrioventricular valves (mitral and tricuspid valves) open during diastole, allowing blood to flow from the atria into the ventricles.

While diastole is crucial for ensuring adequate blood supply to the heart, it does not involve the forceful ejection of blood into circulation that characterizes systole.

Choice D Rationale:

Ejection fraction is a measurement of the heart's pumping efficiency. It represents the percentage of blood that is ejected from the left ventricle with each contraction.

A normal ejection fraction is typically between 55% and 70%.

While ejection fraction is related to systole, it is not a synonym for it. Ejection fraction is a quantitative measure of how well the heart is pumping, while systole refers to the specific phase of the cardiac cycle when contraction and ejection occur.

Choice A rationale:

Incorrect. Scarring on the atria is not an indication of procedure failure in the context of the maze procedure. In fact, it's a desired outcome.

Pacemaker implantation: Not routinely indicated after the maze procedure, even if scarring is present. Pacemakers are primarily used to treat bradyarrhythmias (slow heart rhythms), not atrial fibrillation.

Choice B rationale:

Incorrect. Repeating the maze procedure is generally not considered unless there's clear evidence of recurrent atrial fibrillation despite initial scarring. Scarring formation takes time, and premature repeat procedures are often not necessary.

Consulting the care team: While collaboration is essential, consultation specifically for repeating the procedure based solely on scarring would be premature.

Choice C rationale:

Correct. The maze procedure intentionally creates scar tissue within the atria to block abnormal electrical signals that cause atrial fibrillation. Scarring disrupts the pathways that allow these signals to circulate and trigger fibrillation. Therefore, the presence of scarring is a positive finding that suggests the procedure has achieved its intended effect.

Choice D rationale:

Incorrect. Further diagnostic testing is not routinely indicated solely based on the presence of scarring after the maze procedure. Additional testing might be considered if the patient experiences recurrent atrial fibrillation or other concerning symptoms, but scarring itself does not necessitate immediate further investigation.