The nurse is reviewing the patient’s history and recent lab results. Which of the following findings indicate an increased risk for cardiovascular complications? (Select all that apply)

Mild left ventricular hypertrophy on x-ray

Total cholesterol of 210 mg/dL

Hemoglobin A1C of 7.5%

Sodium level of 138

Creatinine level of 1.6

Oxygen saturation of 95% on room air

Answer and Explanation

Correct Answer : A,B,C,E

Choice A reason: Mild left ventricular hypertrophy indicates cardiac strain from chronic hypertension, increasing risk for heart failure or infarction. It reflects structural change, elevating cardiovascular morbidity as pressure overload progresses, a known precursor to serious events.

Choice B reason: Total cholesterol of 210 mg/dL exceeds optimal (<200 mg/dL), promoting atherosclerosis. Lipid plaques narrow arteries, raising risks for coronary artery disease and stroke, a well-established cardiovascular risk factor needing intervention.

Choice C reason: Hemoglobin A1C of 7.5% shows poor glycemic control (>6.5% is diabetes), damaging vessels via glycation. This accelerates atherosclerosis and microvascular complications, significantly increasing cardiovascular event risk in uncontrolled diabetes.

Choice D reason: Sodium of 138 mEq/L is normal (135-145 mEq/L), not impacting cardiovascular risk directly. It influences fluid balance, but this value doesn’t suggest hypertension or heart strain, making it irrelevant here.

Choice E reason: Creatinine of 1.6 mg/dL (>1.2 mg/dL) signals renal impairment, often from hypertension or diabetes. Kidney dysfunction raises cardiovascular risk by disrupting fluid and pressure regulation, contributing to heart disease progression.

Choice F reason: Oxygen saturation of 95% on room air is normal (95-100%), indicating adequate lung function. It doesn’t suggest hypoxia or cardiovascular compromise, so it’s not a risk factor in this context.

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Correct Answer is B

Explanation

Choice A reason: Beta blockers like metoprolol reduce heart rate and demand, improving heart failure long-term. They don’t directly reduce fluid overload causing dyspnea and fatigue, focusing instead on cardiac remodeling, not acute volume relief.

Choice B reason: Diuretics like furosemide increase urine output, reducing fluid overload in heart failure. They directly relieve dyspnea and fatigue by lowering preload and pulmonary congestion, the most effective class for these symptoms.

Choice C reason: ACE inhibitors like lisinopril ease vascular resistance, aiding heart failure. They reduce fluid indirectly via aldosterone suppression, but diuretics act faster on acute overload, making them secondary for immediate symptom relief.

A. Ceftriaxone 1 gm IVPB B. Antipyretic given every 6 hours C. Blood and sputum cultures D. Monitor Blood Glucose before meals and at Bedtime E. Monitor I and O

Correct Answer is C

Explanation

Choice A reason: Ceftriaxone treats infection, but giving it before cultures risks sterilizing samples, skewing results. It’s critical therapy, yet obtaining accurate diagnostics first ensures targeted treatment, delaying antibiotics briefly.

Choice B reason: Antipyretics reduce fever, a symptom, not the cause. Cultures take priority to identify pathogens before comfort measures, as fever management doesn’t alter diagnostic or treatment urgency in this case.

Choice C reason: Blood and sputum cultures identify the causative organism in suspected infection (e.g., pneumonia). They must be obtained first, before antibiotics, to ensure accuracy, guiding effective therapy and avoiding false negatives.

Choice D reason: Monitoring glucose is routine, not urgent in acute infection unless diabetic crisis is suspected. Cultures precede this, as identifying the pathogen drives treatment, while glucose can wait without immediate risk.

Choice E reason: Monitoring intake and output tracks fluid status, useful but secondary in acute infection. Cultures are the priority to diagnose and treat effectively, as I&O doesn’t alter initial management decisions.

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The nurse is reviewing the patient’s history and recent lab results. Which of the following findings indicate an increased risk for cardiovascular complications? (Select all that apply)

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