The nursing problem of activity Intolerance related to impaired ventricular function is made for a client with myocarditis. Which outcome in the plan of care would reflect resolution of this issue? The client will:
ambulate in the hall 3 times daily without shortness of breath.
have an increase in systolic blood pressure of 20 mmHg during activity.
decrease weight from 150 lbs. (68.2 kg.) to 148 lbs. (67.3 kg.) in five days.
verbalize the signs and symptoms of worsening heart failure by discharge.
The Correct Answer is A
A. ambulate in the hall 3 times daily without shortness of breath: This directly reflects improved tolerance to activity, the central focus of the nursing diagnosis. Being able to ambulate without dyspnea indicates better cardiac output and ventricular function, marking resolution of the identified problem.
B. have an increase in systolic blood pressure of 20 mmHg during activity: A rise in systolic pressure may occur with exertion, but it does not necessarily indicate improved activity tolerance. In fact, an exaggerated BP response could indicate the heart is working harder than it should to meet the demands, suggesting poor cardiovascular adaptation to exercise.
C. decrease weight from 150 lbs. (68.2 kg.) to 148 lbs. (67.3 kg.) in five days: A slight weight reduction may reflect decreased fluid retention, but this outcome is more relevant to volume status and fluid balance than to resolving activity intolerance specifically.
D. verbalize the signs and symptoms of worsening heart failure by discharge:
While important for client education and self-management, this outcome relates to knowledge rather than physical tolerance to activity. It does not directly measure resolution of activity intolerance.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Amiodarone: Amiodarone is a Class III antiarrhythmic that primarily works by blocking potassium channels, thereby prolonging repolarization and the action potential duration. It is used to manage various atrial and ventricular arrhythmias, including atrial fibrillation and ventricular tachycardia.
B. Digoxin: Digoxin is a cardiac glycoside that increases myocardial contractility and slows conduction through the AV node. It does not affect potassium channels directly but rather works by inhibiting the sodium-potassium ATPase pump.
C. Verapamil: Verapamil is a calcium channel blocker (Class IV antiarrhythmic) that slows conduction through the AV node and is used to treat supraventricular tachyarrhythmias and hypertension. It has no significant effect on potassium channels.
D. Carvedilol: Carvedilol is a non-selective beta-blocker with some alpha-blocking effects. It reduces heart rate and blood pressure but does not block potassium channels or have antiarrhythmic properties in that classification.
Correct Answer is B
Explanation
A. Edema of ankles: While peripheral edema may be associated with worsening cardiac function or side effects from other medications, it is not a hallmark adverse effect of amiodarone. It warrants evaluation but is not the most urgent symptom related to this drug.
B. Shortness of breath: Amiodarone is a potent antiarrhythmic medication with several potential serious side effects, including pulmonary toxicity. This can manifest as interstitial pneumonitis or pulmonary fibrosis, which may present as new or worsening shortness of breath cough, and chest pain. This is a potentially life-threatening complication and requires immediate medical attention.
C. Fatigue after exercise: Exercise-induced fatigue can result from many conditions, including heart disease or deconditioning, but it is a nonspecific symptom. It does not point directly to a serious adverse reaction from amiodarone.
D. Abdominal fullness: Abdominal fullness is not typically associated with amiodarone. It may relate to gastrointestinal or hepatic issues, but it is not as immediately concerning as respiratory symptoms suggestive of pulmonary toxicity.
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