While assessing a client diagnosed with angina, the patient asks, “What causes this pain in my heart?” What is the nurse’s BEST response?

Choice A rationale:

Venous thromboembolism (VTE) is a blood clot that forms in a vein, usually in the legs. It can be a serious condition, as the clot can break loose and travel to the lungs, causing a pulmonary embolism (PE).

Crossing the legs at the knees can impede blood flow in the veins of the legs, increasing the risk of VTE. This is because it compresses the veins, slowing the flow of blood and making it more likely for clots to form.

The patient's statement that they will make sure not to cross their legs when resting in bed demonstrates that they understand this important risk factor for VTE and are taking steps to prevent it.

Choice B rationale:

While keeping pillows under the knees can help to improve circulation, it is not a specific measure to prevent VTE. It is more important to avoid crossing the legs and to engage in regular movement and activity to promote blood flow.

Choice C rationale:

Compression stockings can help to reduce the risk of VTE by compressing the veins in the legs and promoting blood flow. However, they should be worn as instructed by a healthcare professional, and not only if the patient experiences pain in their calves. Pain in the calves can be a symptom of VTE, so it is important to seek medical attention if it occurs.

Choice D rationale:

Bed rest is actually a risk factor for VTE, as it can lead to decreased blood flow in the legs. It is important to get up and move around as soon as possible after surgery, even if it is just for short periods of time. This will help to promote blood flow and reduce the risk of VTE.

Choice A rationale:

Bradycardia refers to a slow heart rate, typically defined as less than 60 beats per minute.

While some ICDs can provide pacing for bradycardia, this is not their primary purpose.

Their primary goal is to prevent sudden cardiac death from life-threatening arrhythmias.

Therefore, Choice A is not the best response.

Choice B rationale:

Atrial fibrillation (AFib) is a common heart rhythm disorder characterized by rapid and irregular beating of the atria.

While ICDs can sometimes be used in patients with AFib, this is not their primary indication.

AFib is typically managed with medications to control heart rate and rhythm, or with ablation procedures to disrupt the abnormal electrical pathways.

Therefore, Choice B is not the best response.

Choice C rationale:

Ventricular fibrillation (VF) and ventricular tachycardia (VT) are life-threatening arrhythmias that originate in the ventricles of the heart.

VF is characterized by chaotic, disorganized electrical activity in the ventricles, leading to ineffective pumping and cardiac arrest.

VT is a very fast heart rhythm that can degenerate into VF.

ICDs are specifically designed to detect and treat VF and VT.

They do this by delivering electrical shocks to the heart, which can restore a normal rhythm.

Therefore, Choice C is the best response.

Choice D rationale:

While ICDs can deliver shocks during a heart attack, this is not their primary purpose.

Heart attacks are caused by a blockage of blood flow to the heart muscle, and they are typically treated with medications, such as aspirin, nitroglycerin, and clot-busting drugs.

ICDs are primarily used to prevent sudden cardiac death from life-threatening arrhythmias, not to treat heart attacks themselves.