A client is admitted with heart failure (HF) and left ventricular hypertrophy. Which intervention is most likely to avert development of cardiomegaly and improve myocardial contractility?
Teach about compliance to reduce blood pressure.
Provide rest periods and portable oxygen.
Maintain continuous monitoring of heart rate and rhythm.
Administer nitroglycerin daily.
The Correct Answer is A
A. This is the most likely intervention to avert cardiomegaly and improve myocardial contractility. By reducing blood pressure, the heart doesn't have to work as hard to pump blood, which can help prevent the heart from enlarging (cardiomegaly) and improve its ability to contract effectively.
B. While rest and oxygen can help manage symptoms of heart failure, they do not directly address the underlying issue of increased cardiac workload and hypertrophy.
C. Monitoring heart rate and rhythm is important for assessing the patient's condition, but it does not prevent cardiomegaly or improve contractility.
D. Nitroglycerin is used to treat acute symptoms of heart failure, such as chest pain, but it is not a long- term solution for preventing cardiomegaly or improving contractility.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Vital signs are critical for assessing the client’s current hemodynamic status. Coffee-ground emesis can indicate gastrointestinal bleeding, which might lead to complications like hypovolemia or shock.
Vital signs can provide essential information about the client’s condition and help determine the urgency of intervention. Checking vital signs is a priority in assessing the severity of the situation and guiding further actions.
B. Measuring abdominal girth is useful in assessing for abdominal distention or fluid accumulation, which can be relevant in some gastrointestinal conditions. However, in the immediate context of coffee- ground emesis, the most urgent concern is evaluating the client's hemodynamic stability rather than focusing on abdominal girth.
C. Flushing of the skin might be relevant in certain contexts (e.g., reactions to medications or infections), but it is not directly related to the immediate concern of gastrointestinal bleeding and the client’s hemodynamic status. It is less critical compared to assessing vital signs in this situation.
D. While auscultating breath sounds is important for evaluating respiratory status and detecting any pulmonary complications, it is not the immediate priority in the context of coffee-ground emesis. The primary concern should be assessing for signs of hemodynamic instability that may result from gastrointestinal bleeding.
Correct Answer is A
Explanation
A. The absence of hair growth on the lower legs is a potential sign of peripheral neuropathy, a common complication of diabetes. Assessing the skin for other signs of neuropathy, such as dryness, cracking, or calluses, would provide further evidence to support this diagnosis.
B. While this might indicate neuropathy, it's not as direct a correlation as the skin appearance.
C. Assessing pulses helps to evaluate peripheral circulation, but it doesn't directly address the issue of hair loss, which is more related to nerve damage.
D. Ecchymosis can indicate a bleeding disorder or trauma, not necessarily neuropathy.
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