A client with angina has been prescribed nitroglycerin.
Before administering the drug, what potential adverse effects should the nurse inform the client about?

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.

Choice A rationale:

Bleeding is a concern due to the recent surgery and heparin therapy, which can increase bleeding risk. However, wound dehiscence (wound separation) is less likely in a percutaneous insertion compared to open surgery.

Percutaneous insertion involves a smaller incision and less tissue disruption, reducing the chances of wound dehiscence.

While monitoring for bleeding is crucial, wound dehiscence may not be the most immediate concern in this specific scenario.

Choice B rationale:

Wound dehiscence and evisceration (protrusion of internal organs) are serious complications, but they are less likely to occur with percutaneous insertion compared to open surgery.

The smaller incision and minimal tissue disruption in percutaneous insertion lower the risk of these complications.

While vigilance for wound complications is essential, the priority in this case lies with bleeding and infection.

Choice C rationale:

Thrombosis (blood clot formation) is a potential complication of IVC filter placement, but it's not typically associated with the surgical site itself.

Infection is a concern for any surgical procedure, but it's not the most immediate risk in this scenario given the emphasis on bleeding and the patient's recent heparin therapy.

Choice D rationale:

Bleeding:

Heparin therapy, a blood thinner, increases the risk of bleeding.

The surgical site is a potential area for bleeding, as it involves disruption of blood vessels.

Meticulous monitoring for bleeding is essential to ensure prompt intervention if it occurs.

Infection:

Any surgical procedure carries a risk of infection.

The surgical site is a potential entry point for bacteria.

Close observation for signs of infection, such as redness, swelling, warmth, or drainage, is crucial for early detection and treatment.