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:

While it's important to assess for potential causative factors of premature ventricular contractions (PVCs), such as caffeine intake, it's not the immediate priority in this scenario.

The nurse's primary focus should be on assessing the patient's hemodynamic stability and oxygenation status, as frequent PVCs can compromise cardiac function and lead to serious complications.

Assessment of causative factors can be done subsequently, once the patient's immediate physiological needs have been addressed.

Choice B rationale:

The patient's subjective experience of palpitations or fluttering is valuable information, but it doesn't provide objective data about their cardiovascular status.

The nurse needs to prioritize objective assessment of vital signs, such as blood pressure and oxygen saturation, to evaluate the patient's hemodynamic stability and oxygenation.

Subjective symptoms can be further explored after obtaining objective data.

Choice D rationale:

Precipitating factors, such as infection, can contribute to PVCs, but they are not the immediate priority in this case.

The nurse's focus should be on assessing the patient's current cardiovascular status and ensuring their stability.

Investigation of potential precipitating factors can be done later, as part of a comprehensive assessment and management plan.

Choice C rationale:

Blood pressure and oxygen saturation are the most crucial parameters to assess in a patient with frequent PVCs.

Here's why:

Blood pressure: PVCs can disrupt the normal rhythm of the heart, potentially leading to a decrease in cardiac output and hypotension.

Hypotension can compromise perfusion to vital organs, such as the brain and kidneys, and can be a sign of hemodynamic instability.

Therefore, it's essential to monitor the patient's blood pressure closely.

Oxygen saturation: PVCs can also impair the heart's ability to pump blood effectively, which can lead to decreased oxygen delivery to the tissues.

This can result in hypoxemia, which can further worsen cardiac function and cause other complications.

Monitoring oxygen saturation using pulse oximetry is crucial to ensure adequate oxygenation.

Choice A rationale:

Incorrect. PVCs are not caused by a malfunctioning SA node. The SA node is responsible for initiating the normal heartbeat, while PVCs originate from the ventricles. The underlying cause of PVCs can vary, but it's not directly related to SA node dysfunction. Choice C rationale:

Incorrect. Ventricular tachycardia (VT) is a rapid heart rhythm originating from the ventricles, typically defined as three or more consecutive PVCs. Two PVCs in a row are usually classified as a couplet, not VT.

Choice D rationale:

Incorrect. While PVCs are often harmless, they can sometimes be associated with underlying heart disease or lead to complications, especially if they are frequent or occur in specific patterns. Therefore, careful assessment and potential treatment are necessary.

Choice B rationale:

Correct. Treatment for PVCs is generally only recommended if the patient experiences concerning symptoms or if the PVCs are associated with a risk of developing more serious arrhythmias. Additionally, the QRS complex on the EKG/ECG should be evaluated. A narrow QRS complex during PVCs typically suggests a less concerning origin within the ventricles, while a wide QRS complex may indicate a higher risk of complications.