A nurse is assessing a client who is receiving radiation therapy to the head and neck. Which of the following findings should the nurse expect?

The nurse should first address the client's chest pain followed by the client's irregular heart rate.

Rationale:

Chest pain is the priority concern as it indicates an acute coronary event (ST-elevation myocardial infarction, STEMI). Immediate interventions such as oxygen, nitroglycerin, and pain management are required to reduce myocardial oxygen demand and prevent further cardiac damage.

Irregular heart rate must be addressed next, as tachycardia and arrhythmias can increase myocardial workload and worsen ischemia. Monitoring and possible antiarrhythmic interventions may be required to stabilize cardiac function.

Incorrect:

Troponin levels: Elevated troponin confirms myocardial injury but does not require immediate intervention; managing the ongoing ischemia is the priority.

Oxygen saturation: The client's oxygen saturation is 93% on room air, which is adequate. Oxygen therapy is not the first priority unless levels drop further.

Hyperlipidemia: While a cardiovascular risk factor, it is not an acute concern during an MI. Long-term management is necessary but not the immediate priority.

C-reactive protein: Elevated CRP indicates inflammation but does not require urgent intervention in the acute phase of MI.

• Increase sources of fiber in the diet: Increasing dietary fiber is important for maintaining bowel health, especially when taking iron supplements, as constipation is a common side effect of iron therapy. A higher fiber intake can help alleviate constipation and promote regular bowel movements.
• Take the medication with a source of vitamin C: Vitamin C enhances iron absorption in the gastrointestinal tract. Clients should be instructed to take ferrous sulfate with vitamin C-rich foods (such as citrus fruits) or beverages (like orange juice) to maximize absorption and improve the effectiveness of the iron supplement.
• Take the medication on an empty stomach: Iron supplements are best absorbed when taken on an empty stomach, ideally 1 hour before or 2 hours after meals. However, if gastrointestinal upset occurs, the client may take the medication with food to minimize discomfort, but this can reduce absorption.

• Take an antacid within 30 min after medication administration: Antacids can interfere with the absorption of iron supplements. Clients should be advised to avoid antacids for at least 2 hours before or after taking iron supplements to ensure proper absorption.
• Increase intake of milk and dairy products: Calcium in milk and dairy products can inhibit iron absorption when consumed simultaneously. Clients should be advised to avoid consuming these products around the time they take their iron supplement for optimal absorption.