A nurse is preparing a diagnostic statement for a client who has chronic obstructive pulmonary disease (COPD) and reports shortness of breath and fatigue with minimal exertion. Which of the following formats should the nurse use to write the statement?

Choice A reason:

The nurse reports any changes in the client's vital signs, weight, or fluid status to the primary provider. This action demonstrates the skill of collaborating and communicating with other health care providers because it involves sharing relevant and timely information about the client's condition and needs with the primary provider, who can then make appropriate decisions or adjustments to the plan of care. Reporting changes in vital signs, weight, or fluid status is especially important for a client who has chronic heart failure, as these indicators can reflect worsening or improving cardiac function. Reporting changes also follows the ISBARR format of communication, which is a standardized method of exchanging patient information between health care team members.

Choice B reason:

The nurse administers prescribed medications, such as diuretics, beta blockers, and ACE inhibitors. This action does not demonstrate the skill of collaborating and communicating with other health care providers because it is a routine nursing task that does not involve direct interaction or exchange of information with other health care team members. Administering medications is part of the nurse's scope of practice and responsibility, and does not require collaboration or communication with other providers, unless there are questions, concerns, or issues regarding the medication orders.

Choice C reason:

The nurse educates the client about lifestyle modifications, such as sodium restriction, exercise, and smoking cessation. This action does not demonstrate the skill of collaborating and communicating with other health care providers because it is a nursing intervention that focuses on the client's education and self-management, not on the interaction or exchange of information with other health care team members. Educating the client about lifestyle modifications is part of the nurse's role in promoting health and preventing complications, and does not require collaboration or communication with other providers, unless there are discrepancies or inconsistencies in the education materials or messages.

Choice D reason:.

The nurse assesses the client's cardiac function, such as heart sounds, rhythm, and peripheral pulses. This action does not demonstrate the skill of collaborating and communicating with other health care providers because it is a nursing assessment that does not involve direct interaction or exchange of information with other health care team members. Assessing the client's cardiac function is part of the nurse's role in monitoring and evaluating the client's response to treatment, and does not require collaboration or communication with other providers, unless there are abnormal findings that need to be reported or documented.

Choice A reason:

Administering nitroglycerin sublingually as ordered is the next priority action for the nurse because nitroglycerin is a medication that relaxes the heart arteries and improves blood flow to the heart muscle, which can relieve chest pain and shortness of breath caused by coronary artery disease. Nitroglycerin can also lower blood pressure, which can help reduce the workload of the heart and prevent further damage to the heart muscle. Nitroglycerin is a fast-acting medication that should be given as soon as possible after chest pain occurs or is suspected.

Choice B reason:

Obtaining a complete health history from the patient is not the next priority action for the nurse because it is not an urgent intervention that can address the patient's immediate needs. A complete health history can provide valuable information about the patient's risk factors, past medical history, medications, allergies, and family history, but it can also take a long time to obtain and may not be feasible if the patient is in pain or distress. A complete health history can be obtained later after the patient's condition is stabilized and more urgent interventions are done.

Choice C reason:

Educating the patient about lifestyle modifications is not the next priority action for the nurse because it is not an acute intervention that can relieve the patient's symptoms or prevent further complications. Lifestyle modifications such as quitting smoking, eating a healthy diet, exercising regularly, managing stress, and controlling blood pressure and cholesterol levels are important for preventing or managing coronary artery disease in the long term, but they do not have an immediate effect on the patient's condition. Educating the patient about lifestyle modifications can be done later after the patient's condition is improved and the patient is ready to learn.

Choice D reason:

Preparing the patient for cardiac catheterization is not the next priority action for the nurse because it is not a definitive intervention that can confirm or rule out coronary artery disease or other causes of chest pain and shortness of breath. Cardiac catheterization is a diagnostic procedure that involves inserting a thin tube into an artery in the groin or arm and advancing it to the heart to inject contrast dye and take X-ray images of the heart and blood vessels. Cardiac catheterization can help identify blockages or narrowing in the coronary arteries that may cause chest pain and shortness of breath, but it also carries some risks such as bleeding, infection, allergic reaction, kidney damage, or heart attack. Cardiac catheterization may be ordered by the physician after other tests such as ECG, blood tests, or.