A nurse is providing discharge teaching for a client following coronary artery bypass graft surgery. Which of the following information should the nurse include in the teaching?

"You can lift objects that weigh more than 20 pounds 2 weeks after discharge."

"You should walk 400 feet twice per day for the first week following discharge."

"You should wait at least 4 weeks before returning to work."

"Limit your sodium intake to 4 grams per day for 4 weeks following discharge."

Answer and Explanation

The Correct Answer is C

Rationale:

A. "You can lift objects that weigh more than 20 pounds 2 weeks after discharge." Lifting heavy objects is generally discouraged after coronary artery bypass graft (CABG) surgery for at least 4-6 weeks. Lifting more than 20 pounds too soon can strain the chest and interfere with healing.

B. "You should walk 400 feet twice per day for the first week following discharge." While walking is encouraged to improve circulation and promote recovery, 400 feet twice a day may be too much for the first week following discharge. The client should start with shorter distances and gradually increase activity based on the client's tolerance.

C. "You should wait at least 4 weeks before returning to work." After CABG surgery, clients are typically advised to avoid returning to work, especially if it involves physical labor, for at least 4-6 weeks to allow adequate time for recovery.

D. "Limit your sodium intake to 4 grams per day for 4 weeks following discharge." Clients with heart disease are generally advised to follow a low-sodium diet, usually limiting intake to 2-3 grams per day to prevent fluid retention and reduce strain on the heart.

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Correct Answer is D

Explanation

Rationale:

A. "I am sure you will be able to still spend time with your grandchildren." While reassurance is important, this statement may not be realistic, and it does not acknowledge the client’s feelings of uncertainty. The client may need more support and guidance regarding their post-surgery recovery and limitations.

B. "Why do you think you won't be able to play with your grandchildren?" This question may sound confrontational or dismissive of the client’s concerns. It is more important to validate the client’s emotions and explore their feelings in a non-judgmental way..

C. "You will not be as active for a couple of years." This statement is overly negative and does not provide an opportunity to explore the client’s emotional needs. Recovery from knee arthroplasty varies and focusing on long-term inactivity could discourage the client.

D. "What are some of the activities you like to do with your grandchildren?" This open-ended question validates the client’s feelings and helps shift the focus towards their interests and goals. It allows the nurse to explore realistic expectations and discuss ways to resume activities after recovery, fostering a positive outlook.

A. Blood glucose level B. Bowel sounds C. Blood pressure D. Pain level E. Electrocardiogram findings F. Lung sounds G. Troponin T level

Correct Answer is ["C","D","E","G"]

Explanation

Rationale:

A. Blood glucose level: The blood glucose level of 103 mg/dL is within normal limits (74 to 106 mg/dL) and does not require immediate follow-up. While the client has type 2 diabetes mellitus, the blood glucose is not abnormal at this time.

B. Bowel sounds: Bowel sounds are present in all four quadrants and do not require immediate follow-up. This finding is normal and is unrelated to the acute symptoms being assessed for a possible myocardial infarction.

C. Blood pressure: The client’s blood pressure is elevated at 164/80 mm Hg, which requires immediate attention in the context of chest pain and other symptoms that may suggest an acute myocardial infarction (MI).

D. Pain level: The client rates their chest pain as 7 out of 10, which is significant and consistent with potential myocardial ischemia or infarction. The pain’s radiation to the left arm, along with other symptoms like nausea and diaphoresis, suggest an urgent need for intervention.

E. Electrocardiogram findings: The 12-lead ECG shows tachycardia, ST segment elevation, and T wave changes, which are indicative of acute myocardial injury, such as an ST-elevation myocardial infarction (STEMI). This requires immediate intervention to prevent further myocardial damage.

F. Lung sounds: The lung sounds are clear in all lobes, which is reassuring and does not indicate an immediate concern.

G. Troponin T level: The elevated Troponin T level (0.40 ng/mL) is a key biomarker for myocardial injury. The elevation indicates ongoing cardiac damage, which requires immediate follow-up to assess for the extent of the infarction and initiate treatment.

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A nurse is providing discharge teaching for a client following coronary artery bypass graft surgery. Which of the following information should the nurse include in the teaching?

Nursing Test Bank

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