A nursing student preparing for his first clinical rotation must receive a hepatitis B vaccination series prior to attending clinicals. The nursing student understands that this is

A. Amlodipine is a calcium channel blocker used to manage hypertension. It is not associated with an increased risk of osteoarthritis. While hypertension itself is a health concern, amlodipine does not directly contribute to the development of OA.
B. Prednisone is a corticosteroid that can lead to various side effects, including bone loss and osteoporosis with long-term use. Although osteoporosis and OA are different conditions, long-term use of corticosteroids can potentially increase the risk of joint issues and contribute to the development or exacerbation of OA due to the impact on joint cartilage and bone density.
C. Warfarin is an anticoagulant used to prevent blood clots in atrial fibrillation. It is not directly associated with an increased risk of osteoarthritis. The primary concerns with warfarin involve bleeding risks rather than joint health.
D. Being Caucasian and having multiple children do not directly contribute to an increased risk of osteoarthritis.

Client's Response to Nitroglycerin Therapy

• Unstable Angina:
o Typically, unstable angina responds well to nitroglycerin. The relief of discomfort after nitroglycerin administration suggests that the chest pain was likely related to unstable angina, as it indicates a reduction in coronary artery spasm or temporary ischemia.
• Myocardial Infarction:
o In an MI, nitroglycerin may help alleviate pain, but it does not address the underlying cause of myocardial injury. The pain relief in an MI is generally more variable and may not be as effective if there is significant myocardial damage.

2. Client's Initial Report of Manifestations

• Unstable Angina:
o The symptoms described (shortness of breath, dizziness, and discomfort in the jaw, neck, and left arm) are consistent with unstable angina, which is characterized by episodes of chest pain or discomfort at rest or with minimal exertion, often associated with transient ischemia.
• Myocardial Infarction:
o These symptoms can also be consistent with MI, especially if they are severe or persistent. However, MI often presents with more intense and prolonged pain, and the discomfort might not always resolve with rest.

3. 12 Lead EKG Report

• Unstable Angina:
o ST depression on an EKG is more commonly associated with unstable angina, which indicates transient ischemia rather than a sustained myocardial injury.
• Myocardial Infarction:
o ST depression indicates ischemia commonly in angina.

4. Troponin Results

• Unstable Angina:
o Troponin levels are typically normal in unstable angina. The client’s troponin I (0.01 ng/mL) and troponin T (0.03 ng/mL) are within the normal range, suggesting no significant myocardial injury. This is consistent with unstable angina.
• Myocardial Infarction:
o Elevated troponin levels are a key marker of myocardial injury. The normal troponin results in this case do not support an MI diagnosis, as elevated troponin levels would be expected in MI.