A patient admitted to the unit displays the following cardiac rhythm on telemetry. What is the estimated heart rate?

A. "I will not have to get an IV placed."An IV may be placed in some cases, especially if the stress test includes the use of a pharmacological agent (like adenosine or dobutamine) in place of exercise.

B. "I can eat my breakfast before the test."Clients are typically instructed to fast for at least 3 hours before the exercise stress test. Eating could interfere with accurate test results and the ability to safely exercise. The client should not eat right before the test.

C. "I must not drink my hot chocolate in the morning."Caffeine can interfere with the results of the exercise stress test by increasing heart rate and potentially masking abnormal responses to exercise. Therefore, the client should avoid caffeine (including hot chocolate) before the test.

D. "I can wear the clothes I would wear to the office."The client should wear comfortable clothing and shoes that allow for physical activity and movement, such as athletic wear. Office attire may not be suitable for the physical exertion required during the exercise stress test.

A. "Only take one nitroglycerin tablet for each episode of angina."

This instruction is correct. Sublingual nitroglycerin is typically administered as needed for the relief of angina symptoms, with one tablet being the initial dose. If the chest pain persists after 5 minutes, the client may take a second tablet, and if needed, a third tablet after another 5 minutes. However, if the pain is not relieved after three tablets, they should seek immediate medical attention.

B. "Place the nitroglycerin tablet between cheek and gum."

This instruction is incorrect. Sublingual nitroglycerin tablets should be placed under the tongue, allowing them to dissolve and be absorbed directly into the bloodstream. Placing the tablet between the cheek and gum is not the recommended administration route for sublingual nitroglycerin.

C. "Call 911 if you develop a headache following nitroglycerin use."

This instruction is partially correct. Headache is a common side effect of nitroglycerin due to its vasodilatory effects. Clients should be informed about this potential side effect, but not every headache following nitroglycerin use requires immediate medical attention. However, if the headache is severe, persistent, or accompanied by other concerning symptoms, the client should seek medical evaluation.

D. "See if rest relieves the chest pain before using the nitroglycerin."

This instruction is incorrect. Sublingual nitroglycerin is a rapid-acting medication used to relieve angina symptoms quickly. Clients should not delay taking nitroglycerin and wait for rest to relieve chest pain, as this can lead to worsening symptoms and complications.