A patient recovering from a myocardial infarction (MI) develops cheat pain on day 3 that increases when taking a deep breath, lying flat, and is relieved by leaning forward. Which additional assessment data should the nurse collect next?

Auscultate for a pericardial friction rub

Inspect the skin for petechia

Palpate the radial pulses bilaterally

Assess for abdominal pain

Answer and Explanation

The Correct Answer is A

A. Auscultate for a pericardial friction rub: These symptoms are classic for pericarditis, a complication of MI. A pericardial friction rub is a key diagnostic finding.

B. Inspect the skin for petechiae: Petechiae are associated with conditions like infective endocarditis or thrombocytopenia, not pericarditis.

C. Palpate the radial pulses bilaterally: Assessing radial pulses is essential for circulation but does not directly relate to pericarditis symptoms.

D. Assess for abdominal pain: Abdominal pain is not typical of pericarditis and would not be the priority assessment.

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Correct Answer is B

Explanation

A. Urine glucose, high: High urine glucose would suggest hyperglycemia, typically seen in diabetes mellitus, not diabetes insipidus.

B. Urine specific gravity, 1.001: Diabetes insipidus results in excessive urine output with a low specific gravity (dilute urine), reflecting the inability to concentrate urine.

C. Urine output, 50 ml/hr: This is a relatively low urine output, which does not indicate diabetes insipidus. Diabetes insipidus is characterized by very high urine output, often greater than 3 liters per day.

D. Urine protein, high: High urine protein could suggest kidney disease or glomerular injury, not diabetes insipidus.

A. Hypokalemia B. Hypercalcemia C. Hyponatremia D. Hyperkalemia

Correct Answer is A

Explanation

A. Hypokalemia: U waves are often seen on an electrocardiogram in clients with hypokalemia. They represent delayed repolarization of the Purkinje fibers due to low potassium levels.

B. Hypercalcemia: Hypercalcemia affects the QT interval, typically shortening it, but it does not cause U waves.

C. Hyponatremia: Electrocardiographic changes are not commonly associated with hyponatremia.

D. Hyperkalemia: Hyperkalemia causes peaked T waves, prolonged PR intervals, and wide QRS complexes, not U waves.

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A patient recovering from a myocardial infarction (MI) develops cheat pain on day 3 that increases when taking a deep breath, lying flat, and is relieved by leaning forward. Which additional assessment data should the nurse collect next?

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