A patient with dilated cardiomyopathy has recently developed atrial fibrillation that has been unresponsive to drug therapy for several days.

What topic should the nurse plan to include in patient teaching?

Choice A rationale
Implementing a smoking cessation program, while beneficial for overall health and cardiovascular risk reduction, is not the primary therapeutic goal for secondary hypertension. Secondary hypertension is high blood pressure caused by an underlying condition. Therefore, the primary goal is to treat the underlying condition.
Choice B rationale
Treating the specific etiological disease is the primary therapeutic goal for secondary hypertension. By treating the underlying cause, blood pressure can often be lowered or returned to normal.
Choice C rationale
Initiating a rapid weight-loss program is not the primary therapeutic goal for secondary hypertension. While weight loss can help lower blood pressure in general, the primary goal in secondary hypertension is to treat the underlying cause.
Choice D rationale
Starting a rigorous exercise regimen, while beneficial for overall health and cardiovascular risk reduction, is not the primary therapeutic goal for secondary hypertension. The primary goal is to treat the underlying condition causing the high blood pressure.

Choice A rationale
Low urine osmolarity and creatinine clearance are not the primary indicators of inadequate renal perfusion in a patient being stabilized after an acute coronary syndrome. These measures reflect the concentration of the urine and the kidney’s ability to filter waste from the blood, respectively. While they can be affected by renal perfusion, they are not the most direct or reliable indicators.
Choice B rationale
A decreasing serum blood urea nitrogen (BUN) level is not typically associated with inadequate renal perfusion. In fact, a high BUN level may indicate that the kidneys aren’t working properly. However, BUN levels can be influenced by many factors, including protein intake and liver function, so they are not the most reliable indicator of renal perfusion.
Choice C rationale
A urine output of less than 30 mL/hr is a common sign of inadequate renal perfusion. The kidneys need adequate blood flow to filter waste products from the blood and produce urine. If renal perfusion is inadequate, urine output can decrease.
Choice D rationale
A urine-specific gravity of less than 1.010 is not typically associated with inadequate renal perfusion. Specific gravity is a measure of the concentration of solutes in the urine. It can be influenced by hydration status and certain kidney disorders, but it is not a direct measure of renal perfusion.