The nurse is caring for a client diagnosed with a myocardial infarction (MI) who is reporting severe chest pain.Which interventions should the nurse implement? (Select all that apply.)
Place the client in the supine position.
Administer morphine intramuscularly.
Administer nitroglycerin subcutaneously.
Administer aspirin 325 orally.
Apply oxygen via nasal cannula.
Correct Answer : D,E
Choice D rationale
Administering aspirin 325 orally is important for clients with a myocardial infarction (MI). Aspirin helps to inhibit platelet aggregation, reducing the risk of further clot formation and improving blood flow to the heart. This can significantly decrease mortality and complications associated with MI.
Choice E rationale
Applying oxygen via nasal cannula helps to increase oxygen delivery to the heart and other vital organs during an MI. Ensuring adequate oxygenation can help reduce the extent of myocardial injury and support overall cardiac function during a critical period.
Choice A rationale
Placing the client in a supine position is not appropriate during an MI, as it can increase discomfort and the workload on the heart. Instead, the client should be positioned in a semi-Fowler’s or comfortable position to improve breathing and comfort.
Choice B rationale
Administering morphine intramuscularly is not recommended during an MI. Morphine can be used for pain relief but should be given intravenously to ensure rapid onset and better control over dosing. Intramuscular administration is less effective and can delay pain relief.
Choice C rationale
Administering nitroglycerin subcutaneously is not appropriate. Nitroglycerin is typically given sublingually or intravenously during an MI to provide rapid vasodilation and pain relief. Subcutaneous administration is not effective in this context. .
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale
Hypokalemia involves low potassium levels and is not treated with sodium polystyrene sulfonate. This drug is used to treat elevated potassium levels.
Choice B rationale
Hyperkalemia indicates high potassium levels in the blood. Sodium polystyrene sulfonate (Kayexalate) works by exchanging sodium ions for potassium ions in the intestines, thereby lowering blood potassium levels.
Choice C rationale
Hyponatremia, or low sodium levels, is not treated with sodium polystyrene sulfonate, which targets potassium removal.
Choice D rationale
Hypocalcemia refers to low calcium levels and is unrelated to the action of sodium polystyrene sulfonate, which addresses potassium imbalance.
Correct Answer is C
Explanation
Choice A rationale
Jaundice is not commonly associated with Crohn's disease; it is more related to liver or gallbladder issues.
Choice B rationale
Hypertension is not a common symptom of Crohn's disease. It is generally associated with other conditions such as cardiovascular disease.
Choice C rationale
Abdominal pain and cramping are hallmark symptoms of Crohn's disease due to inflammation in the gastrointestinal tract.
Choice D rationale
Weight loss, rather than weight gain, is typically associated with Crohn's disease due to malabsorption and chronic inflammation.
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