The nurse is evaluating a patient who is experiencing chest pain beneath the sternum.

Which symptom reports would support a diagnosis of stable angina pectoris over a potential myocardial infarction?

(Select All That Apply)

Choice A rationale:

While it's important to assess for potential causative factors of premature ventricular contractions (PVCs), such as caffeine intake, it's not the immediate priority in this scenario.

The nurse's primary focus should be on assessing the patient's hemodynamic stability and oxygenation status, as frequent PVCs can compromise cardiac function and lead to serious complications.

Assessment of causative factors can be done subsequently, once the patient's immediate physiological needs have been addressed.

Choice B rationale:

The patient's subjective experience of palpitations or fluttering is valuable information, but it doesn't provide objective data about their cardiovascular status.

The nurse needs to prioritize objective assessment of vital signs, such as blood pressure and oxygen saturation, to evaluate the patient's hemodynamic stability and oxygenation.

Subjective symptoms can be further explored after obtaining objective data.

Choice D rationale:

Precipitating factors, such as infection, can contribute to PVCs, but they are not the immediate priority in this case.

The nurse's focus should be on assessing the patient's current cardiovascular status and ensuring their stability.

Investigation of potential precipitating factors can be done later, as part of a comprehensive assessment and management plan.

Choice C rationale:

Blood pressure and oxygen saturation are the most crucial parameters to assess in a patient with frequent PVCs.

Here's why:

Blood pressure: PVCs can disrupt the normal rhythm of the heart, potentially leading to a decrease in cardiac output and hypotension.

Hypotension can compromise perfusion to vital organs, such as the brain and kidneys, and can be a sign of hemodynamic instability.

Therefore, it's essential to monitor the patient's blood pressure closely.

Oxygen saturation: PVCs can also impair the heart's ability to pump blood effectively, which can lead to decreased oxygen delivery to the tissues.

This can result in hypoxemia, which can further worsen cardiac function and cause other complications.

Monitoring oxygen saturation using pulse oximetry is crucial to ensure adequate oxygenation.

Choice A rationale:

Drowsiness and blurred vision are not common adverse effects of nitroglycerin.

While some individuals may experience mild drowsiness, it's not a primary concern.

Blurred vision is not typically associated with nitroglycerin use.

Choice B rationale:

Nervousness and paresthesia (tingling or numbness in the extremities) are not common adverse effects of nitroglycerin.

Some individuals may experience transient anxiety or nervousness, but it's not a characteristic side effect.

Paresthesia is more commonly associated with other medications or conditions.

Choice C rationale:

Throbbing headache and dizziness are the most common adverse effects of nitroglycerin.

They occur due to nitroglycerin's vasodilatory effect, which causes blood vessels to relax and widen.

This can lead to a temporary drop in blood pressure, resulting in headaches and dizziness.

The headaches are often described as throbbing or pulsating, and they typically occur in the frontal or temporal regions of the head.

Dizziness may be mild or severe, and it may be accompanied by lightheadedness or a feeling of unsteadiness.

Choice D rationale:

Tinnitus (ringing in the ears) and diplopia (double vision) are not common adverse effects of nitroglycerin.

They may occur in rare cases, but they are not typically associated with its use.