The nurse is planning care for a client diagnosed with cardiogenic shock. Which nursing intervention is most helpful to decrease myocardial oxygen consumption?

Maintain activity restriction to bedrest.

Limit interaction with visitors.

Avoid heavy meals.

Arrange personal care supplies nearby.

Answer and Explanation

The Correct Answer is A

A. Maintain activity restriction to bedrest: Bedrest reduces the heart's workload by minimizing physical exertion, thereby decreasing myocardial oxygen demand. This is crucial in cardiogenic shock, where the heart's pumping ability is severely compromised.
B. Limit interaction with visitors: While excessive stimulation can be stressful, limiting social interaction has a minimal impact on myocardial oxygen consumption compared to physical activity. Emotional support from visitors can actually benefit the client’s overall well-being.
C. Avoid heavy meals: Heavy meals may cause postprandial increases in metabolic demand, but they are not as directly impactful on cardiac workload as restricting physical activity. Meal composition should still be considered, but it's not the most immediate priority.
D. Arrange personal care supplies nearby: Placing supplies within reach helps minimize exertion during ADLs, but this is a supportive measure. Complete activity restriction is a more direct and effective intervention to reduce cardiac oxygen demand in the acute phase.

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Correct Answer is D

Explanation

A. Administer the medications and then notify the health care provider: Administering digoxin with a heart rate below 60 bpm can worsen bradycardia and lead to complications like heart block. The drug should be withheld first.
B. Administer atropine to speed the heart rate and then administer the digoxin: Atropine is not given prophylactically without a provider's order. It is used in emergency settings for symptomatic bradycardia, not as a pre-treatment for digoxin.
C. Administer the medication and inform the charge nurse about the rate: This does not follow safe medication guidelines. Administering digoxin without addressing the low heart rate may lead to serious adverse effects.
D. Withhold the medication and notify the health care provider of the heart rate: This is the safest and most appropriate action. Digoxin should be withheld if the apical pulse is below 60 bpm, and the provider must be informed for further evaluation.

A. Run water to assist in the let-down reflex. B. Measure urinary output. C. Assist to the bathroom. D. Place a urinary catheter. E. Assist the client to stand.

Correct Answer is ["A","C","E"]

Explanation

A. Run water to assist in the let-down reflex: The sound of running water can stimulate the parasympathetic nervous system, triggering the urge to void. It’s a noninvasive and effective first-line intervention. This helps reduce urinary retention without immediate need for catheterization.
B. Measure urinary output: Measuring output is important once urination occurs but does not assist with initiating voiding. It is a monitoring step, not an intervention to promote urination. It should follow once the client successfully voids.
C. Assist to the bathroom: Walking to the bathroom creates a familiar and private setting, promoting comfort and relaxation. These factors help stimulate the natural urge to void. It also supports mobility and patient independence postoperatively.
D. Place a urinary catheter: Catheterization is invasive and should only be done if noninvasive methods fail. It increases the risk of infection and discomfort. Nurses should try simpler interventions first to promote spontaneous voiding.
E. Assist the client to stand: Postural positioning, such as standing, helps mimic the client’s usual urination habits. This can help engage the bladder’s normal neurological pathways. It is especially helpful in male clients to initiate urination.

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The nurse is planning care for a client diagnosed with cardiogenic shock. Which nursing intervention is most helpful to decrease myocardial oxygen consumption?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is preparing to administer digoxin to a client with heart failure. The nurse obtains an apical pulse rate for 1 minute and determines a rate of 52 beats/minute. What is the first action by the nurse?

Correct Answer is D

Explanation

The nurse is caring for a postoperative client who reports difficulty urinating. The client does not have a urinary catheter in place. Which nursing action(s) are most appropriate at this time? Select all that apply.

Correct Answer is ["A","C","E"]

Explanation

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