The nurse is reviewing the chart of a client with a diagnosis of unstable angina. Which laboratory test(s) result(s) should the nurse recognize as an Indication of heart damage? (SELECT ALL THAT APPLY)

Increased platelet count

Elevated troponins

Decreased homocysteine levels

Elevated CK-MB

Decreased alkaline phosphatase (ALT)

Answer and Explanation

The Correct Answer is B

A. Increased platelet count: While platelet activation can occur in unstable angina, an increased platelet count alone does not indicate heart damage. It is more relevant to thrombotic events than direct myocardial injury.

B. Elevated troponins: Troponin is a protein released when the heart muscle is damaged. Elevated levels are a key indicator of myocardial injury, making this a significant finding in the context of unstable angina.

C. Decreased homocysteine levels: Homocysteine levels are related to cardiovascular risk but are not directly indicative of heart damage. Elevated levels may suggest risk but do not confirm damage.

D. Elevated CK-MB: Creatine kinase-MB is an enzyme found in heart muscle. Elevated levels are indicative of myocardial injury, making this a relevant laboratory test for assessing heart damage in unstable angina.

E. Decreased alkaline phosphatase (ALT): Alkaline phosphatase is primarily related to liver and bone health and does not indicate heart damage. Decreased levels of ALT (alanine aminotransferase) are not relevant to myocardial injury.

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Correct Answer is B

Explanation

A) Place a pad under the buttocks: While this can help absorb moisture, it does not directly prevent skin breakdown from fecal contact. Pads may provide some protection but are not a comprehensive solution.

B) Check the rectal area for soiling frequently: This is the best intervention to help prevent skin breakdown. Regular checks allow for prompt cleaning and care of the area, minimizing the risk of irritation and pressure injuries associated with stool incontinence.

C) Wash the buttocks with strong soap and water: Using strong soap may irritate the skin and is not recommended. Gentle cleansing with mild soap is preferred, but this action alone does not address the need for frequent monitoring and prompt care.

D) Place the call bell in reach: While this encourages the client to call for assistance when needed, it does not actively prevent skin breakdown from stool incontinence. Prompt attention to soiling is more effective in protecting the skin.

A. "What were you doing when the pain started?" B. "How long has the pain lasted?" C. "How would you describe the pain?" D. "How has the pain affected your relationship with your spouse?" E. "Can you rate the pain on a 0-10 scale with 10 being the worst?"

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

Explanation

A. "What were you doing when the pain started?" This question helps identify potential triggers or activities that may have precipitated the chest pain, which is crucial for understanding the context of the pain.

B. "How long has the pain lasted?" Knowing the duration of the pain is vital in assessing the urgency of the situation and determining whether it may be related to a serious condition like angina or myocardial infarction.

C. "How would you describe the pain?" This question allows the client to characterize the pain (e.g., sharp, dull, squeezing), which can provide insights into the potential causes and the nature of the chest pain.

D. "How has the pain affected your relationship with your spouse?" While this question might provide some psychosocial context, it is less directly related to the immediate assessment of the chest pain itself and can be considered secondary.

E. "Can you rate the pain on a 0-10 scale with 10 being the worst?" Pain rating is essential in assessing the severity of the pain, which can help guide treatment and interventions.

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The nurse is reviewing the chart of a client with a diagnosis of unstable angina. Which laboratory test(s) result(s) should the nurse recognize as an Indication of heart damage? (SELECT ALL THAT APPLY)

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A client who is mentally impaired is incontinent of stool. What is the nurse's best intervention to help prevent skin breakdown?

Correct Answer is B

Explanation

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