The nurse provides discharge teaching to a client who had a myocardial infarction.
Which statements by the client indicate an understanding? Select all that apply.

I will call the provider for chest pain.

I will gradually increase activity.

I will utilize a diet rich in polyunsaturated fats.

I will use increasing upper body weights to build muscle.

I will take medications as prescribed.

Answer and Explanation

Correct Answer : A,B,C,E

Post-myocardial infarction discharge teaching focuses on secondary prevention and cardiac rehabilitation. Knowledge of cardiovascular physiology, lifestyle modification, and pharmacology is necessary to ensure the client understands how to reduce cardiac workload and prevent further coronary artery occlusion or heart failure.

Choice A rationale

Reporting chest pain is critical as it indicates potential myocardial ischemia. Early intervention can prevent further muscle damage. Clients must understand that any recurrence of angina requires immediate medical evaluation to assess coronary artery patency and perfusion.

Choice B rationale

Gradual activity increase is a hallmark of cardiac rehabilitation. It allows the heart muscle to adapt to increased demands without causing excessive strain or rupture. Controlled exercise improves cardiovascular efficiency and lowers the resting heart rate over time.

Choice C rationale

Polyunsaturated fats help lower low density lipoprotein cholesterol, reducing the risk of further atherosclerosis. A heart healthy diet limits saturated fats and trans fats, which are known to contribute to plaque formation within the coronary arteries.

Choice D rationale

Heavy weightlifting or isometric exercises can significantly increase systemic vascular resistance and blood pressure. This places excessive afterload on the healing myocardium. Clients are usually advised to avoid heavy lifting or straining during the initial recovery phase.

Choice E rationale

Adherence to medications such as beta blockers, antiplatelets, and statins is vital for long term survival. These drugs reduce blood pressure, prevent clot formation, and stabilize plaques, directly impacting the prevention of a secondary cardiac event.

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Correct Answer is A

Explanation

Hyperkalemia management involves identifying medications that facilitate the removal of potassium from the body. Understanding the mechanism of action of various renal and GI medications is necessary. This prevents cardiac arrest by lowering potassium toward the 3.5 to 5.0 mEq/L range.

Choice A rationale

This medication is a cation exchange resin that works in the intestine. It exchanges sodium ions for potassium ions, allowing the potassium to be excreted through the feces. It is specifically indicated for treating high serum potassium levels.

Choice B rationale

Lactulose is an osmotic laxative primarily used to reduce serum ammonia levels in clients with hepatic encephalopathy. It promotes the excretion of ammonia through the stool but has no significant effect on lowering serum potassium levels.

Choice C rationale

This medication is an erythropoiesis stimulating agent used to treat anemia associated with chronic kidney disease. It stimulates red blood cell production in the bone marrow but does not influence electrolyte levels or treat acute hyperkalemia.

Choice D rationale

Sevelamer is a phosphate binder used to manage hyperphosphatemia in clients with chronic kidney disease. It prevents the absorption of dietary phosphorus in the gut but does not have a mechanism to lower serum potassium concentrations.

A. Different blood pressures in the upper limbs. B. Differences in upper and lower lung sounds. C. Different apical and radial pulses. D. Differences between oral and axillary temperatures.

Correct Answer is C

Explanation

Identifying cardiac arrhythmias requires understanding the relationship between electrical conduction and mechanical output. Knowledge of pulse deficits is necessary to recognize when rapid, irregular atrial contractions fail to produce adequate ventricular filling and a palpable peripheral pulse.

Choice A rationale

Blood pressure discrepancies between the upper limbs usually indicate vascular issues like aortic dissection or peripheral arterial disease. Atrial fibrillation affects the rhythm and volume of the pulse rather than creating localized pressure differences between the arms.

Choice B rationale

Variations in lung sounds typically suggest localized pulmonary pathology such as pneumonia or pleural effusion. While atrial fibrillation can lead to heart failure and pulmonary edema, it does not specifically cause differences between upper and lower sounds.

Choice C rationale

A pulse deficit occurs when the apical heart rate is higher than the radial rate. In atrial fibrillation, some ventricular contractions are too weak to perfuse to the periphery, making this a classic assessment finding.

Choice D rationale

Discrepancies between oral and axillary temperatures relate to thermoregulation and measurement accuracy rather than cardiac rhythm. Temperature monitoring is used to screen for infection or inflammation but does not provide diagnostic information regarding atrial arrhythmias..

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The nurse provides discharge teaching to a client who had a myocardial infarction. Which statements by the client indicate an understanding? Select all that apply.

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A nurse is reviewing the laboratory report of a client and identifies a serum potassium level of 6.8 mEq/L. Which of the following medications should the nurse plan to administer?

Correct Answer is A

Explanation

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Correct Answer is C

Explanation

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The nurse provides discharge teaching to a client who had a myocardial infarction.
Which statements by the client indicate an understanding? Select all that apply.