Which outcome is appropriate for the client problem of "ineffective gas exchange" for the client diagnosed with chronic obstructive pulmonary disease (COPD)?

Choice C rationale

Administering another nitroglycerin tablet is appropriate if the client's chest pain has not been fully relieved after the initial dose. Nitroglycerin helps to dilate blood vessels, improving blood flow to the heart and relieving angina. A second dose can be given if the pain persists, following the protocol for managing chest pain.

Choice A rationale

Obtaining an ECG is important for diagnosing and monitoring cardiac conditions; however, in this immediate context, further pain relief takes precedence. After ensuring pain relief, an ECG can be performed to assess the client's cardiac status.

Choice B rationale

Calling the Rapid Response Team is unnecessary if the client’s chest pain severity has already decreased. The priority should be to continue managing the chest pain with additional nitroglycerin if needed and monitoring the client's response.

Choice D rationale

Initiating a peripheral IV might be required for administering medications or fluids, but it is not the immediate action needed in this scenario. The priority is to provide additional pain relief with nitroglycerin.

Choice B rationale

Radiating pain to the left arm is a classic symptom of a myocardial infarction (MI). This pain occurs due to the heart muscle not receiving enough oxygen, often because of a blockage in one or more coronary arteries. The pain can radiate to the left arm, jaw, neck, or back, and is a key indicator for diagnosing an MI.

Choice A rationale

Nausea and vomiting can occur during an MI but are not the most distinctive symptoms for diagnosis. They can also be associated with other conditions, making them less specific indicators of MI.

Choice C rationale

Shortness of breath is a common symptom during an MI, resulting from reduced oxygen supply to the heart. However, while it is an important clinical manifestation, it can also be associated with other cardiac or respiratory conditions.

Choice D rationale

Headache is not a typical symptom of an MI. It is less commonly associated with heart attacks and can be caused by a wide range of other factors, making it an unreliable symptom for diagnosing MI.