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

Condition: Myocardial infarction.

2 actions:

Administer oxygen via nasal cannula 2 L/min,

Request a prescription for aspirin 325 mg.

2 parameters:

Vital signs,

Electrocardiogram (ECG) rhythm.

Rationale for correct condition: A myocardial infarction is indicated by the elevated troponin levels and ST elevation on the ECG. The client’s symptoms of chest pain, elevated heart rate, and low oxygen saturation support this diagnosis. Prompt identification and treatment are crucial to minimize heart damage. The medical history of hypertension and coronary artery disease increases the likelihood. Immediate interventions can significantly improve outcomes.

Rationale for actions: Administer oxygen to improve oxygenation and reduce myocardial workload. Requesting aspirin helps prevent further clot formation. Morphine alleviates pain but may obscure symptoms, making it less urgent. Nitroglycerin relieves chest pain by vasodilation but is secondary. Verapamil is less immediate for acute myocardial infarction management. Vital signs reflect hemodynamic status and response to treatment. ECG rhythm detects ongoing ischemia or arrhythmias. Monitoring WBC count is less relevant acutely. Platelet count is stable; not the focus in immediate management.

Rationale for parameters: Vital signs ensure hemodynamic stability and detect hypotension or shock. ECG rhythm monitors arrhythmias and ongoing ischemia, critical in myocardial infarction. WBC count indicates infection or inflammation, less immediate concern. Platelet count is important for bleeding risks but less immediate. Chronic stable angina presents with predictable, non-severe pain. Ischemic stroke symptoms differ; focus on neurological deficits. Cardiogenic shock would present with more severe hypotension and signs of organ failure.

Choice A rationale

Dysuria, or painful urination, is a common symptom of acute cystitis (bladder infection). Clients with acute cystitis often report burning sensations during urination and frequent urges to urinate.

Choice B rationale

Nasal congestion is not a symptom associated with acute cystitis. It is more commonly related to respiratory conditions like colds or allergies.

Choice C rationale

Joint pain is not related to acute cystitis. Joint pain can be associated with various musculoskeletal or autoimmune conditions, but not typically with a bladder infection.

Choice D rationale

Shortness of breath is not a symptom of acute cystitis. This symptom is more relevant to respiratory or cardiovascular conditions, not bladder infections.