Which term will the nurse use to document the patient’s age-related hearing loss?

Choice A reason: This is an incorrect choice because release of prostaglandins lowers the patient’s heart rate and blood pressure is not a reason why acute pain is particularly dangerous for a patient having a heart attack. Prostaglandins are inflammatory mediators that are involved in pain perception and modulation, but they do not have a direct effect on the heart rate and blood pressure. In fact, some prostaglandins may have a protective role in the cardiovascular system by preventing platelet aggregation and vasodilation.

Choice B reason: This is an incorrect choice because release of substance P narrows the airways and leads to hypoxemia is not a reason why acute pain is particularly dangerous for a patient having a heart attack. Substance P is a neuropeptide that is involved in pain transmission and modulation, but it does not have a significant effect on the airways or the oxygen level. Substance P may cause bronchoconstriction in some patients with asthma or chronic obstructive pulmonary disease, but this is not a common or serious complication of acute pain.

Choice C reason: This is an incorrect choice because release of endorphins causes dangerous elevation of blood pressure is not a reason why acute pain is particularly dangerous for a patient having a heart attack. Endorphins are endogenous opioids that are involved in pain inhibition and modulation, but they do not have a major effect on the blood pressure. Endorphins may cause a slight increase in blood pressure by activating the opioid receptors in the brainstem, but this is not a significant or harmful response to acute pain.

Choice D reason: This is the correct choice because stimulation of the sympathetic nervous system will increase cardiac workload is a reason why acute pain is particularly dangerous for a patient having a heart attack. The sympathetic nervous system is part of the autonomic nervous system that is responsible for the fight-or-flight response, which is triggered by acute pain. The sympathetic nervous system will increase the heart rate, blood pressure, and cardiac contractility, which will increase the oxygen demand and consumption of the heart. This will worsen the ischemia and injury of the myocardium, and may lead to arrhythmias, heart failure, or cardiac arrest.

Choice A reason: This is incorrect. The antipyretic medication will not inhibit bacterial growth within the culture tubes. Antipyretics are medications that reduce fever by affecting the hypothalamus, the part of the brain that regulates body temperature. They do not have any antibacterial effect.

Choice B reason: This is incorrect. Venous distension is not greater because of fluid retention from hyperthermia. Venous distension is the swelling of the veins due to increased pressure or volume of blood. Hyperthermia is the condition of having a body temperature above the normal range. It can cause dehydration, not fluid retention.

Choice C reason: This is incorrect. Elevated temperatures do not slow metabolic rate and improve blood oxygenation. Elevated temperatures increase metabolic rate and demand more oxygen. This can lead to tissue hypoxia, acidosis, and organ damage.

Choice D reason: This is correct. The causative organism is most prevalent during a spike in temperature. A spike in temperature is a sudden rise in body temperature that indicates an infection. Drawing a blood culture before giving an antipyretic medication can help identify the type and number of bacteria in the blood. This can guide the appropriate antibiotic therapy and monitor the response to treatment.