A client who has had a significant myocardial infarction receives a referral to the cardiac rehabilitation unit. During his first visit to the unit, he tells the nurse that he doesn't understand why he needs to be there because there is nothing more to do as the damage is done. Which of the following responses should the nurse make?
"Cardiac rehabilitation cannot undo the damage to your heart, but it can help you get back to your previous level of activity safely."
"Your doctor is the expert here, and I'm sure he would only recommend what is best for you."
"You are probably right and I agree with you, but I still think you should go."
"It's not unusual to feel that way at first, but once you learn the routine, you'll be fine."
The Correct Answer is A
A. "Cardiac rehabilitation cannot undo the damage to your heart, but it can help you get back to your previous level of activity safely." This response is therapeutic and educative, helping the client understand that while damage cannot be reversed, rehabilitation supports safe recovery and improved quality of life.
B. "Your doctor is the expert here, and I'm sure he would only recommend what is best for you." This response does not address the client’s concerns and lacks supportive or educational value.
C. "You are probably right and I agree with you, but I still think you should go." This dismissive response fails to provide support, education, or empathy.
D. "It's not unusual to feel that way at first, but once you learn the routine, you'll be fine." Although this statement offers some support, it lacks the educational element needed to address the client’s concerns about the purpose of rehabilitation.
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Correct Answer is A
Explanation
A. "I'll use my electric razor for shaving." This is correct as using an electric razor helps prevent cuts, which is important since warfarin increases bleeding risk.
B. "I'll be sure to eat foods with lots of vitamin K." Vitamin K reduces the effectiveness of warfarin; clients should be consistent with their intake of vitamin K to avoid fluctuations in INR.
C. "It's okay to have a couple of glasses of wine with dinner." Alcohol can increase the effect of warfarin and the risk of bleeding. Clients should avoid or limit alcohol intake.
D. "I'll take aspirin for my headaches." Aspirin also has anticoagulant effects and can increase bleeding risk when taken with warfarin.
Correct Answer is B
Explanation
A. "I am constipated." Constipation is not a common indicator of digoxin toxicity; it may be more related to diet or other medications.
B. "My vision seems yellow." Yellow or blurred vision, also called xanthopsia, is a classic sign of digoxin toxicity and should be reported immediately.
C. "My tongue is red and beefy." A red and beefy tongue may indicate vitamin B12 deficiency, not digoxin toxicity.
D. "I am gaining weight." Weight gain is usually a sign of fluid retention or worsening heart failure, not specifically digoxin toxicity.