A nurse is assisting with the care of a client in the emergency department and reports severe radiating chest pain and shortness of breath. The client appears restless, frightened, and slightly cyanotic. The provider prescribes oxygen by nasal cannula at 4 L/min stat, cardiac enzyme levels, IV fluids, and a 12-lead ECG. Which of the following actions should the nurse take first?
Obtain a blood sample.
Initiate oxygen therapy.
Attach the leads for a 12-lead ECG.
Insert the IV catheter.
The Correct Answer is B
A. Obtain a blood sample. Although obtaining a blood sample is essential for cardiac enzyme levels, it is not the highest priority. Addressing oxygenation takes precedence to relieve hypoxia.
B. Initiate oxygen therapy. Oxygen is the first priority to improve oxygenation in a client showing signs of hypoxia (cyanosis, dyspnea), which can prevent further ischemic damage to the heart.
C. Attach the leads for a 12-lead ECG. While obtaining an ECG is essential for diagnosing myocardial ischemia, ensuring oxygenation is more critical in this moment.
D. Insert the IV catheter. An IV line is necessary to administer fluids and medications, but oxygenation should be prioritized first to stabilize the client.
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Correct Answer is ["A","C","E"]
Explanation
A. "This medication can make me have mood swings." Beta blockers can cause mood changes, such as depression or mood swings, as a side effect.
B. "I may have urinary incontinence while taking this medication." Urinary incontinence is not a common side effect of beta blockers.
C. "I should not drive while taking this new medication." Beta blockers can cause dizziness or fatigue, so clients should avoid driving until they know how the medication affects them.
D. "I may have frequent hiccups while taking this medication." Hiccups are not a common side effect of beta blockers.
E. "This new medication may decrease my sex drive." Beta blockers can sometimes cause decreased libido as a side effect.
Correct Answer is D
Explanation
A. Elevated thyroid hormone levels. While amiodarone can cause thyroid dysfunction, elevated thyroid levels (hyperthyroidism) would typically present with symptoms like increased energy or restlessness.
B. Low blood glucose levels. Low blood glucose is not related to amiodarone. Symptoms of hypoglycemia include sweating, hunger, and confusion, not heat intolerance or fatigue.
C. Elevated blood glucose levels. Hyperglycemia is not a known side effect of amiodarone.
D. Low thyroid hormone levels. Amiodarone can induce hypothyroidism, which may cause fatigue and heat intolerance. Regular thyroid monitoring is recommended with long-term amiodarone use.