A nurse is caring for a client who experienced severe head trauma. The client's partner asks the nurse why they are concerned about the mean arterial pressure (MAP). The nurse should explain that MAP determines which of the following?
Cerebral blood flow
The client's intake and output needs
Regulation of blood pressure
Resorption of cerebrospinal fluid
The Correct Answer is A
A. Cerebral blood flow. MAP is crucial for maintaining adequate cerebral perfusion pressure, ensuring enough blood flow to the brain.
B. The client's intake and output needs. MAP does not directly influence intake and output needs; it is more directly related to blood flow and tissue perfusion.
C. Regulation of blood pressure. MAP is a measure of average blood pressure but not a regulator of it.
D. Resorption of cerebrospinal fluid. CSF resorption is not directly influenced by MAP; it’s regulated by intracranial pressure and other factors.
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Correct Answer is D
Explanation
A. Depression: While propranolol can sometimes worsen symptoms of depression, this is not as critical as the impact on conditions like heart failure.
B. Glaucoma: Propranolol does not typically affect glaucoma; however, some beta-blockers are used to treat glaucoma.
C. Migraine: Propranolol is sometimes used to prevent migraines, so a history of migraines would not require discontinuation.
D. Heart failure: Propranolol can exacerbate heart failure by reducing myocardial contractility. Clients with heart failure require careful monitoring or an alternative medication.
Correct Answer is A
Explanation
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.