A nurse is reinforcing teaching to a client who has coronary artery disease. Which of the following statements should the nurse include in the teaching to explain the correlation between changes in the coronary arteries and manifestations that occur?
"Coronary arteries become more elastic causing the arteries to stretch as individuals age causing the heart not to receive enough oxygen."
"The heart and the coronary arteries weaken, leading to poor perfusion and resulting in angina."
"Manifestations occur due to dilation of coronary arteries with increased blood flow causing increased pressure."
"Coronary arteries decrease in diameter leading to insufficient blood, oxygen, and nutrients reaching the heart muscle."
The Correct Answer is D
A. While coronary arteries may change with age, the increased elasticity does not lead to insufficient oxygen; rather, it can affect their ability to respond to increased demand.
B. Weakening of the heart can contribute to heart failure but is not a direct explanation for how coronary artery disease causes angina.
C. Dilation of coronary arteries typically does not cause manifestations in coronary artery disease; instead, it is the narrowing (stenosis) that leads to issues.
D. Decreased diameter of the coronary arteries due to atherosclerosis is the primary issue in coronary artery disease, which leads to inadequate blood supply, oxygen, and nutrients to the heart muscle, causing symptoms like angina.
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Correct Answer is D
Explanation
A. Wearing gloves when removing food from the freezer is appropriate and helps prevent exposure to cold, which can trigger symptoms of Raynaud's phenomenon.
B. Completing a smoking cessation program is beneficial, as smoking can exacerbate symptoms of Raynaud's.
C. Avoiding stressful situations is advisable since stress can trigger vasoconstriction and exacerbate symptoms
.
D. Keeping the house at a cool temperature is not recommended, as cold environments can provoke Raynaud's symptoms; the client should aim to maintain a warm environment to minimize triggers.
Correct Answer is D
Explanation
A. The nurse should measure the apical pulse for a full minute (not 30 seconds) before administering digoxin. If the pulse is below 60 beats per minute, the medication should be withheld, making this option incomplete.
B. Digoxin should be withheld if the heart rate is below 60/min, not above 100/min. This statement does not reflect proper nursing protocol.
C. Clients taking digoxin should maintain adequate potassium levels, so advising low potassium intake is incorrect. Foods rich in potassium are encouraged.
D. Monitoring for symptoms such as nausea, vomiting, and yellow vision is essential, as these may indicate digoxin toxicity, making this option correct.