A nurse is reinforcing teaching to a client who has dilated cardiomyopathy (DCM). Which of the following statements by the nurse should be included in the teaching?
"Your heart condition is caused from stiffening of the walls of the ventricles."
"Your heart condition is caused by excessive stretching of the ventricles."
"Your heart condition is caused when the ventricular tissue becomes fibrous and fatty."
"Your heart condition is caused by thickening of the ventricular walls and septum."
The Correct Answer is B
A. "Your heart condition is caused from stiffening of the walls of the ventricles." Stiffening of the ventricular walls describes restrictive cardiomyopathy, not DCM.
B. "Your heart condition is caused by excessive stretching of the ventricles." DCM involves excessive stretching and thinning of the ventricular walls, leading to impaired contraction.
C. "Your heart condition is caused when the ventricular tissue becomes fibrous and fatty." This describes arrhythmogenic right ventricular dysplasia, not DCM.
D. "Your heart condition is caused by thickening of the ventricular walls and septum." This describes hypertrophic cardiomyopathy, not DCM.
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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.
Correct Answer is B
Explanation
A. Creatine kinase-myocardial band (CK-MB) test: While CK-MB is also a marker of myocardial injury, it is less specific than troponin and can be elevated in other conditions, such as muscle injury.
B. Troponin T test. The Troponin T test is highly specific and sensitive for myocardial injury and is considered the gold standard for diagnosing a myocardial infarction. Troponin levels rise within hours of cardiac muscle injury and remain elevated for days, providing an early and reliable indicator of cardiac muscle damage.
C. Brain natriuretic peptide (BNP) test. BNP levels are used to assess heart failure and do not indicate acute cardiac muscle injury.
D. Creatine kinase (CK) test. CK measures overall muscle injury, not specific to cardiac muscle.