A patient is recovering from a myocardial infarction (MI). Which of the following complications should the nurse be most concerned about if the patient reports new-onset shortness of breath and irregular heartbeats?
Peripheral Artery Disease (PAD)
Gastroesophageal Reflux Disease (GERD)
Hypertension
Heart Failure
The Correct Answer is D
A. Peripheral Artery Disease (PAD). PAD is a chronic condition related to reduced blood flow in peripheral arteries. It is not directly associated with MI complications.
B. Gastroesophageal Reflux Disease (GERD). GERD involves acid reflux and is not related to post-MI complications.
C. Hypertension. While hypertension is a risk factor for MI, it does not directly explain the symptoms of shortness of breath and irregular heartbeats following an MI.
D. Heart Failure. Heart failure is a common post-MI complication, especially if a significant portion of heart muscle is damaged. Symptoms of shortness of breath and irregular heartbeats could indicate left-sided heart failure, where fluid backs up into the lungs, or right-sided failure, which can lead to systemic congestion.
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Correct Answer is D
Explanation
A. Irritable bowel syndrome. IBS management typically involves dietary changes, fiber, and stress management, not antibiotics or clear liquids.
B. Chronic diverticulosis. Diverticulosis, when asymptomatic, does not require antibiotics. Treatment focuses on a high-fiber diet to prevent diverticulitis.
C. Complicated diverticulitis with abscess. Complicated diverticulitis may require IV antibiotics, hospitalization, or even surgical intervention if there are abscesses.
D. Uncomplicated diverticulitis. Uncomplicated diverticulitis, without abscess or perforation, is treated with oral antibiotics and a clear liquid diet for bowel rest.
Correct Answer is D
Explanation
A. Warfarin. Warfarin (Coumadin) is an anticoagulant used to prevent blood clots, but it typically requires several days to achieve a therapeutic effect and needs close monitoring of INR (International Normalized Ratio) levels. While it can be used for long-term prevention of DVT, it's not the immediate choice for post-operative prophylaxis.
B. Alteplase (tPA). Alteplase is a thrombolytic agent, used to break down existing clots, not prevent their formation. It is typically used in emergency situations, such as for treating ischemic stroke.
C. Clopidogrel. Clopidogrel is an antiplatelet agent, often used to prevent arterial clots, not DVTs. It is more commonly used in conditions like stroke and heart disease.
D. Enoxaparin. Enoxaparin, a low molecular weight heparin, is commonly used to prevent DVT after surgery by inhibiting specific clotting factors. It’s frequently prescribed for DVT prevention in orthopedic surgery patients.