. A patient who recently underwent percutaneous transluminal coronary angioplasty (PTCA) is being discharged. Which of the following statements made by the patient indicates the need for further teaching?
I need to monitor the puncture site for signs of infection such as redness or swelling.
I should follow a heart healthy diet to support my recovery.
I will take my prescribed medications as directed by my doctor.
I can resume my regular physical activities immediately after I get home.
The Correct Answer is D
A. I need to monitor the puncture site for signs of infection such as redness or swelling. Monitoring the puncture site is crucial for detecting any signs of infection or complications, which the patient should be aware of.
B. I should follow a heart-healthy diet to support my recovery. A heart-healthy diet is recommended to manage cholesterol levels and prevent further coronary artery disease progression.
C. I will take my prescribed medications as directed by my doctor. Following the medication regimen is important for preventing complications and supporting recovery, especially for blood thinners or other cardiac medications.
D. I can resume my regular physical activities immediately after I get home. This statement indicates a need for further teaching, as patients should gradually resume physical activities and avoid strenuous activities immediately after PTCA to prevent complications, such as bleeding at the catheter insertion site.
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Correct Answer is B
Explanation
A. The glomerular filtration rate decreases because there is a reduction of blood flow to the kidneys. Reduced blood flow to the kidneys, or renal hypoperfusion, decreases the glomerular filtration rate (GFR) because less blood is being filtered through the kidneys. This can occur in conditions such as shock, severe dehydration, or heart failure, but it is not the primary mechanism in acute tubular necrosis (ATN).
B. The glomerular filtration rate decreases because there is injury to the renal tubular cells. In ATN, the injury to renal tubular cells impairs their function, leading to reduced reabsorption and filtration ability, which contributes to the decrease in GFR.
C. The glomerular filtration rate decreases because inflammatory cells invade the already damaged kidneys. While inflammation may be present, it is not the primary cause of decreased GFR in acute tubular necrosis; reduced blood flow and tubular cell injury are more direct causes.
D. The glomerular filtration rate decreases because there is obstruction leading to the filtration system backing up and eventually shutting the kidneys down. Obstruction is not typically a characteristic of acute tubular necrosis; ATN is usually caused by ischemic or toxic injury, not physical obstruction.
Correct Answer is A
Explanation
A. Drink plenty of fluids to stay hydrated. Staying hydrated is essential in managing viral pharyngitis to prevent dehydration, soothe the throat, and promote recovery.
B. Take antibiotics as prescribed until the course is complete. Antibiotics are not indicated for viral infections; they are only used for bacterial infections.
C. Avoid all forms of physical activity until fully recovered. While rest is recommended, light activities may be acceptable depending on the patient’s energy levels and symptoms. Total avoidance of all physical activity is unnecessary.
D. Use throat lozenges as needed but avoid resting to prevent throat swelling. Resting is beneficial to recovery. Throat lozenges may soothe irritation, but avoiding rest would be counterproductive.