Physiological Adaptation Q 62

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Which of the following actions is the first priority care for a client exhibiting signs and symptoms of coronary artery disease?

  

     A. Decrease anxiety

     B. Enhance myocardial oxygenation

     C. Administer sublingual nitroglycerin

     D. Educate the client about his symptoms

    

    

Correct Answer: B. Enhance myocardial oxygenation

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Enhancing myocardial oxygenation is always the first priority when a client exhibits signs and symptoms of cardiac compromise. Without adequate oxygen, the myocardium suffers damage.

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Option A: Decreasing the client’s anxiety is also important, but it is not the priority. When someone is anxious, their body reacts in ways that can put an extra strain on their heart. The physical symptoms of anxiety can be especially damaging among individuals with existing cardiac disease.

Option C: Sublingual nitroglycerin is administered to treat acute angina, but its administration isn’t the first priority. Although nitroglycerin has a vasodilatory effect in both arteries and veins, the profound desired effects caused by nitroglycerin are primarily due to venodilation. Venodilation causes pooling of blood within the venous system, reducing preload to the heart, which causes a decrease in cardiac work, reducing anginal symptoms secondary to demand ischemia.

Option D: Although educating the client is important in care delivery, it is not a priority when a client is compromised. Patient education promotes patient-centered care and increases adherence to medication and treatments. An increase in compliance leads to a more efficient and cost-effective healthcare delivery system. Educating patients ensures continuity of care and reduces complications related to the illness.

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