Question

1700:client reports worsening shortness of breath and increasing anxiety. fine crackles noted in bases of lungs. reports chest pain that is \tight and heavy.\ t 98.6°f (37°c), p 110, rr 26, bp 122/85, spo₂ 90%. at 1700, the nurse assesses the client and documents cues in the client’s notes. the nurse contacts the physician to obtain orders and prepares the client’s plan of care. the nurse anticipates which potential treatment for the care of the client? (select all that apply.) 1. albuterol nebulizer 2. large - bore peripheral venous access devices (vads) 3. oxygen via nasal cannula 4. high fowler position 5. sublingual nitroglycerin 6. antacid tablets po 7. levofloxacin iv 8. cardiac catheterization

Explanation:

1. Albuterol nebulizer: Not typically first - line for acute cardiac - related respiratory distress (client has chest pain “tight and heavy” suggesting cardiac issue), so not correct.
2. Large - bore peripheral venous access devices (VADs): For acute coronary syndrome (ACS) - like presentation, large - bore access is needed for possible interventions, so correct.
3. Oxygen via nasal cannula: Client has $SpO_2$ 90% and respiratory distress, oxygen supplementation is appropriate for hypoxia, so correct (already checked).
4. High Fowler position: Improves respiratory mechanics and comfort in respiratory distress, appropriate for this client, so correct (already checked).
5. Sublingual nitroglycerin: Used for angina/ACS to relieve chest pain by vasodilation, appropriate, so should be checked (wasn't initially).
6. Antacid tablets PO: Not related to cardiac/respiratory distress, incorrect.
7. Levofloxacin IV: Antibiotic, no indication of infection here, incorrect.
8. Cardiac catheterization: For diagnosing/treating acute coronary syndrome, appropriate for client with chest pain and cardiac - related distress, so correct (already checked).

So the correct options are:

1. Large - bore peripheral venous access devices (VADs)
2. Oxygen via nasal cannula
3. High Fowler position
4. Sublingual nitroglycerin
5. Cardiac catheterization

Answer:

1. Large - bore peripheral venous access devices (VADs)
2. Oxygen via nasal cannula
3. High Fowler position
4. Sublingual nitroglycerin
5. Cardiac catheterization