The nurse is developing a plan of care for an older client with hypertension who reports chest pain on exertion. Which outcome should the nurse include in the plan of care for this client?
A.
The nurse will call the client weekly to monitor the client’s blood pressure and symptoms.
B.
The nurse will encourage the client to walk thirty minutes every day.
C.
The client will take up to 4 nitroglycerine tablets sublingually for chest pain.
D.
The client will record episodes of angina and self-management for one week.
The Correct Answer and Explanation is:
Correct Answer: D. The client will record episodes of angina and self-management for one week.
Explanation:
The correct outcome for this scenario is option D, which focuses on the client’s self-management and awareness of angina episodes. In developing a plan of care for a client with hypertension who reports chest pain on exertion, it is crucial to encourage self-monitoring, symptom tracking, and self-management strategies. Self-monitoring empowers the client to be more aware of their symptoms and their triggers, allowing for more accurate communication with healthcare providers. By recording episodes of chest pain (angina), the client provides valuable data that can be used to adjust treatments and medications as necessary. Additionally, tracking their symptoms and responses helps the healthcare provider assess the efficacy of interventions and identify any potential worsening of the condition.
Why the other options are incorrect:
- A. The nurse will call the client weekly to monitor the client’s blood pressure and symptoms.
While it is important for the nurse to check in with the client regularly, weekly monitoring by the nurse alone is not an ideal outcome for promoting client independence or long-term management of hypertension and angina. This option lacks the element of client self-management, which is essential for effective chronic disease control. - B. The nurse will encourage the client to walk thirty minutes every day.
While physical activity, such as walking, is generally encouraged for cardiovascular health, this option may not be appropriate for a client reporting chest pain on exertion. Exertional chest pain can indicate underlying ischemic heart disease, which could worsen with unmonitored physical activity. Therefore, exercise recommendations should be made cautiously, typically after further evaluation of the client’s cardiovascular condition. - C. The client will take up to 4 nitroglycerine tablets sublingually for chest pain.
This option is incorrect because the standard dosing of nitroglycerine for chest pain is to take one tablet every 5 minutes, for a maximum of three tablets. If chest pain persists after taking three tablets within a 15-minute period, the client should seek emergency medical attention. Taking more than three tablets could be dangerous, and this recommendation does not align with standard angina management guidelines.
Thus, option D promotes the best outcome, fostering client engagement in symptom tracking, enabling the healthcare team to adjust treatment accordingly, and supporting safer self-management of their condition.