The charge nurse in the coronary care unit must transfer a client to the medical unit to accommodate another acutely ill client from the emergency department. The nurse suggests the transfer of which client to the health care provider?

Question

The charge nurse in the coronary care unit must transfer a client to the medical unit to accommodate another acutely ill client from the emergency department.  The nurse suggests the transfer of which client to the health care provider?

Quizplus · Accepted Answer

Palliative and end-of-life care for end-stage heart failure focuses on client-centered interventions to provide symptom and pain relief and psychological and spiritual support, rather than on curative interventions. The client with end-stage heart failure, a terminal illness, would be most appropriate to transfer as palliative care can be provided in any health care setting. (Option A) Cardiac troponins are proteins released into the blood by damaged cardiac muscle (ie, myocardial infarction). Serial troponin I levels are normal (<0.5 ng/mL [0.5 mcg/L]) in clients with unstable angina as there is no muscle injury; however, cardiac ischemia is present. This client requires continual cardiac monitoring and interventions to restore blood flow to the heart. (Option B) Atrial fibrillation involves the rapid firing of irritable foci in the atria and an irregular, sometimes rapid, ventricular response. To slow the heart rate (goal <100/min), an IV infusion of the calcium channel blocker diltiazem (Cardizem) is prescribed; this requires continual cardiac monitoring. (Option C) Complete heart block is life-threatening and requires a pacemaker. This client should not be transferred. Educational objective: Clients with unstable angina experiencing chest pain and clients newly admitted with complete heart block or atrial fibrillation with a rapid ventricular response are unstable and require continual monitoring in an intensive care unit.

The Charge Nurse in the Coronary Care Unit Must Transfer