A 40-year-old client has been admitted to the hospital with severe substernal chest pain radiating down his left arm. The nurse caring for the client establishes the following priority nursing…

Question

Options

• AIncreased excretion of lactic acid due to myocardial hypoxia
• BIncreased blood flow through the coronary arteries
• CDecreased stimulation of the sympathetic nervous system
• DDecreased secretion of catecholamines secondary to anxiety

• A
  43% (16)
• B
  30% (11)
• C
  19% (7)
• D
  8% (3)

Explanation

(A) Anaerobic metabolism results because the decreased blood supply to the myocardium causes a release of lactic acid. Lactic acid is an irritant to the myocardial neural receptors, producing chest pain. (B) Chest pain is caused by a decrease in the O2 supply to the myocardial cells. Treatment modalities for chest pain are aimed toward increasing the blood flow through coronary arteries. (C) Chest pain causes an increase in the stimulation of the sympathetic nervous system. This stimulation increases the heart rate and blood pressure, causing an increase in myocardial workload aggravating the chest pain. (D) Chest pain and anxiety cause increased secretion of catecholamines by stimulating the sympathetic nervous system. This stimulation increases chest pain by increasing the workload of

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