The nurse is planning care for a client who is beginning a structured cardiac rehabilitation program. Before starting the program, what should the nurse do first?
a. Administer nitroglycerin to increase blood flow to the heart.
b. Assess the client for orthostatic hypoten-sion.
c. Start oxygen at 2 L/min via nasal cannula.
d. Determine the level of activity before shortness of breath occurs.
D
The level of activity that can be accomplished without experiencing shortness of breath needs to be established before activity is begun. This will alleviate fear and anxiety and will prevent the occurrence of cardiac symptoms. Oxygen should be started only if the pulse oximetry reading is below 90%, or if electrocardiographic changes or cardiac symptoms occur, none of which is in-dicated in this question. Nitroglycerin should be given only if the client has a history of angina. Orthostatic hypotension should be assessed before a client is ambulated, but this assessment does not provide information specific to the client's cardiac rehabilitation program.
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