An older man who paints houses for a living has had a myocardial infarction (MI). Which intervention should the nurse implement to prevent adverse health effects from his occupational history?
a. Provide low-cholesterol diet meals.
b. Avoid substances that are hepatotoxic.
c. Promote coughing and deep breathing.
d. Analyze the electrocardiogram's rhythm.
C
The nurse implements coughing and deep breathing because of the older man's history of expo-sure to environmental toxins from the paint vapor. Therefore to promote oxygenation and venti-lation and to prevent atelectasis and pneumonia, the nurse instructs him to cough and deep breathe at regular intervals. Hypercholesterolemia is a common co-morbidity with coronary artery disease; if his total cholesterol is greater than 200 mg/dl, then the nurse should provide a low-cholesterol diet. Inhalation of paint vapor over a long period has adverse effects primarily on the lungs. However, some hepatotoxic substances are used in health care, such as immunosup-pressants and aminoglycoside antibiotics, and must be given to this individual with caution. Be-cause he had a MI, the nurse closely monitors the heart's rhythm to detect ventricular dysrhyth-mias, tachycardia, and other potentially harmful rhythms, but such abnormal rhythms are unlikely to be directly related to his occupational history.
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