Molly Carpenter a 44-year-old female client

Molly Carpenter, a 44-year-old female client, is admitted with an embolic stroke, and the cardiologist ordered a transesophageal echocardiogram (TEE). The client refused to sign the informed written consent when the cardiologist presented it to the client. The client has a shaky voice, she complains of palpitations, and there is visible diaphoresis present on Molly’s forehead.

Molly is pacing back and forth in the room and her eyes are dilated. The vital signs include T, 98 °F; BP, 140/90 mmHg; HR, 110 beats/minute; RR, 28 breaths/minute. The cardiologist talked with the client, stating that the test needs to be done to clearly find out if there are any blood clots in the heart that could travel and cause a future stroke.

The client recognizes the test is needed but stated she is freaked out by the thought of a tube being shoved down her throat. The LPN/LVN needs to provide nursing interventions to reduce Molly’s anxiety so she can learn more about the TEE and comfort measures that will be taken during the procedure. The cardiologist asked the LPN/LVN to call if the client changes her mind to have the procedure.

a. What nursing interventions should the LPN/LVN provide to decrease Molly’s anxiety about the TEE?

b. How can the LPN/LVN help the client to make an informed decision regarding the TEE?

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