A 24-year-old client comes into the clinic complaining of right-sided chest pain and shortness of breath. He reports that it started suddenly. The assessment should include which of the following interventions?
A. Auscultation of breath sounds
B. Chest x-ray
C. Echocardiogram
D. Electrocardiogram (ECG)
Correct Answer: A. Auscultation of breath sounds
Because the client is short of breath, listening to breath sounds is a good idea. He may need a chest x-ray and an ECG, but a physician must order these tests.
Option B: A chest x-ray is one of the first diagnostic tests that should be utilized in evaluating dyspnea. If abnormal the disease process is likely cardiac or a primary pulmonary process. If the chest x-ray is normal, then spirometry is needed to determine lung function.
Option C: Unless a cardiac source for the client’s pain is identified, he won’t need an echocardiogram. An echocardiogram is needed to evaluate cardiac function and valvular function.
Option D: Additionally, an electrocardiogram should be obtained to evaluate for myocardial infarction or right-sided heart pattern strain. Elevated proBNP levels can further a congestive heart disease diagnosis.
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