Answer to Question 1
3. Decreased perfusion and may experience symptoms
Rationale:
Normal ejection fraction ranges from 5070. An ejection fraction of 30 is not normal. The client with an ejection fraction of 30 has a decrease in perfusion and may experience symptoms. This ejection fraction is not adequate to support minimal activities of daily living. Increasing the heart rate for some clients may improve perfusion to an extent but a sustained heart rate of 120 beats per minute could cause the cardiac output to drop leading to a further reduction in perfusion.
Answer to Question 2
3. Much of your care will be covered by Medicare..
Rationale:
The Medicare amendments to the Social Security Act and their subsequent expansions provide a national and state health insurance program that includes extremely expensive hospital care and prescription drug coverage for adults over the age of 65. Ignoring the client's concerns by telling him not to worry is not therapeutic communication and does little, if anything, to confront the client's concerns. Passing the concern to the business office does not address the client's concerns. Nurses should have some knowledge about the payment sources of their clients, especially those who have automatic coverage with Medicare because of their age.