A client is brought to the emergency department by ambulance with chest pain 10/10 which began 30 minutes prior. The client's troponin levels are 1.20 ng/mL and an ST-elevation is noted on the electrocardiogram (ECG). The nurse understands that the priority intervention for this patient is which of the following?
Transport the patient to the cardiac catheterization lab for percutaneous coronary intervention (PCI).
Begin aggressive diuresis with furosemide and obtain an order for digoxin.
Prepare the patient for synchronized cardioversion and radiofrequency catheter ablation.
Administer gemfibrozil (Lopid) while preparing the client for a cardiac stress test.
The Correct Answer is A
A. Transporting the patient to the cardiac catheterization lab for percutaneous coronary intervention (PCI) is the priority intervention for a patient with an ST-elevation myocardial infarction (STEMI). PCI is the preferred treatment to restore blood flow to the affected coronary artery.
B. Aggressive diuresis and digoxin are not appropriate for the acute management of a STEMI. Diuresis may be used in cases of heart failure but is not the immediate priority.
C. Synchronized cardioversion and radiofrequency catheter ablation are treatments for certain arrhythmias but are not indicated for the acute management of STEMI.
D. Administering gemfibrozil, a lipid-lowering agent, and preparing for a stress test are not appropriate interventions in the acute setting of a STEMI. Immediate reperfusion therapy is necessary.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Taking furosemide in the morning helps prevent nocturia and ensures better management of fluid balance during the day.
B. Gaining 3 pounds in 2 days likely indicates fluid retention rather than an issue with calorie intake. The client should contact their healthcare provider as it may indicate worsening heart failure.
C. Avoiding extreme temperatures is important as they can place additional stress on the cardiovascular system.
D. Limiting salt intake to 2 grams or less per day and reading nutrition labels is appropriate for managing heart failure.
Correct Answer is D
Explanation
A. NSTEMI would present with elevated troponin levels indicating myocardial injury, which is not the case here.
B. Stable angina occurs predictably with exertion and is relieved by rest or nitroglycerin.
C. STEMI is characterized by ST-elevation on the ECG and elevated troponin levels, indicating significant myocardial injury.
D. Unstable angina presents with chest pain that occurs at rest or with minimal exertion and is not predictable. The presence of T-wave inversion and normal troponin levels is consistent with this diagnosis.
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