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 D
Explanation
A. Jugular vein distention (JVD) is more commonly associated with right-sided heart failure, not left-sided heart failure.
B. Peripheral edema is also more commonly associated with right-sided heart failure.
C. Ascites or fluid accumulation in the abdomen is typically associated with right-sided heart failure.
D. Pink, frothy sputum is indicative of pulmonary edema, which is a common symptom of left-sided heart failure due to the backup of blood into the lungs.
Correct Answer is D
Explanation
A. While a platelet transfusion can temporarily increase platelet counts, it does not reduce the destruction of platelets in ITP and is generally not effective as a long-term solution.
B. Replacement of ADAMTS-13 is relevant in thrombotic thrombocytopenic purpura (TTP), not ITP. It is not used for reducing platelet destruction in ITP.
C. Protamine sulfate is an antidote for heparin overdose and does not address the platelet destruction in ITP.
D. A laparoscopic splenectomy is often considered for clients with ITP who do not respond to medication therapy. The spleen is a primary site for platelet destruction, and its removal can reduce the destruction of platelets, leading to increased platelet counts.
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