A nurse in an emergency department is assessing a client who is having a suspected acute myocardial infarction (MI). Which of the following manifestations should the nurse expect to find for a client experiencing an acute MI? (Select all that apply.)
Orthopnea
Diaphoresis
Nausea
Headache
Tachycardia
Correct Answer : B,C,E
A. Orthopnea is difficulty breathing while lying flat, and it is typically associated with heart failure or pulmonary conditions, not an acute MI.
B. Diaphoresis (excessive sweating) is a common symptom of an acute MI due to the body's stress response to the myocardial injury.
C. Nausea can occur during an acute MI, particularly in women, as a result of the stress response or ischemia affecting the gastrointestinal system.
D. Headache is not a typical symptom of an acute MI. While it can occur due to stress or other factors, it is not a hallmark of myocardial infarction.
E. Tachycardia (increased heart rate) is a common response to an acute MI as the body attempts to compensate for reduced cardiac output and oxygenation.
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Correct Answer is B
Explanation
A. Heparin should not be discontinued immediately after starting warfarin, as warfarin takes several days to reach therapeutic levels. Discontinuing heparin too early could put the client at risk for clotting.
B. Warfarin takes several days to reach a therapeutic effect, so heparin is continued initially to provide immediate anticoagulation until the warfarin becomes effective.
C. Heparin does not increase the effects of warfarin, but both medications are used together temporarily to ensure adequate anticoagulation until warfarin reaches therapeutic levels.
D. Neither heparin nor warfarin dissolves clots. They are anticoagulants that prevent further clot formation, not thrombolytics that break down existing clots.
Correct Answer is C
Explanation
A. Troponin is not an enzyme that indicates damage to brain, heart, and skeletal muscle tissues. It is a protein specifically related to heart muscle injury. Therefore, this explanation is inaccurate.
B. Troponin is not a lipid, and it does not reflect the risk for coronary artery disease. It is a cardiac-specific protein released into the bloodstream when heart muscle cells are damaged, particularly during a myocardial infarction.
C. Troponin is a heart muscle protein that appears in the bloodstream when there is damage to the heart. It is a highly sensitive and specific marker for myocardial injury, making it a critical test for diagnosing a myocardial infarction.
D. Troponin is not involved in oxygen transport. Hemoglobin is the protein responsible for oxygen transport throughout the body, not troponin.
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