A nurse in the emergency room is caring for a client who presents with manifestations that indicate a myocardial infarction. Which of the following prescriptions should the nurse take first?
Attach the leads for a 12-lead ECG.
Initiate oxygen therapy.
Insert the IV catheter.
Obtain a blood sample.
The Correct Answer is B
The correct answer is: B. Initiate oxygen therapy.
Choice A reason:
Attaching the leads for a 12-lead ECG is crucial for diagnosing a myocardial infarction. However, it is not the first priority. Ensuring the patient receives adequate oxygen is more critical to prevent further myocardial damage. The ECG can be performed immediately after oxygen therapy is initiated to confirm the diagnosis and guide further treatment.
Choice B reason:
Initiating oxygen therapy is the first priority because it ensures that the heart muscle receives adequate oxygen, which is essential to prevent further damage during a myocardial infarction. Oxygen therapy helps to maintain tissue oxygenation and can reduce the extent of myocardial injury. This immediate intervention is vital to stabilize the patient and improve outcomes.
Choice C reason:
Inserting the IV catheter is important for administering medications and fluids. However, it is not the first step. Oxygen therapy takes precedence to ensure the heart and other vital organs receive sufficient oxygen. Once oxygen is administered, IV access can be established to facilitate further treatment.
Choice D reason:
Obtaining a blood sample is necessary for confirming the diagnosis and assessing cardiac markers. However, it is not the immediate priority. Ensuring the patient is oxygenated is more urgent to prevent further myocardial damage. Blood samples can be drawn after oxygen therapy is initiated.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A: Decreased specific gravity is not a finding of right-sided heart failure. Specific gravity is a measure of urine concentration, which can be affected by fluid intake, dehydration, kidney function, and diuretic use. Right-sided heart failure does not directly affect urine concentration, but it can cause fluid retention and edema in the body.
Choice B: Decreased brain natriuretic peptide (BNP) is not a finding of right-sided heart failure. BNP is a hormone that is released by the heart when it is stretched or overloaded. BNP helps to lower blood pressure and reduce fluid volume by increasing urine output and dilating blood vessels. BNP levels are elevated in both left-sided and right- sided heart failure, as the heart is under increased pressure and volume.
Choice C: Increased pulmonary artery wedge pressure (PAWP) is not a finding of right-sided heart failure. PAWP is a measure of the pressure in the left atrium, which reflects the pressure in the pulmonary capillaries. PAWP is elevated in left-sided heart failure, as the blood backs up in the lungs due to impaired left ventricular function. PAWP is normal or low in right-sided heart failure, as the blood backs up in the systemic circulation due to impaired right ventricular function.
Choice D: Elevated central venous pressure (CVP) is a finding of right-sided heart failure. CVP is a measure of the pressure in the right atrium, which reflects the pressure in the systemic venous system. CVP is elevated in right-sided heart failure, as the blood backs up in the body due to impaired right ventricular function. CVP can cause jugular venous distension, hepatomegaly, splenomegaly, ascites, and peripheral edema.
Correct Answer is B
Explanation
Choice a) is incorrect because vesicles on the skin are a sign of cutaneous anthrax, not inhalation anthrax. Cutaneous anthrax is caused by direct contact with anthrax spores through a break in the skin. It causes a painless, black, necrotic lesion on the affected area.
Choice b) is correct because respiratory failure is a sign of inhalation anthrax, which is the most deadly form of anthrax. Inhalation anthrax is caused by breathing in anthrax spores that enter the lungs and spread to the bloodstream. It causes severe breathing problems, chest pain, shock, and death.
Choice c) is incorrect because sloughing of skin is a sign of necrotizing fasciitis, not inhalation anthrax. Necrotizing fasciitis is a rare bacterial infection that destroys the soft tissue under the skin. It causes severe pain, swelling, redness, blisters, and gangrene.
Choice d) is incorrect because flu-like symptoms are not specific to inhalation anthrax. Flu-like symptoms can be caused by many other conditions, such as influenza, common cold, or COVID-19. Flu-like symptoms include fever, cough, sore throat, headache, and muscle aches.
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