A nurse is assisting in the plan of care for a client who has a suspected myocardial infarction. Which of the following medications should the nurse plan to administer first?

Choice A reason: The PR interval, which is the time from the onset of atrial depolarization (beginning of the P wave) to the onset of ventricular depolarization (beginning of the QRS complex), normally ranges from 0.12 to 0.20 seconds. A PR interval of 0.15 second is within the normal range and does not indicate an acute myocardial infarction.

Choice B reason: The QT interval represents the total time for ventricular depolarization and repolarization. The normal QT interval varies based on heart rate and gender but is typically less than half of the R-R interval in a normal heart rhythm. Therefore, a QT interval equal to the R-R interval is abnormally prolonged, which may suggest other conditions but is not a specific indicator of acute myocardial infarction.

Choice C reason: The QRS complex reflects ventricular depolarization and normally ranges from 0.06 to 0.10 seconds. A QRS interval of 0.08 second is within the normal range and does not suggest an acute myocardial infarction.

Choice D reason: ST segment elevation is a critical finding in the diagnosis of acute myocardial infarction. The ST segment should be at the isoelectric line; elevation above this line is indicative of myocardial injury and is a key diagnostic criterion for ST-elevation myocardial infarction (STEMI). An elevated ST segment is often seen in the early stages of an acute myocardial infarction and requires immediate medical attention.

Choice A reason: Monitoring cholesterol levels is essential while taking lisinopril. This medication is an angiotensin-converting enzyme (ACE) inhibitor used to treat high blood pressure, heart failure, and heart attack. Regular monitoring helps assess the impact of lisinopril on lipid levels and overall cardiovascular health. Elevated cholesterol can contribute to heart disease, so monitoring allows for timely interventions and adjustments in treatment.

Choice C reason: Potassium-rich foods are relevant because lisinopril can affect potassium levels. ACE inhibitors may lead to hyperkalemia (high potassium levels), especially in patients with impaired kidney function. Encouraging potassium-rich foods helps maintain a balance and prevent complications.

Choice D reason: Reporting a persistent dry cough is crucial. Lisinopril is associated with a common side effect: a dry, persistent cough. This occurs due to increased levels of bradykinin, a substance affected by ACE inhibitors. If the client experiences this cough, it's essential to notify the doctor for potential medication adjustments.

Choice E reason: Monitoring blood pressure aligns with the purpose of lisinopril. Regular blood pressure checks help assess the effectiveness of the medication in controlling hypertension. Consistent monitoring ensures timely adjustments and prevents complications related to high blood pressure.