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?
Morphine
Nitroglycerin
Aspirin
Oxygen
The Correct Answer is D
Choice A reason : Morphine is an opioid analgesic used to relieve severe pain and can be administered to patients with myocardial infarction to alleviate chest pain and anxiety. However, it is not the first medication given as it does not address the underlying cause of the myocardial infarction, which is the formation of a blood clot in the coronary arteries.
Choice B reason : Nitroglycerin is a nitrate that helps to dilate blood vessels and improve blood flow. It can be used to relieve chest pain in myocardial infarction, but similar to morphine, it is not the initial medication of choice. The priority is to prevent further blood clotting.
Choice C reason : Administered as soon as possible to inhibit platelet aggregation and reduce clot progression.
Choice D reason : When a myocardial infarction (MI) is suspected, the priority is to address tissue hypoxia and ensure adequate oxygenation to minimize myocardial damage. Administering oxygen helps increase oxygen availability to the ischemic heart tissue, reducing further damage.
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Correct Answer is A
Explanation
Choice A reason : Aspirin is well-known for its antiplatelet properties, which inhibit platelet aggregation and thus prevent the formation of new blood clots. This is particularly important following a myocardial infarction, as it helps to prevent further clotting events that could lead to additional heart attacks or strokes. Aspirin's effect on platelets is so significant that it is often one of the first medications administered in the setting of acute coronary syndrome.
Choice B reason : While aspirin does have analgesic properties, this is not the primary reason it is prescribed post-myocardial infarction. The analgesic effect of aspirin is more commonly utilized for minor pains and aches, and it is not sufficient for the pain associated with coronary artery disease.
Choice C reason : Aspirin can reduce fever, but this is not relevant to its use in coronary artery disease. Fever reduction is not a concern when prescribing aspirin for myocardial infarction patients, as the primary goal is to manage the risk of thrombosis.
Choice D reason : Aspirin does have anti-inflammatory effects, but again, this is not the primary reason for its prescription following a myocardial infarction. While inflammation plays a role in atherosclerosis and coronary artery disease, the anti-inflammatory properties of aspirin are not the main focus in the context of post-myocardial infarction treatment.
Correct Answer is B
Explanation
Choice A : While vitamin K is essential for normal blood clotting, warfarin works by blocking the action of vitamin K. Therefore, clients taking warfarin should maintain a consistent intake of vitamin K-rich foods to avoid fluctuations in their response to the medication. Inconsistent vitamin K intake can affect the effectiveness of warfarin. The nurse should educate the client to consume a consistent amount of vitamin K-containing foods rather than emphasizing "lots" of vitamin K.
Choice B : Warfarin is an anticoagulant that increases the risk of bleeding. Taking aspirin (another blood-thinning medication) along with warfarin can further enhance this risk. The nurse should emphasize that clients should avoid taking aspirin or other nonsteroidal anti-inflammatory drugs (NSAIDs) without consulting their healthcare provider while on warfarin therapy.
Choice C : Alcohol can interact with warfarin and increase the risk of bleeding. Clients should be advised to limit alcohol consumption while taking warfarin. The nurse should educate the client that alcohol intake should be moderate and consistent, rather than encouraging wine consumption.
Choice D :While it is essential to minimize the risk of cuts and bleeding, the use of an electric razor is not specific to warfarin therapy. Clients should be cautious with any sharp objects, including razors, to prevent bleeding. The nurse should provide general safety instructions for shaving, but this choice does not directly relate to warfarin effects.
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