A nurse is assisting with the care of a client who was admitted to the telemetry unit after experiencing chest pain, dyspnea, and diaphoresis. Which of the following ECG findings is a manifestation of acute myocardial infarction?

Choice A reason : The therapeutic INR range for a patient on Warfarin, especially for conditions such as atrial fibrillation, venous thromboembolism, and for the prevention of thrombosis in patients with prosthetic heart valves, is typically 2.0-3.0. This range balances the risk of clotting with the risk of bleeding. An INR of 2.0-3.0 means that the blood is taking twice to three times as long as normal blood to clot, which is the desired effect of the medication in preventing harmful clots.

Choice B reason : An INR range of 4.0-5.0 is generally considered too high for most therapeutic purposes and increases the risk of bleeding complications. This range might be appropriate in very specific clinical situations, such as for patients with mechanical heart valves who may require a slightly higher INR, but it is not the standard therapeutic range.

Choice C reason : An INR range of 1.0-2.0 is below the therapeutic range for patients on Warfarin. This range would not provide sufficient anticoagulation and would leave the patient at risk for thrombotic events.

Choice D reason : An INR range of 3.0-4.9 is higher than the standard therapeutic range and could lead to an increased risk of bleeding. While some patients with mechanical heart valves in the mitral position may require an INR up to 3.5, an INR higher than this is usually not necessary and could be dangerous.

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.