A nurse is caring for a school-age child who is postoperative and received morphine via IV bolus for pain 10 min ago.

Which of the following findings is the nurse’s priority?

The correct answer is choice D. Avoid using nail polish remover around the client. Nail polish remover contains acetone, which is a flammable substance that can ignite in the presence of oxygen.

Using nail polish remover around the client can increase the risk of fire and burn injuries.

Choice A is wrong because synthetic fabrics can generate static electricity, which can also cause sparks and ignite oxygen.

The client’s bedding should be made of cotton or wool, which are natural fabrics that do not produce static electricity.

Choice B is wrong because petroleum jelly is a petroleum-based product that can react with oxygen and cause skin irritation or burns.

The client should use water-based moisturizers to soothe the mucous membranes.

Choice C is wrong because alcohol-based cleaning products are also flammable and can cause fires or explosions when exposed to oxygen.

The client should use mild soap and water to clean the equipment, and follow the manufacturer’s instructions for maintenance.

Some general safety tips for home oxygen therapy are:

• Keep away from heat and flame, such as candles, matches, lighters, stoves, fireplaces, etc.
• Do not smoke or allow others to smoke near the oxygen source
• Do not use aerosols, vapor rubs, oils, or other products that contain flammable substances near the oxygen source
• Store oxygen tanks or cylinders in a well-ventilated area away from direct sunlight and heat sources
• Secure oxygen tanks or cylinders to prevent them from falling or rolling
• Use the exact rate of oxygen prescribed by the doctor for each activity
• Check the oxygen gauge or level regularly and call the medical supply company when it is low
• Use a humidifier bottle if prescribed by the doctor to prevent dryness of the mucous membranes
• Change the nasal cannula, mask, and tubing as instructed by the medical supply company to prevent

Answer:D. Troponin T test

Rationale:

A. Creatine kinase (CK) test: While creatine kinase isoenzymes, including CK-MB, can be elevated following myocardial infarction (MI), they are not specific to cardiac muscle injury. CK is found in various tissues throughout the body, so elevated levels can also indicate damage to skeletal muscle or brain tissue, among other sources.

B. Creatine kinase-myocardial band (CK-MB) test: CK-MB is a cardiac-specific isoform of creatine kinase, and elevated levels can indicate myocardial injury, particularly in the context of an acute MI. However, troponin T is a more sensitive and specific marker for myocardial injury.

C. Brain natriuretic peptide (BNP) test: Brain natriuretic peptide is primarily used in the diagnosis and management of heart failure. While elevated BNP levels can indicate heart muscle strain or stress, they are not specific markers for acute myocardial infarction or early injury to the cardiac muscle.

D. Troponin T test: This is the correct answer. Troponin T is a highly specific marker for cardiac muscle injury. Elevated troponin levels can be detected within hours of myocardial infarction and persist for several days, making it an essential tool in the diagnosis of acute coronary syndromes, including myocardial infarction. Troponin T is considered one of the gold standard biomarkers for detecting early injury to the cardiac muscle.