A patient is admitted to the emergency department with clinical indications of an ST elevated myocardial infarction. The facility does not have the capability for percutaneous coronary intervention. Given this scenario, what is the priority intervention in the treatment and nursing management of this patient?
Administer thrombolytic therapy unless contraindicated
Keep oxygen saturation levels to at least 88%
Maintain heart rate above 100 beats/min
Administer diuretics aggressively and monitor daily weight
The Correct Answer is A
A. Thrombolytic therapy is the priority in managing an ST-elevated myocardial infarction (STEMI) when percutaneous coronary intervention (PCI) is not available. It helps dissolve the blood clot causing the blockage in the coronary artery.
B. Maintaining oxygen saturation is important, but the priority is to restore coronary blood flow.
C. The focus should be on stabilizing the heart rhythm, not specifically maintaining a high heart rate.
D. Diuretics are important in managing heart failure but are not the priority in acute STEMI management.
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Related Questions
Correct Answer is D
Explanation
A. A coronary artery bypass graft is used to treat coronary artery disease but is not typically indicated for end-stage heart failure.
B. Percutaneous coronary intervention is also used for coronary artery disease, not for improving quality of life in terminal heart failure.
C. This option dismisses potential interventions that could improve quality of life, such as an LVAD.
D. An LVAD is a mechanical pump that assists the left ventricle in pumping blood, often used as a bridge to heart transplant or as a long-term solution to improve quality of life in patients with terminal heart failure.
Correct Answer is A
Explanation
A. Clustering nursing activities helps to minimize interruptions, allowing the patient to have longer periods of uninterrupted rest, which is essential for recovery and reducing sensory disturbances from sleep deprivation.
B. Silencing alarms could compromise patient safety and is not recommended.
C. Administering sedatives or opioids should be done cautiously and is not a first-line approach for promoting sleep, especially if non-pharmacological methods can be effective.
D. While reducing nighttime assessments may help with sleep, it is not always feasible and should be balanced with the need for monitoring the patient’s condition.
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