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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["B","C","E"]
Explanation
A. Crackles are more commonly associated with left ventricular failure, which leads to pulmonary congestion.
B. Hepatomegaly, or an enlarged liver, is a sign of right ventricular failure due to blood backing up in the systemic circulation.
C. Jugular venous distention is a classic sign of right ventricular failure as blood accumulates in the venous system.
D. Orthopnea, or difficulty breathing while lying down, is more indicative of left ventricular failure.
E. Peripheral edema is a hallmark of right ventricular failure, resulting from increased venous pressure.
Correct Answer is {"A":{"answers":"A"},"B":{"answers":"A"},"C":{"answers":"C"},"D":{"answers":"A"},"E":{"answers":"B"},"F":{"answers":"A"}}
Explanation
Furosemide: Furosemide is a diuretic that is commonly used to manage fluid overload in patients with heart failure. The patient has significant pitting edema, increasing dyspnea, and elevated BNP levels, indicating worsening heart failure. Administering furosemide is a high priority to reduce fluid overload and relieve symptoms.
Echocardiogram: An echocardiogram can provide valuable information about heart function.
Aspirin: Aspirin is typically used for its antiplatelet effects in conditions like coronary artery disease. It is not essential for managing acute symptoms of heart failure. The patient’s primary issue is fluid overload rather than a clotting concern.
Losartan: Losartan, an angiotensin II receptor blocker (ARB), is commonly used in the management of chronic heart failure to reduce afterload and prevent further cardiac remodeling. It is essential as part of the long-term management plan for heart failure.
Cardiac catheterization: Cardiac catheterization is an invasive procedure typically used to assess coronary artery disease or for interventional procedures. It is not indicated for the acute management of heart failure symptoms and could pose unnecessary risks in this context.
Chest X-ray: A chest X-ray is essential to assess the extent of pulmonary congestion and rule out other causes of respiratory distress, such as pneumonia or pleural effusion, which are important in managing a patient with worsening heart failure.
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