A patient presents to the emergency department with a complaint of sudden, severe pain to the left eye, nausea, and seeing halos around lights. The nurse suspects primary angle-closure glaucoma. The nurse anticipates that in order to relieve intraocular pressure, the patient should be prepared for which of the following procedures?

A. Cardiac catheterization is often used in the management of an acute myocardial infarction to assess the extent of coronary artery disease and to determine the need for interventions such as angioplasty and stenting. This procedure is crucial for reperfusion therapy, especially in the context of ST-elevation MI (STEMI). Given the client’s symptoms and diagnostic findings, preparing for cardiac catheterization is an appropriate order.
B. While an echocardiogram can be useful for evaluating cardiac function and determining the extent of myocardial damage, it is not typically the immediate priority in the acute management of an MI. The focus is usually on rapid reperfusion therapy and stabilizing the patient. Therefore, this option is less urgent compared to others like administering oxygen and preparing for cardiac catheterization.
C. Warfarin is an oral anticoagulant used for long-term anticoagulation management and is not typically used in the acute setting of an MI. In acute MI management, other anticoagulants such as heparin or low molecular weight heparin are preferred for immediate anticoagulation. Administering warfarin in the acute setting is not appropriate.
D. Furosemide is a diuretic used to manage fluid overload and reduce symptoms of heart failure. It is not indicated as an immediate intervention in acute MI unless there is evidence of significant fluid overload or heart failure symptoms. The client’s current presentation does not suggest an immediate need for furosemide.
E. Supplemental oxygen is important in the management of acute myocardial infarction to ensure
adequate oxygen delivery to the myocardium and to alleviate hypoxia, especially since the client’s oxygen saturation is low at 92%. Providing supplemental oxygen is a standard intervention in the acute management of MI.
F. Sublingual nitroglycerin is commonly used to relieve chest pain in myocardial infarction by causing vasodilation. However, it should be used with caution in the presence of hypotension or other contraindications. Given the client’s symptoms and high heart rate, nitroglycerin could be appropriate,
but should be carefully monitored for effects on blood pressure.
G. A clear liquid diet is not an immediate priority in the management of acute myocardial infarction. Diet modification may be considered later in the course of treatment, but it is not a critical intervention in the acute phase.

A. This statement is not accurate in the context of miotic medications. Miotic drugs do not work by blocking neural impulses to the muscles. Instead, they directly affect the eye's pupil size and fluid dynamics. This response does not correctly describe the action of miotic agents.
B. This response is incorrect because miotic medications actually constrict the pupil, not dilate it. In acute angle-closure glaucoma, dilation of the pupil would worsen the condition by further blocking the drainage angle. Miotics are used to constrict the pupil, which helps open the angle between the iris and the cornea, thereby facilitating fluid drainage.

C. Miotic medications cause the pupil to constrict (miosis), which helps in opening the narrow angle between the iris and the cornea. In acute angle-closure glaucoma, the angle is closed or narrow, preventing proper drainage of aqueous humor. By constricting the pupil, miotic medications can help to relieve this obstruction and allow better drainage of fluid, thereby reducing intraocular pressure.
D. This statement is incorrect regarding the action of miotic medications. Miotic drugs do not pull aqueous humor into the bloodstream. Their primary effect is on the pupil's size and the angle of the eye to improve drainage. Medications that reduce aqueous humor production or increase its outflow, such as carbonic anhydrase inhibitors or prostaglandin analogs, are responsible for these actions