An ECG has been ordered for a newly admitted patient.
What should the nurse do prior to electrode placement?

Choice B rationale:

LDL (low-density lipoprotein) cholesterol is often referred to as "bad" cholesterol. It contributes to the buildup of plaque in the arteries, which narrows the arteries and can lead to coronary artery disease (CAD). CAD is a major risk factor for heart attack and stroke.

HDL (high-density lipoprotein) cholesterol is often referred to as "good" cholesterol. It helps to remove LDL cholesterol from the arteries and transport it back to the liver, where it can be broken down and removed from the body. Therefore, a high HDL level is protective against heart disease.

An elevated LDL level and a lowered HDL level are both associated with an increased risk of CAD. This is because the elevated LDL level contributes to plaque buildup, while the lowered HDL level means that there is less "good" cholesterol available to remove the "bad" cholesterol from the arteries.

Therefore, the statement "Increased LDL and decreased HDL increase my risk of coronary artery disease" indicates an understanding of the significance of these cholesterol levels.

Choice A rationale:

This statement is incorrect. An increased LDL level will actually increase the amount of cholesterol deposited on the artery walls.

Choice C rationale:

This statement is also incorrect. A decreased HDL level will decrease the amount of cholesterol moved away from the artery walls.

Choice D rationale:

This statement is incorrect. Increased LDL has the potential to increase, not decrease, the risk of heart disease.

Choice A rationale:

Pain relief is a primary benefit of morphine administration in the setting of myocardial infarction.

Pain can trigger a stress response, leading to increased heart rate, blood pressure, and myocardial oxygen demand.

Morphine effectively reduces pain, thereby lessening the stress response and its detrimental effects on the heart.

This helps to minimize myocardial ischemia and potential further damage to the heart muscle.

Pain control also improves patient comfort and overall well-being, which can indirectly contribute to better cardiac outcomes.

Choice B rationale:

Sedation is another important benefit of morphine in this context.

It promotes rest and relaxation, which can lower heart rate, blood pressure, and myocardial oxygen demand.

This is crucial for patients with myocardial infarction, as their hearts require reduced workload to heal and recover.

Sedation also helps to alleviate anxiety and agitation, which can further strain the heart.

By inducing a state of calmness, morphine can indirectly protect the heart from additional stress.

Choice C rationale:

While morphine does have diuretic effects, increasing urinary output is not a primary goal in the management of myocardial infarction.

In fact, excessive diuresis could potentially lead to dehydration and hypotension, which could be detrimental to cardiac function.

Therefore, while morphine may slightly increase urine output, this is not a major reason for its use in this setting.

Choice D rationale:

Decreasing myocardial demand is a key benefit of morphine administration in patients with myocardial infarction.

Morphine achieves this by:

Reducing pain and the associated stress response

Promoting sedation and relaxation

Diminishing anxiety and agitation

Exerting a direct vasodilatory effect on blood vessels

This collective action of morphine leads to a decrease in heart rate, blood pressure, and the heart’s overall workload.

As a result, the heart requires less oxygen and experiences reduced strain, allowing for better healing and recovery following a myocardial infarction.