The nurse is evaluating a patient who is experiencing chest pain beneath the sternum.

Which symptom reports would support a diagnosis of stable angina pectoris over a potential myocardial infarction?

(Select All That Apply)

Choice A rationale:

Clopidogrel is an antiplatelet medication that is essential for preventing blood clots from forming within coronary artery stents. It works by inhibiting the binding of adenosine diphosphate (ADP) to its receptors on platelets, thereby reducing platelet aggregation. This is crucial following stent placement because the stent itself can act as a trigger for platelet activation and clotting. By suppressing platelet function, clopidogrel helps to maintain blood flow through the stented artery and reduces the risk of stent thrombosis, a potentially life-threatening complication.

Here's a detailed explanation of why the other choices are incorrect:

Choice B: Ibuprofen

Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that is primarily used to treat pain and inflammation.

It does not have significant antiplatelet effects and is not typically used for the prevention of stent thrombosis.

While it might be prescribed for pain management after stent placement, it would not be the primary medication expected on the daily medication administration record for this purpose.

Choice C: Dipyridamole

Dipyridamole is an antiplatelet medication, but it is not as potent as clopidogrel and is not considered the first-line agent for preventing stent thrombosis.

It might be used in combination with clopidogrel in certain cases, but it would not be the sole antiplatelet medication expected on the daily medication administration record.

Choice D: Acetaminophen

Acetaminophen is a pain reliever and fever reducer.

It does not have any antiplatelet effects and would not be used to prevent stent thrombosis.

It might be prescribed for pain or fever after stent placement, but it would not be the primary medication expected on the daily medication administration record for this purpose.

Choice A rationale:

The ST segment represents the period of time between ventricular depolarization and repolarization. Its elevation or depression can indicate myocardial ischemia or injury, but it's not directly related to normal sinus rhythm determination.

The PR interval, on the other hand, measures the time it takes for the electrical impulse to travel from the atria to the ventricles. While a normal PR interval is essential for normal sinus rhythm, its height relative to the ST segment is not a determining factor.

Choice B rationale:

The number of complexes in a 6-second strip can provide a quick estimate of heart rate, but it's not a definitive criterion for normal sinus rhythm. A normal heart rate in adults typically ranges from 60 to 100 beats per minute, which could correspond to 5-10 complexes in a 6-second strip. However, other factors, such as rhythm regularity and P wave morphology, must also be considered. Choice C rationale:

RR intervals that are relatively consistent are a hallmark of normal sinus rhythm. This indicates that the heart is beating at a regular pace, with equal time intervals between each QRS complex. In contrast, irregular RR intervals suggest dysrhythmia, such as atrial fibrillation or premature ventricular contractions.

Choice D rationale:

One P wave preceding each QRS complex is another essential feature of normal sinus rhythm. The P wave represents atrial depolarization, and its consistent presence before each QRS complex (which represents ventricular depolarization) indicates that the electrical impulse is originating in the sinoatrial (SA) node, the heart's natural pacemaker, and is propagating through the atria and ventricles in a coordinated manner.