A patient enters the emergency department complaining of chest ...

[leilurhhh]

A patient enters the emergency department complaining of chest pain that is radiating down the left arm. The emergent treatment plan for this patient should include which nursing actions?
 
  Select all that apply.
  1. morphine intravenously and oxygen
  2. aspirin 325 mg orally
  3. open heart surgery
  4. heparin drip at 100 units per hour
  5. Foley catheter insertion

Question 2

A patient reports chest pain, nausea, and vomiting off and on for the last 4 days, which the patient interpreted as the flu. What laboratory test(s) will provide information about acute cardiac damage for this patient?
 
  1. troponin I and T
  2. red blood cells
  3. CK-MB
  4. homocysteine and platelets

[diesoon]

Answer to Question 1

Correct Answer: 1, 2
Pain relief is vital in treating the patient with acute myocardial infarction (AMI). Pain stimulates the sympathetic nervous system, increasing the heart rate and blood pressure and, in turn, myocardial workload. Oxygen is administered by nasal cannula at 2 to 5 L/min to improve oxygenation of the myocardium and other tissues. Aspirin, a platelet inhibitor, is now considered an essential part of AMI treatment. A 160- to 325-mg aspirin tablet is given by emergency personnel, with the instructions that it is to be chewed (for buccal absorption). Open heart surgery may be indicated later. Heparin is not part of the admission protocol. A Foley catheter is not part of the admission protocol.

Answer to Question 2

Correct Answer: 1
The levels of Troponin T begin to rise within 24 hours after myocardial injury and remain elevated 1014 days. Levels of Troponin I begin to increase in about 24 hours after myocardial ischemia and peak at 2436 hours and remain elevated for 710 days. Red blood cells are unaffected by acute cardiac damage. The CK-MB rises within 48 hours after the MI, peaks within 1824 hours and levels return to normal 23 days following the infarction. This patient would most likely have normal values 4 days out from the onset of symptoms. Homocysteine does not change with acute cardiac damage. Platelets are unaffected by acute cardiac damage.