A patient who has had chest pain for several hours is admitted ...

[james9437]

A patient who has had chest pain for several hours is admitted with a diagnosis of rule out acute myocardial infarction (AMI). Which laboratory test should the nurse monitor to help determine whether the patient has had an AMI?
 
  a. Myoglobin
  b. Homocysteine
  c. C-reactive protein
  d. Cardiac-specific troponin

Question 2

After the nurse teaches the patient about the use of carvedilol (Coreg) in preventing anginal episodes, which statement by a patient indicates that the teaching has been effective?
 
  a. Carvedilol will help my heart muscle work harder.
  b. It is important not to suddenly stop taking the carvedilol.
  c. I can expect to feel short of breath when taking carvedilol.
  d. Carvedilol will increase the blood flow to my heart muscle.

[cat123]

Answer to Question 1

ANS: D
Troponin levels increase about 4 to 6 hours after the onset of myocardial infarction (MI) and are highly specific indicators for MI. Myoglobin is released within 2 hours of MI, but it lacks specificity and its use is limited. The other laboratory data are useful in determining the patient's risk for developing coronary artery disease (CAD) but are not helpful in determining whether an acute MI is in progress.

Answer to Question 2

ANS: B
Patients who have been taking -adrenergic blockers can develop intense and frequent angina if the medication is suddenly discontinued. Carvedilol (Coreg) decreases myocardial contractility. Shortness of breath that occurs when taking -adrenergic blockers for angina may be due to bronchospasm and should be reported to the health care provider. Carvedilol works by decreasing myocardial oxygen demand, not by increasing blood flow to the coronary arteries.