When assessing a newly admitted patient, the nurse notes a murmur ...

[ec501234]

When assessing a newly admitted patient, the nurse notes a murmur along the left sternal border. To document more information about the murmur, which action will the nurse take next?
 
  a. Find the point of maximal impulse.
  b. Determine the timing of the murmur.
  c. Compare the apical and radial pulse rates.
  d. Palpate the quality of the peripheral puls-es.

Question 2

The nurse has received the laboratory results for a patient who developed chest pain 4 hours ago and may be having a myocardial infarction. The most important laboratory result to review will be
 
  a. myoglobin.
  b. low-density lipoprotein (LDL) cholesterol.
  c. troponins T and I.
  d. creatine kinase-MB (CK-MB).

[Animal_Goddess]

Answer to Question 1

ANS: B
Murmurs are caused by turbulent blood flow, such as occurs when blood flows through a dam-aged valve. Relevant information includes the position in which the murmur is heard best (e.g., sitting and leaning forward), the timing of the murmur in relation to the cardiac cycle (e.g., sys-tole, diastole), and where on the thorax the murmur is heard best. The other information is also important in the cardiac assessment but will not provide information that is relevant to the mur-mur.

Answer to Question 2

ANS: C
Cardiac troponins start to elevate 4 to 6 hours after myocardial injury and are highly specific to myocardium. They are the preferred diagnostic marker for myocardial infarction. Myoglobin rises in response to myocardial injury within 30 to 60 minutes. It is rapidly cleared from the body, thus limiting its use in the diagnosis of myocardial infarction. LDL cholesterol is useful in assessing cardiovascular risk but is not helpful in determining whether a patient is having an acute myocar-dial infarction. Creatine kinase (CK-MB) is specific to myocardial injury and infarction and in-creases 4 to 6 hours after the infarction occurs. It is often trended with troponin levels.

[ec501234]

Thank you

[Animal_Goddess]

No problemo