A client is 12 hours post-myocardial infarction and is exhibiting a heart rate of 118 bpm, blood pressure of 98/64 mmHg, and reports ongoing chest discomfort. The nurse collaborates with the provider to implement interventions aimed at preventing sustained tachycardia. What is the primary goal of this intervention?
Enhance preload to maximize cardiac workload efficiency.
Stimulate the sympathetic nervous system to maintain blood pressure.
Decrease myocardial oxygen consumption and preserve ischemic tissue
Enhance coronary artery perfusion during systole
The Correct Answer is C
A. Enhancing preload increases ventricular filling, which may increase myocardial oxygen demand, not reduce it.
B. Stimulating the sympathetic nervous system (e.g., with catecholamines) raises heart rate and contractility, which increases myocardial oxygen consumption, potentially worsening ischemia.
C. Sustained tachycardia post-MI increases myocardial oxygen demand, which can worsen ischemic injury. Interventions aimed at reducing heart rate (such as beta-blockers) decrease oxygen consumption, reduce cardiac workload, and help preserve ischemic tissue.
D. Coronary perfusion primarily occurs during diastole, not systole. While improving perfusion is important, the primary goal here is reducing oxygen demand by controlling heart rate.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Dyspnea, unusual fatigue, and diaphoresis are classic early signs and symptoms of ACS and may indicate myocardial ischemia or infarction.
B. Peripheral cyanosis and hypertension are not typical presenting symptoms of ACS and may indicate other cardiovascular issues.
C. Hypotension and cyanosis can occur in severe ACS but are not the most common initial signs.
D. Peripheral cyanosis and hypertension are less specific for ACS; dyspnea alone is insufficient without other classic symptoms.
Correct Answer is C
Explanation
A. Amiodarone is used to treat arrhythmias and does not address hypotension caused by nitroglycerin.
B. Increasing the tPA infusion rate could worsen bleeding risks and does not correct hypotension.
C. Nitroglycerin is a vasodilator that can lower blood pressure; decreasing the infusion rate is the immediate priority to stabilize the client’s hemodynamics.
D. Obtaining a chest x-ray may be useful for other assessments but does not address the acute hypotensive event.
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