A client is admitted to the Emergency Department with a suspected STEMI. The nurse anticipates that this client will be immediately prepared for the cardiac catheterization laboratory because the goal of treatment is to:

measure heart chamber pressures to assess for heart failure.

evaluate the extent of occlusion of the coronary arteries involved.

determine cardiac output during the procedure.

prevent extensive myocardial damage.

Answer and Explanation

The Correct Answer is D

A. Measure heart chamber pressures to assess for heart failure: While measuring heart chamber pressures may be important in other situations, it is not the immediate goal in the treatment of a suspected STEMI (ST-Elevation Myocardial Infarction). The priority in STEMI is to restore blood flow to the affected area of the heart, not to assess for heart failure through pressure measurements.

B. Evaluate the extent of occlusion of the coronary arteries involved: Although evaluating the extent of coronary artery occlusion is a part of the procedure, it is not the immediate goal. The priority in STEMI treatment is rapid reperfusion of the blocked artery to minimize myocardial damage. The catheterization will help guide interventions like angioplasty or stent placement to restore blood flow.

C. Determine cardiac output during the procedure: While cardiac output may be monitored during the procedure, the primary goal of the catheterization in a suspected STEMI is not to determine cardiac output but to restore blood flow to the heart and minimize the damage to the heart muscle.

D. Prevent extensive myocardial damage: The primary goal of immediate treatment for STEMI is to restore blood flow to the blocked coronary artery as quickly as possible, either through primary PCI (Percutaneous Coronary Intervention), angioplasty, or thrombolytics, in order to prevent extensive damage to the heart muscle. The earlier blood flow is restored, the less damage occurs to the heart tissue, which is critical for improving outcomes.

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Correct Answer is A

Explanation

A. Blood pressure is 92/50: Nitroglycerin is a vasodilator, and one of its common side effects is a reduction in blood pressure. A blood pressure of 92/50 indicates hypotension, which could be dangerous, especially in a patient with a myocardial infarction. The nurse should report this immediately as further reduction in blood pressure could lead to inadequate perfusion of vital organs, including the heart, and worsen the patient’s condition.

B. Serum potassium is 5.1 mEq/L: A serum potassium level of 5.1 mEq/L is within the normal range (3.5–5.0 mEq/L). While potassium imbalances can affect cardiac function, this level is not dangerously high and would not warrant immediate intervention.

C. Heart rate is 90 beats/minute: A heart rate of 90 beats per minute is within normal limits for an adult. It does not require immediate intervention in the context of a myocardial infarction unless there are signs of arrhythmias or other concerning changes.

D. T wave depression on the electrocardiogram: T wave depression can be a normal finding in patients with myocardial infarction, especially in the early stages. While it can indicate ischemia, it does not require immediate reporting unless there are more severe changes on the ECG or the patient’s condition deteriorates.

A. You have had some heart muscle damage but it involved a small area." B. "This is no different than the angina attacks that you have had in the past." C. "You have had a very serious heart attack and will need open heart surgery." D. The cardiac catheterization will diagnose this problem and correct it."

Correct Answer is A

Explanation

A. NSTEMI (Non-ST-Elevation Myocardial Infarction) refers to a heart attack where there is partial blockage or damage to the heart muscle but less severe than in STEMI (ST-Elevation Myocardial Infarction). The damage in NSTEMI typically affects a smaller area of the heart muscle, and it may not involve a full-thickness injury like in STEMI. This response provides the client with a clear, understandable explanation of their condition.

B. This statement is incorrect because NSTEMI is not the same as angina. Angina is chest pain due to temporary lack of blood flow to the heart, while NSTEMI involves actual damage to the heart muscle due to a more significant reduction in blood flow, even if the heart attack is less severe than a STEMI.

C. While NSTEMI is a serious condition, it does not automatically require open heart surgery. Treatment often involves medications (like antiplatelets or anticoagulants) and procedures like angioplasty or stenting to address the blockage, not necessarily surgery.

D. This response is somewhat misleading. Cardiac catheterization may be used to assess the severity and location of the blockage, but it is not always used to directly correct the problem. Procedures such as angioplasty or stent placement may follow the catheterization, but not all patients with NSTEMI will need immediate intervention.

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A client is admitted to the Emergency Department with a suspected STEMI. The nurse anticipates that this client will be immediately prepared for the cardiac catheterization laboratory because the goal of treatment is to:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is A

Explanation

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Correct Answer is A

Explanation

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