A nurse is providing care and education to a client after an acute myocardial infarction. Which of the following statements should the nurse make regarding cardiac enzyme studies?
"Cardiac enzymes assist in diagnosing the presence of pulmonary congestion."
"These tests will enable the provider to determine the heart structure and mobility of the heart valves."
"These tests help determine the degree of damage to the heart tissues."
"Cardiac enzymes will identify the location of the MI."
The Correct Answer is C
A. Cardiac enzymes do not diagnose pulmonary congestion. Pulmonary congestion is typically assessed using imaging, such as a chest X-ray or echocardiography.
B. Cardiac enzyme tests do not assess heart structure or valve mobility. An echocardiogram or cardiac MRI is used for that purpose.
C. Cardiac enzymes, such as troponins and creatine kinase-MB (CK-MB), indicate the extent of myocardial damage and are essential for diagnosing and managing acute myocardial infarction.
D. Cardiac enzymes confirm myocardial injury but do not pinpoint the exact location of the infarction. The location is determined using ECG findings and imaging studies.
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Related Questions
Correct Answer is []
Explanation
- Worsening of congestive heart failure is suggested by symptoms including labored breathing, coarse crackles, jugular vein distention (JVD), cool/clammy skin, and low oxygen saturation. These findings indicate pulmonary congestion due to fluid overload.
- Applying O₂ at 6L/min helps improve oxygenation and alleviate respiratory distress. Lower-flow oxygen (such as 2L/min) may not be sufficient in acute heart failure exacerbation.
- Monitoring respiratory rate is essential to track breathing effort and response to treatment.
- Monitoring oxygen saturation helps assess oxygenation status and effectiveness of interventions.
- Smoking cessation is important for long-term lung and cardiovascular health but does not address the acute issue.
- WBC count and temperature are more relevant to infections like pneumonia rather than acute heart failure.
Correct Answer is A
Explanation
A. Stage 1 hypertension is classified as a systolic BP of 130-139 mm Hg or diastolic BP of 80-89 mm Hg. While the readings provided are close, the higher diastolic value of 88 mm Hg falls into the Stage 1 hypertension category.
B. The term prehypertension is outdated and replaced by elevated BP, which refers to systolic 120-129 mm Hg and diastolic <80 mm Hg. The client’s diastolic values are too high for this category.
C. A normal BP is <120/80 mm Hg, and the client’s readings exceed this range.
D. Stage 2 hypertension is ≥140/90 mm Hg, which does not apply to this client.
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