A nurse on a telemetry unit is caring for four clients. Which of the following clients is experiencing potential manifestations of a myocardial infarction?

A client who has intrascapular pain and indigestion

A client who has pain and swelling in one lower limb

A client who has elevated serum creatinine

A client who has crackles in the lungs and an elevate

Answer and Explanation

The Correct Answer is A

A. Intrascapular pain and indigestion can be atypical presentations of myocardial infarction, particularly in women.
B. Pain and swelling in one lower limb suggest deep vein thrombosis (DVT), not myocardial infarction.
C. Elevated serum creatinine indicates kidney dysfunction but is not a direct manifestation of myocardial infarction.
D. Crackles in the lungs and elevated temperature suggest possible infection or heart failure exacerbation, but not specifically myocardial infarction.

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Correct Answer is C

Explanation

A. Pleural effusion may be a complication of heart failure but does not directly explain the decreased urine output and elevated serum creatinine.

B. Myocardial infarction would present with different symptoms, such as chest pain, rather than decreased urine output and elevated creatinine.

C. Cardiorenal syndrome refers to the interdependence of the heart and kidneys, where chronic heart failure leads to worsening kidney function, causing symptoms like decreased urine output and elevated serum creatinine.

D. Heparin-induced thrombocytopenia (HIT) is related to the use of heparin and presents with low platelet counts, not decreased urine output and elevated creatinine.

A. Transport the patient to the cardiac catheterization lab for percutaneous coronary intervention (PCI). B. Begin aggressive diuresis with furosemide and obtain an order for digoxin. C. Prepare the patient for synchronized cardioversion and radiofrequency catheter ablation. D. Administer gemfibrozil (Lopid) while preparing the client for a cardiac stress test.

Correct Answer is A

Explanation

A. Transporting the patient to the cardiac catheterization lab for percutaneous coronary intervention (PCI) is the priority intervention for a patient with an ST-elevation myocardial infarction (STEMI). PCI is the preferred treatment to restore blood flow to the affected coronary artery.
B. Aggressive diuresis and digoxin are not appropriate for the acute management of a STEMI. Diuresis may be used in cases of heart failure but is not the immediate priority.
C. Synchronized cardioversion and radiofrequency catheter ablation are treatments for certain arrhythmias but are not indicated for the acute management of STEMI.
D. Administering gemfibrozil, a lipid-lowering agent, and preparing for a stress test are not appropriate interventions in the acute setting of a STEMI. Immediate reperfusion therapy is necessary.

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A nurse on a telemetry unit is caring for four clients. Which of the following clients is experiencing potential manifestations of a myocardial infarction?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client with a long history of poorly-managed left-sided heart failure complains of decreased urine output. Lab results show anemia and elevated serum creatinine levels. Based on these findings, which condition should the nurse suspect the client is experiencing?

Correct Answer is C

Explanation

Correct Answer is A

Explanation

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