A nursing student preparing for his first clinical rotation must receive a hepatitis B vaccination series prior to attending clinicals. The nursing student understands that this is

A. Cardiac catheterization is often used in the management of an acute myocardial infarction to assess the extent of coronary artery disease and to determine the need for interventions such as angioplasty and stenting. This procedure is crucial for reperfusion therapy, especially in the context of ST-elevation MI (STEMI). Given the client’s symptoms and diagnostic findings, preparing for cardiac catheterization is an appropriate order.
B. While an echocardiogram can be useful for evaluating cardiac function and determining the extent of myocardial damage, it is not typically the immediate priority in the acute management of an MI. The focus is usually on rapid reperfusion therapy and stabilizing the patient. Therefore, this option is less urgent compared to others like administering oxygen and preparing for cardiac catheterization.
C. Warfarin is an oral anticoagulant used for long-term anticoagulation management and is not typically used in the acute setting of an MI. In acute MI management, other anticoagulants such as heparin or low molecular weight heparin are preferred for immediate anticoagulation. Administering warfarin in the acute setting is not appropriate.
D. Furosemide is a diuretic used to manage fluid overload and reduce symptoms of heart failure. It is not indicated as an immediate intervention in acute MI unless there is evidence of significant fluid overload or heart failure symptoms. The client’s current presentation does not suggest an immediate need for furosemide.
E. Supplemental oxygen is important in the management of acute myocardial infarction to ensure
adequate oxygen delivery to the myocardium and to alleviate hypoxia, especially since the client’s oxygen saturation is low at 92%. Providing supplemental oxygen is a standard intervention in the acute management of MI.
F. Sublingual nitroglycerin is commonly used to relieve chest pain in myocardial infarction by causing vasodilation. However, it should be used with caution in the presence of hypotension or other contraindications. Given the client’s symptoms and high heart rate, nitroglycerin could be appropriate,
but should be carefully monitored for effects on blood pressure.
G. A clear liquid diet is not an immediate priority in the management of acute myocardial infarction. Diet modification may be considered later in the course of treatment, but it is not a critical intervention in the acute phase.

A. Laparoscopic splenectomy involves the surgical removal of the spleen. The spleen is an organ where platelets are often destroyed in ITP. Removing the spleen can reduce the destruction of platelets and potentially improve platelet counts. This procedure is considered when medical therapy fails to adequately control the condition and is often effective in increasing platelet counts for many patients with chronic ITP.
B. Transfusion of platelets is generally not effective in ITP because the underlying problem is that the platelets are being destroyed by the immune system. Platelet transfusions may provide a temporary increase in platelet count but do not address the underlying cause of platelet destruction.
C. ADAMTS-13 is a von Willebrand factor-cleaving protease associated with thrombotic thrombocytopenic purpura (TTP), not ITP. Replacement of ADAMTS-13 is relevant for treating TTP, a different condition that also involves thrombocytopenia but has a different pathophysiology.
D. Protamine sulfate is used to reverse the effects of heparin, an anticoagulant. It is not used to treat ITP and does not affect platelet destruction or platelet count. This procedure is not relevant to the management of ITP.