A patient is admitted to the emergency department with clinical indications of an ST elevated myocardial infarction. The facility does not have the capability for percutaneous coronary intervention. Given this scenario, what is the priority intervention in the treatment and nursing management of this patient?
Administer thrombolytic therapy unless contraindicated
Keep oxygen saturation levels to at least 88%
Maintain heart rate above 100 beats/min
Administer diuretics aggressively and monitor daily weight
The Correct Answer is A
A. Thrombolytic therapy is the priority in managing an ST-elevated myocardial infarction (STEMI) when percutaneous coronary intervention (PCI) is not available. It helps dissolve the blood clot causing the blockage in the coronary artery.
B. Maintaining oxygen saturation is important, but the priority is to restore coronary blood flow.
C. The focus should be on stabilizing the heart rhythm, not specifically maintaining a high heart rate.
D. Diuretics are important in managing heart failure but are not the priority in acute STEMI management.
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Related Questions
Correct Answer is C
Explanation
A. Secondary hypertension is high blood pressure due to an identifiable cause, such as renal disease, but it does not describe an acute situation with target organ damage.
B. Hypertensive urgency is a situation where the blood pressure is severely elevated but without evidence of target organ damage.
C. Hypertensive emergency is characterized by severely elevated blood pressure with evidence of acute target organ damage, such as encephalopathy, myocardial infarction, or renal failure, requiring immediate medical intervention.
D. Primary hypertension, also known as essential hypertension, is high blood pressure without a known secondary cause and does not describe an acute emergency.
Correct Answer is D
Explanation
A. Homocysteine is a marker for cardiovascular risk but is not used to monitor heart failure therapy.
B. LDL levels are associated with cholesterol management and do not directly reflect heart failure treatment effectiveness.
C. Troponin is a marker of myocardial injury, not heart failure severity.
D. B-type natriuretic peptide (BNP) levels correlate with the severity of heart failure and are used to monitor the effectiveness of heart failure therapy.
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