A patient who has chest pain is admitted to the emergency department (ED), and all of the following are ordered. Which one should the nurse arrange to be completed first?
Troponin level
Electrocardiogram (ECG)
Insertion of a peripheral IV
Chest X-ray
The Correct Answer is B
A. A troponin level will confirm myocardial injury but should be done after an ECG, as the ECG provides immediate information on the condition.
B. The first action in a chest pain situation is to obtain an ECG to assess for myocardial infarction or other cardiac abnormalities. The ECG provides immediate information about the heart's electrical activity and can help identify whether the chest pain is related to a cardiac event.
C. Insertion of a peripheral IV is important for administering medications and fluids, but it is not as urgent as obtaining an ECG to evaluate the patient's heart.
D. A chest X-ray is useful for other potential diagnoses (e.g., pulmonary embolism or pneumothorax) but is not the first step in diagnosing a myocardial event.
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Related Questions
Correct Answer is D
Explanation
A. Cutting toenails straight across is an appropriate action for PAD clients because it prevents injury or infection, as clipping nails too short or rounding the edges can cause cuts or ingrown nails.
B. Wearing shoes and socks instead of open-toed shoes is recommended to protect the feet from injury, as individuals with PAD have decreased sensation in their feet, increasing the risk of unnoticed injury.
C. Inspecting the feet daily for cuts is a crucial step in PAD management to detect early signs of infection or injury, which can lead to complications such as gangrene or amputation.
D. Raising the legs above the heart level can worsen symptoms in PAD by further reducing arterial blood flow to the lower extremities, where circulation is already compromised. This technique is typically used in venous insufficiency, not PAD.
Correct Answer is C
Explanation
A. AST and ALT are liver enzymes, primarily used to assess liver function, not directly related to monitoring heparin therapy.
B. Prothrombin time (PT) is used to monitor warfarin therapy, not heparin. Heparin therapy is typically monitored with aPTT, whereas warfarin is monitored with PT/INR.
C. Heparin is an anticoagulant that works by inhibiting clotting factors, and the aPTT is used to monitor its effectiveness. The aPTT measures the time it takes for blood to clot and helps ensure the heparin dose is therapeutic without causing excessive bleeding. The typical therapeutic range for aPTT on heparin therapy is 1.5 to 2.5 times the normal value.
D. INR is used to monitor warfarin therapy, not heparin. Heparin does not affect INR levels.
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