A young adult is brought to the Emergency Department (ED) after a motor vehicle accident (MVA). The patient has severe right chest pain where there was impact with the steering wheel. Which is the priority patient goal?

Reduce the patient's anxiety

Assure adequate circulating volume

Decrease the patient's chest pain

Maintain adequate oxygenation

Answer and Explanation

The Correct Answer is D

A) Reduce the patient's anxiety:
While reducing anxiety is an important aspect of patient care, particularly in emergency situations, it is not the priority when life-threatening conditions may be present. Anxiety reduction can be addressed after ensuring that the patient’s more critical physiological needs (such as adequate oxygenation and circulation) are met.

B) Assure adequate circulating volume:
Maintaining adequate circulating volume is important, especially in trauma cases where blood loss is a concern. However, adequate oxygenation takes precedence over circulating volume in this scenario because without proper oxygenation, the patient’s vital organs and tissues may suffer from hypoxia, leading to further complications.

C) Decrease the patient's chest pain:
Chest pain following a motor vehicle accident (MVA) can be a symptom of serious injuries, such as rib fractures, pneumothorax, or even a cardiac contusion. While relieving pain is important for comfort and overall well-being, the priority in the immediate post-trauma phase is to ensure that the patient is receiving adequate oxygen.

D) Maintain adequate oxygenation:
The most critical concern after trauma, especially in a case involving chest impact, is ensuring that the patient is adequately oxygenated. Chest trauma can cause injuries to the lungs or pleural space (e.g., pneumothorax, hemothorax), leading to compromised oxygen exchange. The priority is to assess and maintain the patient's airway, breathing, and oxygenation first.

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Correct Answer is D

Explanation

A) Measure heart chamber pressures to assess for heart failure:
Measuring heart chamber pressures is an important diagnostic tool in assessing heart failure, but it is not the primary goal in the case of a STEMI (ST-Elevation Myocardial Infarction). In STEMI, the primary goal is to identify and treat the blockage in the coronary arteries that is causing the heart attack.

B) Determine cardiac output during the procedure:
Cardiac output is a useful measurement for assessing heart function, but it is not the main focus during the treatment of STEMI. While monitoring cardiac output may be part of the overall care, the urgent priority in STEMI management is to restore blood flow to the affected myocardial tissue as quickly as possible to minimize damage, not to measure cardiac output.

C) Evaluate the extent of the occlusion of the coronary arteries involved:
While evaluating the extent of coronary artery occlusion is part of the process during a cardiac catheterization, the immediate priority for a patient with STEMI is to treat the blockage, not just evaluate it. While the angiogram will reveal the blockage, the treatment goal is to restore perfusion to the affected area of the heart through procedures such as balloon angioplasty or stent placement.

D) Prevent extensive myocardial damage:
This is the correct answer. The main goal of treatment for STEMI is to prevent extensive myocardial damage. In a STEMI, the coronary artery is blocked, depriving the heart muscle of oxygen, which can cause significant damage or death of the myocardial tissue. The most effective way to limit the extent of damage is to restore blood flow as quickly as possible, often through emergent procedures like percutaneous coronary intervention (PCI) or fibrinolytic therapy.

A. isolate away from the family in a separate room B. retest for opportunistic infections monthly. C. live alone to prevent any transmission of HIV. D. clean any of their blood that spills with bleach

Correct Answer is D

Explanation

A) Isolate away from the family in a separate room:
Isolation is unnecessary for a client with HIV. HIV is primarily transmitted through specific bodily fluids such as blood, semen, vaginal fluids, and breast milk. The virus is not transmitted through casual contact, so there is no need for the client to isolate from their family.

B) Retest for opportunistic infections monthly:
While it is important for clients with HIV to be regularly monitored for opportunistic infections, monthly testing is not typically necessary unless specific symptoms or clinical indicators warrant it. Routine follow-up with a healthcare provider to monitor CD4 count, viral load, and overall health status is essential, but frequent opportunistic infection screening is not a general requirement.

C) Live alone to prevent any transmission of HIV:
There is no need for individuals with HIV to live alone to prevent transmission. As mentioned earlier, HIV is not spread through casual contact, so the client can live with family members without concern, as long as they follow proper precautions regarding handling blood or bodily fluids.

D) Clean any of their blood that spills with bleach:
Blood and other bodily fluids containing HIV are the primary sources of transmission. If any blood spills, cleaning the area with bleach (a disinfectant known to destroy HIV) is an important safety measure to reduce the risk of transmission. The client should also be taught to use gloves when cleaning blood spills, and to follow universal precautions when handling items contaminated with blood or other potentially infectious fluids.

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A young adult is brought to the Emergency Department (ED) after a motor vehicle accident (MVA). The patient has severe right chest pain where there was impact with the steering wheel. Which is the priority patient goal?

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