After an acute myocardial infarction, the client is receiving tissue plasminogen activator (tPA) and nitroglycerin continuous infusion. The client's blood pressure has dropped from 100160 mm Hg to 80/50 mm Hg. What is the most important nursing action?
Administer a bolus of amiodarone
Increase the tPA infusion rate
Decrease the nitroglycerin infusion rate
Obtain a STAT chest x-ray
The Correct Answer is C
A. Amiodarone is used to treat arrhythmias and does not address hypotension caused by nitroglycerin.
B. Increasing the tPA infusion rate could worsen bleeding risks and does not correct hypotension.
C. Nitroglycerin is a vasodilator that can lower blood pressure; decreasing the infusion rate is the immediate priority to stabilize the client’s hemodynamics.
D. Obtaining a chest x-ray may be useful for other assessments but does not address the acute hypotensive event.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. The development of a significant Q wave indicates myocardial necrosis and usually persists permanently, reflecting permanent loss of myocardial tissue.
B. Troponin levels rise during a myocardial infarction but return to normal over several days as the acute injury resolves.
C. T wave inversion may occur during ischemia and typically normalizes over time after the infarction.
D. ST elevation is an acute change during myocardial injury and generally returns to baseline after reperfusion or healing.
Correct Answer is C
Explanation
A. Severe dilated cardiomyopathy may require medical management or heart transplantation, not necessarily CABG.
B. Being a good candidate for angioplasty and stenting is an indication for percutaneous coronary intervention, not CABG.
C. Persistent angina that is not relieved by medical therapy indicates significant coronary artery disease requiring surgical revascularization, making CABG appropriate.
D. Right heart failure is a symptom of underlying cardiac disease but is not a primary indication for CABG.
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