Ten hours after successful thrombolysis for ST elevation myocardial infarction (STEMI), a client is receiving lidocaine and heparin infusions. Which assessment(s) should the nurse monitor regularly during the reperfusion period? Select all that apply.

Activated partial thromboplastin time (APTT).

Electrocardiographic changes.

Recurrence of chest pain.

Prothrombin time (PT).

Answer and Explanation

Correct Answer : A,B,C

Choice A reason: APTT is essential for monitoring the therapeutic effect of heparin. It helps ensure anticoagulation is within a safe and effective range, reducing the risk of bleeding or clot formation.

Choice B reason: Electrocardiographic changes, especially ST-segment resolution and T-wave inversion, are key indicators of successful reperfusion. Continuous ECG monitoring helps detect re-occlusion or arrhythmias.

Choice C reason: Recurrence of chest pain may signal failed or incomplete reperfusion, or new ischemic events. It is a critical symptom that warrants immediate evaluation.

Choice D reason: PT is primarily used to monitor warfarin therapy, not heparin. It is less relevant in the context of thrombolysis and heparin infusion, making it a lower priority in this scenario.

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Correct Answer is A

Explanation

Choice A reason: Comparing the client’s pain scale rating with the prescribed dosing ensures that the nurse selects the most appropriate medication based on the severity of pain. This aligns with safe medication administration practices and supports individualized pain management.
Choice B reason: While onset of action is important, it should be considered after matching the pain level to the appropriate medication. Quick relief is valuable, but not at the expense of dosing accuracy.
Choice C reason: Documentation is essential but should follow clinical decision-making and administration. It is not the first action when choosing between medications.
Choice D reason: Asking the client to choose the medication is inappropriate. Clients may not understand pharmacologic differences, and the nurse must use clinical judgment to select the safest and most effective option.

Correct Answer is ["3"]

Explanation

To calculate the volume needed, use the ratio:
1,200,000 units / 2 mL = 600,000 units per mL.
To deliver 1,800,000 units:
1,800,000 ÷ 600,000 = 3 mL.

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Ten hours after successful thrombolysis for ST elevation myocardial infarction (STEMI), a client is receiving lidocaine and heparin infusions. Which assessment(s) should the nurse monitor regularly during the reperfusion period? Select all that apply.

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Naxlex Comprehensive Predictor Exams

A postoperative client reports incisional pain. The client has two prescriptions for PRN analgesia that accompanied the client from the postanesthesia care unit (PACU). Before selecting which medication to administer, which action should the nurse implement?

Correct Answer is A

Explanation

Correct Answer is ["3"]

Explanation

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