The nurse easily and quickly assesses changes in level of consciousness (eye opening, verbal responses motor response) using which neurological exams?

A) Glasgow Coma Scale:
The Glasgow Coma Scale (GCS) is a standardized neurological assessment tool used to assess a patient's level of consciousness based on three criteria: eye opening, verbal response, and motor response. Each of these categories is scored, and the total score helps to determine the depth of the patient's consciousness. The GCS is commonly used to monitor changes in a patient's neurological status, especially after trauma, stroke, or other conditions that may impair brain function.

B) NIH Stroke Scale:
The NIH Stroke Scale (NIHSS) is used to assess the severity of stroke symptoms and includes measures such as facial droop, arm and leg motor function, speech, and language abilities. It is used specifically to evaluate stroke symptoms and is not designed for the rapid assessment of general consciousness like the Glasgow Coma Scale.

C) Romberg Test:
The Romberg Test is a test of balance that is performed by having the patient stand with their feet together, eyes closed, and observing for any swaying or loss of balance. It is used to evaluate proprioception and cerebellar function, not to assess the level of consciousness.

D) Mini Mental Status Exam:
The Mini-Mental Status Exam (MMSE) is a brief cognitive screening tool that assesses aspects of cognitive function such as orientation, attention, memory, language, and visuospatial skills. While the MMSE can provide insight into cognitive function, it does not focus on the specific assessment of consciousness level (eye opening, verbal response, motor response) as the GCS does.

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.