The nurse understands myocardial oxygen consumption increases as which of the following parameters increase? Preload, afterload and....

A. Do not use positive end expiratory pressure (PEEP):PEEP is commonly used in ARDS management to prevent alveolar collapse and improve oxygenation. It helps keep the airways open during expiration, which is critical for patients with ARDS.

B. Use high rates of ventilation: High ventilation rates are generally avoided in ARDS as they can increase the risk of ventilator-induced lung injury. ARDS patients require controlled ventilation with careful attention to oxygen levels and carbon dioxide removal, not excessive ventilation rates.

C. Place client in Trendelenburg position: The Trendelenburg position (head down, feet elevated) is not recommended for ARDS patients. This position can increase intracranial pressure and may worsen oxygenation. The prone position is preferred for ARDS management to improve oxygenation.

D. Use low but adequate tidal volume: In ARDS, a low tidal volume strategy (typically 6 mL/kg of ideal body weight) is recommended to minimize ventilator-induced lung injury. It helps prevent overdistension of the alveoli and improves lung protection, which is crucial for ARDS patients.

A. Brain natriuretic peptide (BNP) test: BNP is a biomarker primarily used to assess heart failure and fluid overload, not for detecting early myocardial injury. While BNP levels can be elevated in heart failure or other cardiac conditions, they are not specific for myocardial infarction (MI) or early cardiac muscle injury.

B. Creatine kinase-myocardial band (CK-MB) test: CK-MB is an enzyme found in cardiac muscle that rises in the blood when there is damage to the heart muscle. It is specific to myocardial injury and increases early (within a few hours) after a myocardial infarction. CK-MB is commonly used to detect and assess the extent of heart damage.

C. Troponin T test: While troponin T is a highly sensitive and specific biomarker for cardiac muscle injury and is often used to detect myocardial infarctions, it tends to rise later than CK-MB. Troponin levels remain elevated longer and are considered the gold standard for diagnosing myocardial injury, but CK-MB may identify early injury more quickly.

D. Creatine kinase (CK) test: The CK test measures total creatine kinase, which is found in various tissues, including skeletal muscle, brain, and cardiac muscle. Although it is elevated after myocardial injury, it is less specific to the heart compared to CK-MB, as other tissues may contribute to elevated levels