What action would be most helpful to the nurse in determining whether the chest pain of a patient who has just entered the emergency department is cardiac in origin?
Performing a 12-lead ECG
Administering NTG to see if the pain goes away
Gathering a complete medical history
Asking the patient if performing a Valsalva maneuver reduces the pain
The Correct Answer is A
A. Performing a 12-lead ECG: An ECG is the most definitive and immediate tool to determine if chest pain is cardiac in origin, as it can detect ischemic changes, arrhythmias, or other cardiac abnormalities.
B. Administering NTG to see if the pain goes away: While nitroglycerin (NTG) may relieve ischemic chest pain, it is not definitive for diagnosing the pain's origin and should not be the first step without further assessment.
C. Gathering a complete medical history: Although a medical history is important, it will not immediately determine if the pain is cardiac in origin.
D. Asking the patient if performing a Valsalva maneuver reduces the pain: The Valsalva maneuver is not a reliable method to differentiate cardiac from non-cardiac chest pain and could potentially worsen certain conditions.
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Related Questions
Correct Answer is B
Explanation
A. Pallor and/or cyanosis of extremities: While pallor and cyanosis can indicate severe heart failure, they are not early signs. These symptoms usually appear later in the disease process.
B. Orthopnea, peripheral edema, crackles: These are early signs of heart failure indicating fluid overload due to decreased cardiac output. Orthopnea is difficulty breathing when lying flat, peripheral edema is swelling in the limbs, and crackles indicate fluid in the lungs.
C. Dizziness, syncope, palpitations:These symptoms can occur in heart failure but are not specific to fluid overload; they are more indicative of decreased cardiac output and possible arrhythmias.
D. PAWP of 12 and CVP of 6: These values are within normal limits. PAWP (Pulmonary Artery Wedge Pressure) and CVP (Central Venous Pressure) would be elevated in fluid overload.
Correct Answer is A
Explanation
A. ST segment elevation: ST segment elevation is a classic sign of myocardial injury, indicating that a portion of the heart muscle is not receiving enough oxygen and is actively injured.
B. Q wave: A Q wave typically appears later, representing a previous myocardial infarction (necrosis), not acute injury.
C. Inverted T wave: This indicates myocardial ischemia, which is a precursor to injury but not indicative of injury itself.
D. ST segment depression: This is typically associated with ischemia or subendocardial infarction, not full-thickness myocardial injury.
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