Which of the following EKG changes is commonly seen in a myocardial infarction?

A. Document that the client experienced an anaphylactic reaction to the medication. – The symptoms described (flushing and tachycardia) are more indicative of Red Man Syndrome, a rate-related infusion reaction, not an anaphylactic allergic response.
B. Change the IV infusion site. – There’s no indication of infiltration or phlebitis at the IV site. The issue is related to infusion speed, not the site.
C. Apply cold compresses to the neck area. – Cold compresses will not address the systemic reaction caused by rapid vancomycin infusion.
D. Decrease the infusion rate on the IV. – Flushing of the neck and upper body with tachycardia suggests Red Man Syndrome, a common reaction to rapid infusion of vancomycin. The appropriate action is to slow the infusion rate, which often resolves the symptoms.

A. Pitting edema – Fluid accumulation in the interstitial tissues can lead to pitting edema, a clear sign of fluid volume excess.
B. Swelling at the IV site – This could indicate infiltration or phlebitis, but it is localized and not a systemic sign of fluid overload.
C. Bounding pulse – A strong, bounding pulse is associated with increased circulatory volume, a hallmark of fluid overload.
D. Crackles upon auscultation – Crackles in the lungs may indicate pulmonary edema, which occurs with fluid volume excess when fluid backs up into the lungs.
E. Urine-specific gravity greater than 1.030 – Incorrect. A high urine-specific gravity usually indicates concentrated urine, more consistent with dehydration, not fluid overload.