A patient is admitted to the emergency department with clinical indications of an acute myocardial infarction. Symptoms began 3 hours ago. The facility does not have the capability for percutaneous coronary intervention
Given this scenario, what is the priority intervention in the treatment and nursing management of this patient? a. Administer thrombolytic therapy unless contraindicated
b. Diurese aggressively and monitor daily weight
c. Keep oxygen saturation levels at least 88%
d. Maintain heart rate above 100 beats/min
A
Medical treatment of AMI is aimed at relieving pain, providing adequate oxygenation to the myocardium, preventing platelet aggregation, and restoring blood flow to the myocardium through thrombolytic therapy or acute interventional therapy such as angioplasty. Since interventional cardiology is not available, thrombolytic therapy is indicated. Oxygen saturation should be maintained at higher levels to ensure adequate oxygenation to the heart muscle. An elevated heart rate increases oxygen demands and should be avoided. Diuresis is not indicated with this scenario.
You might also like to view...
The nurse is caring for a patient who has been admitted with a diagnosis of heart failure. What does the term "heart failure" mean?
A) It is characterized by rales and alveolar edema. B) It results from damage caused by acute myocardial infarction. C) It is a general clinical syndrome with many etiologies. D) All patients have similar symptoms.
What is the main purpose for obtaining a blood culture?
A) Detect bacterial invasion and the spread of the infection through the bloodstream B) Detect the spread of a viral infection in the cardiovascular system C) Test the glucose level of a patient with diabetes D) Determine the blood type of a patient undergoing a transfusion
An elderly client with a history of stable chronic obstructive pulmonary disease, alcohol abuse, and cirrhosis has a serum theophylline level of 25.8 mcg/mL (143 µmol/L). Which clinical manifestation associated with theophylline toxicity should worry the nurse most?
a. Alterations in color vision b. Gum (gingival) hypertrophy c. Hyperthermia d. Seizure activity
The hospitalized postsurgical patient is reluctant to take the opioid pain medication because of drowsiness. Which response is most informative for the nurse to make?
a. "Mental stimulation after the medication will keep you more alert." b. "Sleep and pain relief promote healing." c. "Drowsiness is an undesirable side effect." d. "The medication should be taken only before bedtime."