Which of the following interventions would the emergency department nurse anticipate in a patient being treated for a non-ST-segment elevation myocardial infarction (NSTEMI)?
A) Sublingual nitroglycerin for up to three doses 5 minute apart
B) Intravenous nitroglycerin, if the patient has recently used a phosphodiesterase inhibitor drug
C) Enteric-coated aspirin
D) Intravenous beta blocker
A) Sublingual nitroglycerin for up to three doses 5 minute apart
Explanation: A) Short-acting sublingual nitroglycerin (in a dose of 0.3-0.4 mg) should be administered under the patient's tongue every 5 minutes for up to three doses.
B) If ischemic chest pain continues, intravenous nitroglycerin may be considered, especially in the presence of hypertension. However, nitrates (sublingual nitroglycerin or intravenous) are contraindicated if the patient has recently used a phosphodiesterase inhibitor such as sildenafil (Viagra) or tadalafil (Cialis).
C) Non-enteric-coated chewable aspirin should be given at presentation of symptoms and continued throughout the patient's life because of its antiplatelet function in preventing future thrombosis and coronary artery occlusion.
D) Oral, not intravenous, beta blockers are initiated within the first 24 hours if the patient does not have contraindications such as signs of heart failure or low cardiac output, risk for cardiogenic shock, heart block without a pacemaker, and asthma or reactive airway disease.
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Team intelligence refers to
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A Latin American woman refuses to participate in an assertiveness training group. Which cultural belief should a nurse identify as most likely to have influenced this client's decision?
A. Future orientation causes the client to devalue assertiveness skills. B. Decreased emotional expression makes it difficult to be assertive. C. Assertiveness techniques may not be aligned with the client's definition of the female role. D. Religious prohibitions prevent the client's participation in assertiveness training.
Select the appropriate interventions to discourage verbal abuse between physicians and nurses. Select all that apply
1. Approach those involved in private and identify a need for change in behavior. 2. Gain a better understanding of each profession's viewpoint. 3. Appoint a professional from another discipline to take charge of training and education programs for physicians and nurses. 4. Encourage nurses who are involved in this behavior to find employment elsewhere. 5. Disseminate code-of-conduct policies and reporting guidelines to both nurses and physicians.