The multidisciplinary team would identify which goals for initial collaborative management of a patient with an acute coronary event (ACS)? Note: Credit will be given only if all correct choices and no incorrect choices are selected

Question

Select all that apply. 1. Limit the size of infarction by decreasing oxygen demands.
2. Maximize coronary artery blood flow.
3. Strengthen the heart by increasing activity as soon as possible.
4. Balance oxygen demand with supply.
5. Prevent dysrhythmias with prophylactic antidysrhythmic medications.

Answer 1

1,2,4
Rationale 1: The symptoms are caused by decreased oxygen or increased demand for oxygen in the myocardium. If the nurse increases the oxygen supply and decreases the level of activity (decreasing metabolic rates) to decrease the demands, ischemic tissue can recover or limit additional tissue death. Prolonged continually, hypoxia will eventually cause tissue necrosis (death).
Rationale 2: In a collaborative environment, maximization of coronary artery blood flow would be achieved through medication therapy, procedural intervention, and rest.
Rationale 3: Ambulation will increase demand for O2 and is not recommended until the patient is stable.
Rationale 4: The symptoms are caused by decreased oxygen or increased demand for oxygen in the myocardium. If the nurse increases the oxygen supply and decreases the level of activity (decreasing metabolic rates) to decrease the demands, ischemic tissue can recover or limit additional tissue death.
Rationale 5: Preventing dysrhythmias prophylactically is not appropriate because the nurse may not know which type of irregularity will occur until it does occur. Early treatment should be used once the irregularity has been identified but it is not recommended to give medications before symptoms have developed. Dysrhythmias occur due to hypoxia, electrolyte imbalance, necrosis, or fluid shifts in the myocardium once the vessel has ruptured or occluded in ACS.