A client in the emergency department complains of squeezing substernal pain that radiates to the left shoulder and jaw. He also complains of nausea, diaphoresis, and shortness of breath. What should the nurse do?
a) Alert the cardiac catheterization team, administer oxygen, attach a cardiac monitor, and notify the physician.
b) Complete the client's registration information, perform an electrocardiogram, gain I.V. access, and take vital signs.
c) Administer oxygen, attach a cardiac monitor, take vital signs, and administer sublingual nitroglycerin.
d) Gain I.V. access, give sublingual nitroglycerin, and alert the cardiac catheterization team.
A, C, D
• Tobacco use
Modifiable risk factors for coronary artery disease include hyperlipidemia, tobacco use, hypertension, diabetes mellitus, metabolic syndrome, obesity, and physical inactivity. Nonmodifiable risk factors include family history, advanced age, gender, and race.
A client was transferring a load of fire wood from his front driveway to his backyard woodpile at 10 a.m. when he experienced a heaviness in his chest and dyspnea. He stopped working and rested, and the pain subsided. At noon, the pain returned. At 1:30 p.m., his wife took him to the emergency department. Around 2 p.m., the emergency department physician diagnoses an anterior myocardial infarction (MI). The nurse should anticipate which orders by the physician?
a) Serial liver enzyme testing, telemetry, and a lidocaine infusion
b) Streptokinase, aspirin, and morphine administration
c) Sublingual nitroglycerin, tissue plasminogen activator (tPA), and telemetry
d) Morphine administration, stress testing, and admission to the cardiac care unit