A nurse enters a client's room and finds the client pulseless. The family has requested a do-not-resuscitate (DNR) order from the provider, but he has not written the order yet. Which of the following actions should the nurse take?
Call the provider for a stat DNR order.
Start CPR and call the emergency response team.
Seek immediate help from the risk manager.
Respect the family's wishes and do nothing.
The Correct Answer is B
Rationale:
A. There is no time to wait for a DNR order in an emergency; immediate action is needed.
B. Without a written DNR order, the nurse is legally and ethically obligated to initiate CPR and call the emergency response team to attempt to save the client’s life.
C. Contacting the risk manager is not an immediate action that would benefit the patient in this emergency situation.
D. The family’s wishes cannot be respected in this scenario without a formal DNR order in place; thus, the nurse must perform CPR.
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Correct Answer is D
Explanation
Rationale:
A. CK-MB is a cardiac enzyme that rises in response to myocardial injury, but it is less specific and takes longer to rise than troponin.
B. BNP is associated with heart failure, not myocardial infarction.
C. Myoglobin is an early marker but is non-specific, as it rises with any muscle damage.
D. Troponin is the most specific and sensitive biomarker for myocardial infarction. It rises within 3-4 hours after myocardial injury and remains elevated for days, making it the most useful test for confirming an MI.
Correct Answer is B
Explanation
Rationale:
A. While a CVP catheter might be in place for an extended period, its purpose is not directly related to heart healing.
B. The CVP catheter is used to monitor central venous pressure, which helps guide fluid management and assess right heart function.
C. The CVP catheter does not extend into the left ventricle; it is typically positioned in the superior vena cava or right atrium.
D. The CVP catheter may have multiple lumens for administering fluids, but its primary purpose is hemodynamic monitoring, not just providing IV access.