The patient is admitted with a suspected acute myocardial infarction (AMI). In assessing the 12-lead electrocardiogram (ECG) changes, which findings would indicate to the nurse that the patient is in the process of a myocardial infarction (MI)?
Depressed ST-segment on ECG and elevated total CPK
Depressed ST-segment on ECG and normal cardiac enzymes
ST-segment elevation on ECG and elevated CK-MB or troponin levels
Q wave on ECG with normal enzymes and troponin levels
The Correct Answer is C
Rationale:
A. A depressed ST-segment is often associated with ischemia or non-ST elevation myocardial infarction (NSTEMI), not an ongoing MI.
B. A depressed ST-segment with normal cardiac enzymes suggests ischemia rather than an active MI.
C. ST-segment elevation on ECG combined with elevated cardiac biomarkers such as CK-MB or troponin levels is a hallmark of an acute ST-segment elevation myocardial infarction (STEMI), indicating an ongoing MI.
D. A Q wave on ECG indicates an old infarction and is not associated with an acute MI if enzymes and troponin levels are normal.
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Correct Answer is A
Explanation
Rationale:
A. Clustering nursing activities helps to minimize interruptions, allowing the patient to have longer periods of uninterrupted rest, which is essential for recovery and reducing sensory disturbances from sleep deprivation.
B. Silencing alarms could compromise patient safety and is not recommended.
C. Administering sedatives or opioids should be done cautiously and is not a first-line approach for promoting sleep, especially if non-pharmacological methods can be effective.
D. While reducing nighttime assessments may help with sleep, it is not always feasible and should be balanced with the need for monitoring the patient’s condition.
Correct Answer is C
Explanation
Rationale:
A. Deaths of patients with communicable diseases still need to be reported because tissue and organ viability must be assessed on a case-by-case basis.
B. Tissue donation is voluntary and requires consent from the patient or their legal representative.
C. Organ donation can be authorized by a client's surrogate if the client has not previously given or refused consent. This allows for the surrogate to make decisions in line with the client’s wishes or best interests.
D. While facilities may have committees involved in the process, reporting is to organ procurement organizations, not solely to a facility's committee.