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 B
Explanation
Rationale:
A. Spironolactone is a potassium-sparing diuretic, so it would not cause hypokalemia.
B. Furosemide is a loop diuretic that causes the kidneys to excrete potassium, leading to hypokalemia.
C. Metoprolol is a beta-blocker and does not directly affect potassium levels.
D. Nitroglycerin is a vasodilator and does not affect potassium levels.
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.