The patient presents to the ED with severe chest discomfort. A cardiac catheterization and angiography shows an 90% occlusion of the left main coronary artery. Which procedure will be most likely performed on this patient?
Coronary artery bypass graft surgery
Radiofrequency catheter ablation
Implantable cardioverter-defibrillator placement
Circulatory assist device
The Correct Answer is A
Rationale:
A. Coronary artery bypass graft (CABG) surgery is typically recommended for patients with significant occlusion of the left main coronary artery, as it effectively restores blood flow to the heart muscle by bypassing the blocked artery.
B. Radiofrequency catheter ablation is used to treat arrhythmias, not coronary artery occlusions.
C. Implantable cardioverter-defibrillator (ICD) placement is for managing life-threatening arrhythmias, not directly for treating coronary artery blockages.
D. A circulatory assist device is used in severe cases of heart failure, but it does not address the underlying issue of coronary artery occlusion.
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Correct Answer is B
Explanation
Rationale:
A. Obtaining a stat chest x-ray is important if catheter misplacement is suspected, but in this situation, ensuring the accuracy of the pressure reading through proper leveling and zeroing is the priority.
B. Zero referencing and leveling the catheter at the phlebostatic axis is essential to ensure accurate readings of the pulmonary artery pressure, which is critical for patient assessment and management.
C. Increasing supplemental oxygen is unnecessary given the patient’s stable oxygen saturation and normal respiratory status.
D. While notifying the provider is important, ensuring the accuracy of the pressure reading by leveling and zeroing the catheter should be done first.
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.