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 C
Explanation
Rationale:
A. Secondary hypertension is high blood pressure due to an identifiable cause, such as renal disease, but it does not describe an acute situation with target organ damage.
B. Hypertensive urgency is a situation where the blood pressure is severely elevated but without evidence of target organ damage.
C. Hypertensive emergency is characterized by severely elevated blood pressure with evidence of acute target organ damage, such as encephalopathy, myocardial infarction, or renal failure, requiring immediate medical intervention.
D. Primary hypertension, also known as essential hypertension, is high blood pressure without a known secondary cause and does not describe an acute emergency.
Correct Answer is B
Explanation
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.