Myocardial Infarction - ML8
The health care provider tells the client, "You are experiencing an MI," and leaves the room. The client asks the nurse what an MI stands for. What response by the nurse is most accurate? "Myocardial infarction." "Muscle infection." Myopia instability." "Mitochondria inflammation."
"Myocardial infarction." The common abbreviation for myocardial infarction is MI.
A client is diagnosed with angina pectoris. What would the nurse include when explaining this condition to the client? "The heart muscle isn't getting enough oxygen." "The arteries are narrowed due to fatty deposits." "The heart muscle has grown larger to compensate." "The heart muscle has become damaged due to blocked blood flow."
"The heart muscle isn't getting enough oxygen." The body's response to a lack of oxygen in the heart muscle is pain, which is called angina. The narrowing of arteries due to fatty deposits is called atherosclerosis. Although left ventricular enlargement may occur with coronary artery disease, it is not the underlying mechanism involved with angina. Damage to the heart muscle in response to ischemia is called a myocardial infarction.
A patient is experiencing an acute myocardial infarction. The physician orders metoprolol to be given as an intravenous bolus injection. The patient responds, and the physician then orders metoprolol oral therapy. The nurse would expect to administer the first oral dose at which time after the last intravenous bolus dose? Immediately 5 minutes 10 minutes 15 minutes
15 minutes For acute myocardial infarction, metoprolol is given via intravenous bolus. Three doses, each given at 2-minute intervals, are used and then the patient is started on oral therapy, which is started 15 minutes after the last intravenous dose.
To be effective, percutaneous transluminal coronary angioplasty (PTCA) must be performed within what time frame, beginning with arrival at the emergency department after diagnosis of myocardial infarction (MI)? 30 minutes 60 minutes 9 days 6 to 12 months
60 minutes The 60-minute interval is known as "door-to-balloon time" in which a PTCA can be performed on a client with a diagnosed MI. The 30-minute interval is known as "door-to-needle time" for the administration of thrombolytics after MI. The time frame of 9 days refers to the time until the onset of vasculitis after administration of streptokinase for thrombolysis in a client with an acute MI. The 6- to 12-month time frame refers to the time period during which streptokinase will not be used again in the same client for acute MI.
The health care provider orders thrombolytic agents when treating a client diagnosed with acute myocardial infarction. When specifically considering this client, which drug should the nurse keep readily available when blood flow is reestablished? Anticoagulants Antidysrhythmics Antihypertensives Antianginals
Antidysrhythmics When the thrombolytic agents are used in acute myocardial infarction, cardiac dysrhythmias may occur when blood flow is reestablished; antidysrhythmic drugs should be readily available.
A 61-year-old man is prescribed alteplase for an acute myocardial infarction. A priority nursing intervention will be to monitor for what during and after drug therapy? Gastrointestinal distress Liver failure A drop in blood pressure Arrhythmias
Arrhythmias A patient who is on alteplase therapy to treat a myocardial infarction should be monitored for arrhythmias using a cardiac monitor. Reperfusion arrhythmias are common when blood flow to the heart has been reestablished. The patient's blood pressure should also be monitored but would not be the priority intervention. Gastrointestinal distress and liver failure are not associated with alteplase therapy.
A client comes to the emergency department reporting severe substernal chest pain radiating down the left arm. The client is admitted to the coronary care unit with a diagnosis of myocardial infarction (MI). Which should the nurse do first when the client is admitted to the coronary care unit? Begin telemetry monitoring. Obtain a health history. Auscultate heart sounds. Evaluate the client's pain.
Begin telemetry monitoring. Telemetry monitoring should be started as soon as possible. Life-threatening arrhythmias are the leading cause of death in the first hours after MI. The other options are secondary in importance to assessing abnormal, life-threatening rhythms.
A nurse is caring for a client with type 2 diabetes who has had a myocardial infarction (MI) and is reporting nausea, vomiting, dyspnea, and substernal chest pain. Which is the priorityintervention? Reduce the nausea and vomiting and stabilize the blood glucose. Control the pain and support breathing and oxygenation. Decrease the anxiety and reduce the workload on the heart. Monitor and manage potential complications.
Control the pain and support breathing and oxygenation. Support of breathing and ensuring adequate oxygenation are the two most important priorities. Reducing the substernal pain is also important because upset and anxiety will increase the demand for oxygen in the body. Controlling nausea, vomiting, and anxiety are all secondary in importance. Prevention of complications is important following initial stabilization and control of pain.
You are monitoring the results of laboratory tests performed on a client admitted to the cardiac ICU with a diagnosis of myocardial infarction. Which test would you expect to show elevated levels? RBC Platelets Enzymes WBC
Enzymes When tissues and cells break down, are damaged, or die, great quantities of certain enzymes are released into the bloodstream. Enzymes can be elevated in response to cardiac or other organ damage. After an MI, RBCs and platelets should not be elevated. WBCs would only be elevated if there was a bacterial infection present.
The nurse working in the emergency room triages a client who comes in reporting chest pain, shortness of breath, sweating and elevated anxiety. The physician suspects a myodardial infarction. The client is given a nitrate, which does nothing for his pain. Which medication should the nurse suspect the doctor will order next for the pain? Demerol Morphine Fentanyl Codeine
Morphine Although a number of analgesic agents have been used to treat pain of myocardial infarction, morphine is the drug of choice and is usually indicated if chest pain is unrelieved with oxygen and nitrates.
Severe chest pain is reported by a client during an acute myocardial infarction. Which of the following is the most appropriate drug for the nurse to administer? Isosorbide mononitrate (Isordil) Meperidine hydrochloride (Demerol) Morphine sulfate (Morphine) Nitroglycerin transdermal patch
Morphine sulfate (Morphine) Morphine sulfate not only decreases pain perception and anxiety but also helps to decrease heart rate, blood pressure, and demand for oxygen. Nitrates are administered for vasodilation and pain control in clients with angina-type pain, but oral forms (such as isosorbide dinitrate) have a large first-pass effect, and transdermal patch is used for long-term management. Meperidine hydrochloride is a synthetic opioid usually reserved for treatment of postoperative or migraine pain.
A 40-year-old client has been admitted to the cardiac intensive care unit after having an anterior wall myocardial infarction (MI). The nurse is reviewing modifiable risk factors with the client to avoid the redevelopment of thromboembolic complications, possibly leading to a second MI. Which of the following increases this risk? Oral contraceptives Caffeine intake Hypoglycemic states Factor V Leiden mutation
Oral contraceptives The best answer is oral contraceptives. Modifiable risk factors for the development of thrombosis include oral contraceptives, prolonged bed rest, smoking, and obesity. Nonmodifiable risk factors include Factor V Leiden mutation, myocardial infarction, coronary artery disease, and cancer.
A nurse is explaining blood flow through the heart to a patient who has experienced a myocardial infarction. How would the nurse explain flow from the lungs to the heart? Deoxygenated blood from the lungs enters the left artrium through the pulmonary artery. Oxygenated blood from the lungs enters the right atrium through the pulmonary veins. Deoxygenated blood from the lungs enters the right atrium through pulmonary veins. Oxygenated blood from the lungs enters the left artium through the pulmonary veins.
Oxygenated blood from the lungs enters the left artium through the pulmonary veins. The left atrium receives oxygenated blood from the lungs through the pulmonary veins.
A triage team is assessing a client to determine if reported chest pain is a manifestation of angina pectoris or an MI. The nurse knows that a primary distinction of angina pain is? Described as crushing and substernal Associated with nausea and vomiting Relieved by rest and nitroglycerin Accompanied by diaphoresis and dyspnea
Relieved by rest and nitroglycerin One characteristic that can differentiate the pain of angina from a myocardial infarction is pain that is relieved by rest and nitroglycerine. There may be some exceptions (unstable angina), but the distinction is helpful especially when combined with other assessment data.
A client with a myocardial infarction develops acute mitral valve regurgitation. The nurse knows to assess for which manifestation that would indicate that the client is developing pulmonary congestion? A loud, blowing murmur Hypertension Shortness of breath Tachycardia
Shortness of breath Chronic mitral regurgitation is often asymptomatic, but acute mitral regurgitation (e.g., resulting from a myocardial infarction) usually manifests as severe congestive heart failure. Dyspnea, fatigue, and weakness are the most common symptoms. Palpitations, shortness of breath upon exertion, and cough from pulmonary congestion also occur. A loud, blowing murmur often is heard throughout ventricular systole at the apex of the heart. Hypertension may develop when reduced cardiac output triggers the renin-angiotensin-aldosterone cycle. Tachycardia is a compensatory mechanism when stroke volume decreases.
The nurse is caring for a client on a telemetry unit following a myocardial infarction. The client has undergone numerous medication changes since the event. Which food should be avoided when a client is taking warfarin sodium following a myocardial infarction? Spinach Milk Orange juice Wheat bread
Spinach Spinach is an essential source of vitamin K. Since vitamin K is essential for clotting, it should be consumed sparingly with anticoagulant therapy.
A nurse is evaluating a client who had a myocardial infarction (MI) 7 days earlier. Which outcome indicates that the client is responding favorably to therapy? The client demonstrates ability to tolerate more activity without chest pain. The client exhibits a heart rate within normal limits. The client requests information regarding smoking cessation. The client is able to verbalize the action of all prescribed medications.
The client demonstrates ability to tolerate more activity without chest pain. The ability to tolerate more activity without chest pain indicates a favorable response to therapy in a client who is recovering from an MI or who has a history of coronary artery disease. A heart rate within the normal limits of 60-100 per minute does not necessarily indicate a favorable response to treatment. Smoking is a cardiovascular risk factor that the client would be wise to eliminate, but it does not indicate favorable response to treatment. Knowledge of prescribed meds is a good thing, but again does not impact response to treatment.
Which serum biomarker is highly specific for myocardial tissue? Troponin Creatine kinase White blood cells C-reactive protein
Troponin The troponin assays have high specificity for myocardial tissue and have become the primary biomarker tests for the diagnosis of myocardial infarction. Creatine kinase is specific for muscle injury but is not as focused as is troponin. White blood cells and C-reactive protein are associated with inflammation.
A nurse is caring for a dying client following myocardial infarction. The client is experiencing apnea with a falling blood pressure of 60 per palpation. Which documentation of pulse quality does the nurse anticipate? Bounding pulse Weak pulse Thready pulse A pulse deficit
Thready pulse The nurse is most correct to anticipate a thready (barely palpable) pulse quality. A bounding pulse indicates a strong cardiac output. A weak pulse indicates a lower pulse quality. A pulse deficit occurs when the pulses between the apex of the heart differs from the radial pulse.
The client has had biomarkers tested after reporting chest pain. Which diagnostic marker of myocardial infarction remains elevated for as long as 2 weeks? Myoglobin Troponin Total creatine kinase CK-MB
Troponin Troponin remains elevated for a long period, often as long as 2 weeks, and it therefore can be used to detect recent myocardial damage. Myoglobin peaks within 12 hours after the onset of symptoms. Total creatine kinase (CK) returns to normal in 3 days. CK-MB returns to normal in 3 to 4 days.
When a physician suspects a client has suffered an acute myocardial infarction, which serum biomarkers should he order? Select all that apply. Troponin 1 Creatine kinase Troponin T Phosphorous Magnesium
Troponin 1 Creatine kinase Troponin T Serum biomarkers for acute coronary syndrome (ACS) include troponin 1 and troponin T as well as creatine kinase. The others may be drawn but they are not used for diagnosing and treating an acute myocardial infarction.
A client is admitted to the emergency department with chest pain and doesn't respond to nitroglycerin. The health care team obtains an electrocardiogram and administers I.V. morphine. The health care provider also considers administering alteplase. This thrombolytic agent must be administered how soon after onset of myocardial infarction (MI) symptoms? Within 6 hours Within 12 hours Within 24 to 48 hours Within 5 to 7 days
Within 6 hours For the best chance of salvaging the client's myocardium, a thrombolytic agent must be administered within 6 hours after onset of chest pain or other signs or symptoms of MI. Sudden death is most likely to occur within the first 24 hours after an MI. Health care providers initiate I.V. heparin therapy after administration of a thrombolytic agent; it usually continues for 5 to 7 days.
A client reports substernal chest pain that radiates to the neck. The pain lasts 5 minutes and then subsides with relaxation. What is the most likely cause of the chest pain? myocardial infarction intermittent claudication hypertension angina pectoris
angina pectoris Classic angina pain related to angina pectoris is substernal chest pain that can radiate to the jaw. Chest pain that lasts longer than 5 minutes is not associated with angina but is associated with myocardial infarction. Hypertension is usually a condition in which the client is pain free. Intermittent claudication is not associated with chest pain.
Based on the nurse's knowledge about thyroid hormone supplements, the nurse administers levothyroxine cautiously to a client who has recently had which condition or disorder? myocardial infarction cataract surgery seizure hypoglycemic episode
myocardial infarction A nurse should be cautious not to administer levothyroxine to a client who has recently had a myocardial infarction. Drug interactions with oral antidiabetics and insulin with hormone supplements can cause hyperglycemia. Seizure and cataract surgery are not contraindicated with the use of levothyroxine.
A client who was admitted to the hospital with a diagnosis of thrombophlebitis 1 day ago suddenly reports chest pain and shortness of breath and is visibly anxious. The nurse immediately assesses the client for other signs and symptoms of myocardial infarction. pulmonary embolism. pneumonia. pulmonary edema.
pulmonary embolism. Pulmonary embolism is a potentially life-threatening disorder typically caused by blood clots in the lungs. This disorder poses a particular threat to people with cardiovascular disease. Blood clots that form in the deep veins of the legs and embolize to the lungs can cause a pulmonary infarction, whereby emboli mechanically obstruct the pulmonary vessels, cutting off the blood supply to sections of the lung. Clinical indicators of pulmonary embolism can vary but typically include dyspnea, pleuritic chest pain, and tachypnea.
A client who is experiencing angina at rest that has been increasing in intensity should be instructed to: take a second nitroglycerine. give it 5-10 minutes more to see if there is relief. see the doctor for evaluation immediately. not worry about it as this is common for someone who has already had a myocardial infarction.
see the doctor for evaluation immediately. Angina that occurs at rest, is of new onset, or is increasing in intensity or duration denotes an increased risk for myocardial infarction and should be seen immediately using the criteria for acute coronary syndrome (ACS).
A 52-year-old client who experienced a myocardial infarction has an order for discharge. Part of the discharge teaching includes prior administration of nitroglycerin for chest pain. Which statement by the client indicates understanding of the teaching provided? "I will take two nitroglycerin tablets 15 minutes apart, and if I do not have any relief I will contact my health care provider." "I will take three nitroglycerin tablets 5 minutes apart, and if I do not have any relief I will seek emergency care immediately." "I will take three tables every 5 minutes until the chest pain subsides." "I will take one tablet and lay down for an hour."
"I will take three nitroglycerin tablets 5 minutes apart, and if I do not have any relief I will seek emergency care immediately." The client with stable or unstable angina will be prescribed sublingual nitroglycerin to relieve chest pain symptoms. The client may take up to three tablets of sublingual nitroglycerin 5 minutes apart. If the chest pain is unrelieved, the client needs to seek emergency medical care immediately.
A client with an acute myocardial infarction is receiving nitroglycerin by continuous I.V. infusion. Which client statement indicates that this drug is producing its therapeutic effect? "I have a bad headache." "My chest pain is decreasing." "I feel a tingling sensation around my mouth." "My vision is blurred, so my blood pressure must be up."
"My chest pain is decreasing." Nitroglycerin, a vasodilator, increases the arterial supply of oxygen-rich blood to the myocardium. This action produces the drug's intended effect: relief of chest pain. Headache is an adverse effect of nitroglycerin. The drug shouldn't cause a tingling sensation around the mouth and should lower, not raise, blood pressure.
The nurse is assessing vital signs on a client who is 3 months status post myocardial infarction (MI). While the healthcare provider is examining the client, the client's spouse approaches the nurse and states "We are too afraid he will have another heart attack, so we just don't have sex anymore." What is the nurse's best response? "The physiologic demands are greatest during orgasm and are equivalent to walking 3 to 4 miles per hour on a treadmill." "It is usually better to just give up sex after a heart attack." "Having an orgasm is very strenuous and your husband must be in excellent physical shape before attempting it." "The medications will prevent your husband from having an erection."
"The physiologic demands are greatest during orgasm and are equivalent to walking 3 to 4 miles per hour on a treadmill." The physiologic demands are greatest during orgasm. The level of activity is equivalent to walking 3 to 4 miles per hour on a treadmill. Sexuality is an important quality of life, so the healthcare provider will be determining when it is safe to have intercourse. Erectile dysfunction may be a side effect of beta-blockers, but other medications may be substituted.
Which client should most benefit from treatment with anti-thrombin agents? Young client diagnosed with hypertrophic cardiomyopathy (HCM) Client who was thought to have had an MI but who was later diagnosed with pericarditis 29-year-old client who developed endocarditis by injecting with a dirty needle 57-year-old client who has recently been diagnosed with unstable angina
57-year-old client who has recently been diagnosed with unstable angina Anticoagulation therapy prevents myocardial infarction in clients with acute coronary syndrome. Pericarditis, HCM, and endocarditis do not normally warrant anticoagulation.
A middle-aged client presents to the ED reporting severe chest discomfort. Which finding is most indicative of a possible myocardial infarction (MI)? Chest discomfort not relieved by rest or nitroglycerin Intermittent nausea and emesis for 3 days Cool, clammy skin and a diaphoretic, pale appearance Anxiousness, restlessness, and lightheadedness
Chest discomfort not relieved by rest or nitroglycerin Chest pain or discomfort not relieved by rest or nitroglycerin is associated with an acute MI. The other findings, although associated with acute coronary syndrome or MI, may also occur with angina and, alone, are not indicative of an MI.
Which drug is used to decrease the risk of myocardial infarction in patients with unstable angina or previous myocardial infarction? Aspirin Diflunisal Magnesium salicylate Salsalate
Aspirin Aspirin is used to decrease the risk of myocardial infarction in patients with unstable angina or previous myocardial infarction. Diflunisal, magnesium salicylate, or salsalate do not significantly decrease the risk of myocardial infarction.
A nurse is caring for a client who is exhibiting signs and symptoms characteristic of a myocardial infarction (MI). Which statement describes priorities the nurse should establish while performing the physical assessment? Assess the client's level of pain, and administer prescribed analgesics. Assess the client's level of anxiety, and provide emotional support. Prepare the client for pulmonary artery catheterization. Ensure that the client's family is kept informed of the client status.
Assess the client's level of pain, and administer prescribed analgesics. The cardinal symptom of MI is persistent, crushing substernal pain or pressure. The nurse should first assess the client's pain and prepare to administer nitroglycerin or morphine for pain control. The client must be medically stabilized before pulmonary artery catheterization can be used as a diagnostic procedure. Anxiety and a feeling of impending doom are characteristic of MI, but the priority is to stabilize the client medically. Although the client and their family should be kept informed at every step of the recovery process, this action isn't the priority when treating a client with a suspected MI.
A nurse is caring for a client who experienced an MI. The client is ordered to received metoprolol. The nurse understands that this medication has which therapeutic effect? Decreases resting heart rate Decreases cholesterol level Increases cardiac output Decreases platelet aggregation
Decreases resting heart rate The therapeutic effects of beta-adrenergic blocking agents such as metoprolol are to reduce myocardial oxygen consumption by blocking beta-adrenergic sympathetic stimulation to the heart. The result is reduced heart rate, slowed conduction of impulses through the conduction system, decreased blood pressure, and reduced myocardial contractility to balance the myocardial oxygen needs and amount of oxygen available. This helps to control chest pain and delays the onset of ischemia during work or exercise. This classification of medication also reduces the incidence of recurrent angina, infarction, and cardiac mortality. In general, the dosage of medication is titrated to achieve a resting heart rate of 50-60 bpm. Metoprolol is not administered to decrease cholesterol levels, increase cardiac output, or decrease platelet aggregation.
Following a left anterior myocardial infarction, a client undergoes insertion of a pulmonary artery catheter. Which finding most strongly suggests left-sided heart failure? Decreased central venous pressure Increase in the cardiac index Increased pulmonary artery diastolic pressure Decreased mean pulmonary artery pressure
Increased pulmonary artery diastolic pressure Increased pulmonary artery diastolic pressure suggests left-sided heart failure. Central venous pressure increases in heart failure rather than decreases. The cardiac index decreases in heart failure. The mean pulmonary artery pressure increases in heart failure.
A client comes to the emergency room exhibiting signs and symptoms of right-sided heart failure. Upon X-ray it is determined that he has 250 mL of fluid in the pericardial cavity. Which disease should the nurse suspect this client is suffering? Pericarditis Myocardial infarction Pericardial effusion COPD
Pericardial effusion Pericardial effusion refers to the accumulation of fluid in the pericardial cavity, usually as a result of an inflammatory or infectious process. A sudden accumulation of even 200 mL of fluid may raise intracardiac pressure to levels that will cause symptoms similar to right-sided heart failure. Pericarditis is inflammation of the pericardium while COPD is a respiratory disease.
A client is seen in the emergency room reporting sharp chest pain that started abruptly. He says it has radiated to his neck and abdomen. He also states that it is worse when he takes a deep breath or swallows. He tells the nurse that when he sits up and leans forward the pain is better. Upon examination the nurse notes a pericardial friction rub and some EKG changes. Which disease should the nurse suspect this client to have? Myocardial infarction Abdominal aortic aneurysm Pericarditis Pneumonia
Pericarditis This client is demonstrating signs and symptoms of pericarditis, which includes a triad of chest pain, pericardial friction rub, and EKG changes. Other signs are that the pain is usually abrupt in onset, occurs in the pericardial area, and may radiate to the neck, back, abdomen or side. It is usually worse with deep breathing and swallowing, and the person often finds relief when sitting up and leaning forward.
The troponin complex is one of a number of important proteins that regulate actin-myosin binding. Troponin works in striated muscle to help regulate calcium-mediated contraction of the muscle. Which of the troponin complexes is diagnostic of a myocardial infarction? Troponin C and troponin T Troponin A and troponin I Troponin T and troponin I Troponin A and troponin C
Troponin T and troponin I In clinical practice, the measurement of the cardiac forms of troponin T and troponin I is used in the diagnosis of myocardial infarction. Troponin C is not diagnostic of a myocardial infarction. Troponin A is not one of the troponin complexes.
A patient is receiving a beta-1 selective blocker after a myocardial infarction to prevent reinfarction. The nurse understands that the rationale for using the drug would be to: improve contractility. enhance excitability. decrease cardiac workload. decrease blood pressure.
decrease cardiac workload. A beta-1 selective blocker is helpful after a myocardial infarction because it decreases the cardiac workload and myocardial oxygen demand. The drug decreases contractility, excitability, and the heart rate. Although it also decreases blood pressure, it is not this effect that makes it a useful in preventing reinfarction.
The nurse is assessing a client admitted with a myocardial infarction with the following assessment: dyspnea, heart rate of 140 bpm, and crackles in the posterior chest. The nurse would interpret these findings as which condition? a hypoglycemic reaction cardiogenic shock associated with heart block development of congestive heart failure acute renal failure
development of congestive heart failure Crackles probably signify pulmonary edema, which occurs when there is left-sided congestive heart failure. The client is very dyspneic, and the heart appears to be compensating (increased rate because of respiratory congestion). Initiation of measures to help strengthen the heartbeat is a very important priority. Signs and symptoms do not indicate hypoglycemic reaction or renal failure. Heart block would be indicated by bradycardia.
A client comes to the emergency department complaining of chest pain. An electrocardiogram (ECG) reveals myocardial ischemia and an anterior-wall myocardial infarction (MI). Which ECG characteristic does the nurse expect to see? prolonged PR interval absent Q wave elevated ST segment widened QRS complex
elevated ST segment Ischemic myocardial tissue changes cause elevation of the ST segment, an inverted T wave, and a pathological Q wave. A prolonged PR interval occurs with first-degree heart block, the least dangerous atrioventricular heart block; this disorder may arise in healthy people but sometimes results from drug toxicity, electrolyte or metabolic disturbances, rheumatic fever, or chronic degenerative disease of the conduction system. An absent Q wave is normal; an MI may cause a significant Q wave. A widened QRS complex indicates a conduction delay in the His-Purkinje system.
A client is diagnosed with myocardial infarction. Which data collection findings indicate that the client has developed left-sided heart failure? Select all that apply. ascites jugular vein distention orthopnea cough hepatomegaly crackles
orthopnea cough crackles Left-sided heart failure produces primarily pulmonary signs and symptoms, such as orthopnea, cough, and crackles. Right-sided heart failure primarily produces systemic signs and symptoms, such as ascites, jugular vein distention, and hepatomegaly.
Two days after a myocardial infarction (MI), a client's temperature is elevated. The nurse understands which response to be most likely related to the infarction? possible infection tissue necrosis pulmonary infarction pneumonia
tissue necrosis The body's general inflammatory response to myocardial necrosis causes an elevation of temperature as well as leukocytosis within 24 to 48 hours. Possible infection is not correct because an MI won't cause infection. Pneumonia is not related to an MI. Pneumonia could be related to less movement, a potential later cause not associated with MI.
A client with severe angina pectoris and ST-segment elevation on an electrocardiogram is being seen in the emergency department. In terms of diagnostic laboratory testing, it's most important for the nurse to advocate ordering a: creatine kinase level. hemoglobin (Hb) level. troponin level. liver panel.
troponin level. Troponin is a myocardial cell protein that is elevated in the serum when myocardial damage has occurred during a myocardial infarction (MI). It's the best serum indicator of MI and is more indicative of cardiac damage than creatine kinase. Hb values and liver panel components aren't as useful in the diagnosis of MI as a troponin level.
A client with chest pain doesn't respond to nitroglycerin. When the client is admitted to the emergency department, the healthcare team obtains an electrocardiogram and administers I.V. morphine. The physician also considers administering alteplase. This thrombolytic agent must be administered how soon after onset of myocardial infarction (MI) symptoms? wthin 6 hours within 12 hours within 24 to 48 hours within 5 to 7 days
wthin 6 hours For the best chance of salvaging the client's myocardium, a thrombolytic agent must be administered within 6 hours after onset of chest pain or other signs or symptoms of MI. Sudden death is most likely to occur within the first 24 hours after an MI. Physicians initiate I.V. heparin therapy after administration of a thrombolytic agent; it usually continues for 5 to 7 days.
A client with suspected acute myocardial infarction is admitted to the coronary care unit. To help confirm the diagnosis, the physician orders serial enzyme tests. Increased serum levels of the isoenzyme creatinine kinase of myocardial muscle (CK-MB), found only in cardiac muscle, can be detected how soon after the onset of chest pain? 30 minutes to 1 hour 2 to 3 hours 4 to 6 hours 12 to 18 hours
4 to 6 hours Serum CK-MB levels can be detected 4 to 6 hours after the onset of chest pain. These levels peak within 12 to 18 hours and return to normal within 3 to 4 days.
A client comes to the emergency room with reports of chest pain. When the nurse reads his ECG she sees changes which include T-wave inversion, ST-segment elevation, and an abnormal Q wave. What should she suspect? Pericarditis Acute myocardial infarction Pleural effusion Coronary artery disease (CAD)
Acute myocardial infarction An acute myocardial infarction diagnosis includes unstable angina, T-wave inversion, ST-segment elevation, and abnormal Q wave on the ECG. The other diagnoses do not normally exhibit these findings on the ECG.
A client who has suffered a myocardial infarction is prescribed a laxative to help prevent straining during defecation. Which medication would the nurse expect to administer? docusate psyllium lubiprostone lactulose
docusate Docusate a stool softener, may be prescribed after a myocardial infarction to prevent straining during defecation. Psyllium is a bulk-forming laxative and may require straining to eliminate. Lubiprostone and lactulose are hyperosmotic agents that are used to relieve constipation and the reduction of blood ammonia levels in hepatic encephalopathy which may require straining.
To be effective, percutaneous transluminal coronary angioplasty (PTCA) must be performed within what time frame, beginning with arrival at the emergency department after diagnosis of myocardial infarction (MI)? 30 minutes 60 minutes 9 days 6 to 12 months
60 minutes The 60-minute interval is known as "door-to-balloon time" in which to perform PTCA on a client diagnosed with MI. The 30-minute interval is known as "door-to-needle time" for administration of thrombolytics after MI. The time frame of 9 days refers to the time until the onset of vasculitis after administration of streptokinase for thrombolysis in a client with an acute MI. The 6- to 12-month time frame refers to the time period during which streptokinase will not be used again in the same client for acute MI.
A client is being discharged following a myocardial infarction (MI) and asks the nurse why two blood thinners are prescribed. The nurse explains that the acetylsalicylic acid (ASA) and clopidogrel are both prescribed to reduce the risk of which complication? Cerebrovascular hemorrhage Deep vein thrombosis Transient thrombocytosis Pulmonary edema
Deep vein thrombosis Research studies support that ASA and clopidogrel given together decrease the incidence of deep vein thrombosis, pulmonary emboli, and cerebral embolization.
When the electrocardiogram (ECG) of a client in the emergency department indicates an ST elevation myocardial infarction (STEMI) in progress, the physician orders a beta-adrenergic blocker. Which factors in the client's history will cause the nurse to withhold medication pending discussion with physician? Select all that apply. Myocardial infarction caused by cocaine use Third-degree heart block Hypertension Shock Cerebrovascular accident
Myocardial infarction caused by cocaine use Third-degree heart block Shock Beta-adrenergic blockers (beta-blockers) are beneficial during acute coronary syndrome because they enhance myocardial perfusion by lengthening diastole. They also reduce sympathetic response, thus decreasing myocardial oxygen demand and systolic blood pressure. However, if a STEMI was caused by cocaine use, beta blockers can intensify the coronary spasm. Additional reasons to avoid beta blockers include left ventricular failure, hypotension, shock, second- or third-degree heart block, and symptomatic bradycardia.
The nurse is developing a plan of care for a client diagnosed with stable angina. Select the most important goal for this client. Myocardial infarction prevention Ensuring adequate oxygenation with continuous oxygen administration Preventing clotting disorders Assisting the client to return to previous lifestyle
Myocardial infarction prevention Symptom reduction for quality of life and prevention of MI are treatment goals for stable angina. The other options would not be treatment goals for stable angina.
Unstable plaque, a condition of atherosclerotic heart disease, occurs in unstable angina and myocardial infarction. Unstable plaque can rupture, causing platelet aggregation and thrombus formation. What are the major determinants of the vulnerability of plaque to rupture? Select all that apply. Size of lipid-rich core Preponderance of smooth muscle cells Presence of inflammation Decrease in blood pressure and coronary blood flow Thickness of fibrous cap
Size of lipid-rich core Presence of inflammation Thickness of fibrous cap The major determinants of plaque vulnerability to disruption include the size of the lipid-rich core, the stability and thickness of its fibrous cap, the presence of inflammation, and lack of smooth muscle cells. A decrease in blood pressure and coronary blood flow are not determinants of plaque vulnerability to rupture.
The nurse advises a client recovering from a myocardial infarction to decrease fat and sodium intake. Which foods should the nurse instruct the client to avoid? Select all that apply. pepperoni pizza oatmeal bacon cheese apple juice soft drinks
pepperoni pizza bacon cheese soft drinks Foods high in sodium include cheese, processed meats such as pepperoni and bacon, and soft drinks. Bacon and cheese also have a high fat content.
A nurse is awaiting the arrival of a client from the emergency department with a diagnosis of anterior wall myocardial infarction. In caring for this client, the nurse would be alert for which signs and symptoms of left-sided heart failure? Select all that apply. jugular vein distention hepatomegaly dyspnea crackles tachycardia skin tenting
dyspnea crackles tachycardia The right side of the heart is where the body deposits deoxygenated blood from the systematic circulation. Blood is then pumped from the right side of the heart to the lungs, where it exchanges CO2 and picks up oxygen. Once the blood is oxygenated, it flows to the left side of the heart which pumps to the rest of the body. Signs and symptoms of left-sided heart failure include dyspnea, orthopnea, and paroxysmal nocturnal dyspnea; fatigue; nonproductive cough and crackles; hemoptysis; point of maximal impulse displaced toward the left anterior axillary line; tachycardia; S3 and S4 heart sounds; and cool, pale skin. Jugular vein distention, hepatomegaly, and right upper quadrant pain are all signs of right-sided heart failure. Skin tenting is a sign of dehydration.
The nurse recognizes that the treatment for a non-ST-elevation myocardial infarction (NSTEMI) differs from that for a STEMI, in that a STEMI is more frequently treated with percutaneous coronary intervention (PCI). IV heparin. IV nitroglycerin. thrombolytics.
percutaneous coronary intervention (PCI). The client with a STEMI is often taken directly to the cardiac catheterization laboratory for an immediate PCI. Superior outcomes have been reported with the use of PCI compared to thrombolytics. IV heparin and IV nitroglycerin are used to treat NSTEMI.
A client has had a myocardial infarction and is to receive propranolol. The nurse understands that this drug is being used to: reduce the risk for recurrent anginal attacks. control the risk for vasospasm. prevent reinfarction. prevent the development of hypertension.
prevent reinfarction. Propranolol is used after a myocardial infarction to prevent reinfarction. The drug could cause vasospasm and as such would not be indicated for the treatment of Prinzmetal's angina.
A client comes to the physician's office for a follow-up visit 4 weeks after suffering a myocardial infarction (MI). The nurse takes this opportunity to evaluate the client's knowledge of the ordered cardiac rehabilitation program. Which evaluation statement suggests that the client needs more instruction? "Client performs relaxation exercises three times per day to reduce stress." "Client's 24-hour dietary recall reveals low intake of fat and cholesterol." "Client verbalizes an understanding of the need to seek emergency help if his heart rate increases markedly while at rest." "Client walks 4 miles (6.4 kilometers) in 1 hour every day."
"Client walks 4 miles (6.4 kilometers) in 1 hour every day." Four weeks after an MI, a client's walking program should aim for a goal of 2 miles (3.2 kilometers) in less than 1 hour. Walking 4 miles (6.4 kilometers) in 1 hour is excessive and may induce another MI by increasing the heart's oxygen demands. Therefore, this client requires appropriate exercise guidelines and precautions. Performing relaxation exercises; following a low-fat, low-cholesterol diet; and seeking emergency help if the heart rate increases markedly at rest indicate understanding of the cardiac rehabilitation program. For example, the client should reduce stress, which speeds the heart rate and thus increases myocardial oxygen demands. Reducing dietary fat and cholesterol intake helps lower risk of atherosclerosis. A sudden rise in the heart rate while at rest warrants emergency medical attention because it may signal a life-threatening arrhythmia and increase myocardial oxygen demands.
The nurse educates a client with a suspected myocardial infarction (MI) about the blood test to evaluate troponin levels. The nurse knows the education has been successful when the client says: "A result below 2 micrograms indicates I have no heart damage." "This test is specific to components found in my heart muscle." "An elevated level means I need to increase calcium intake." "My lifestyle changes will help this level drop quickly."
"This test is specific to components found in my heart muscle." Normally, during the noncontracted state of a cardiac or skeletal muscle cell, troponin covers the tropomyosin-binding sites on the actin filament and prevents formation of cross-bridges. During electrical stimulus, calcium binds with troponin to open the binding sites and allow actin-myosin cross-bridges to form. The presence of troponin I or troponin T (specialized troponins found in the heart muscle) in the blood indicates that cardiac muscle damage released troponin into the bloodstream. The damage could arise from MI or other conditions such as ischemia, sepsis, or renal failure. Troponin levels remain elevated for at least a week after cardiac injury. Lifestyle modification will not lower troponin levels.
ST-elevated myocardial infarction (STEMI) is accompanied by severe, crushing pain. Morphine is the drug of choice used to treat the pain of STEMI when the pain cannot be relieved with oxygen and nitrates. Why is morphine considered the drug of choice in STEMI? Action increases autonomic nervous system activity. Action decreases metabolic demands of the heart. Action increases anxiety, in turn increasing metabolic demands of the heart. Action relieves pain and gives sense of depression.
Action decreases metabolic demands of the heart. Although a number of analgesic agents have been used to treat the pain of STEMI, morphine is usually the drug of choice. It usually is indicated if chest pain is unrelieved with oxygen and nitrates. The reduction in anxiety that accompanies the administration of morphine contributes to a decrease in restlessness and autonomic nervous system activity, with a subsequent decrease in the metabolic demands of the heart. Morphine does not cause a feeling of depression to the client.
A nurse educator explains a type of cardiac condition as "a heterogeneous group of diseases of the myocardium associated with mechanical and/or electrical dysfunction that usually exhibit inappropriate ventricular hypertrophy or dilation and often lead to cardiovascular death or progressive heart failure." Which condition fits this definition? Heart failure Cardiomyopathy Myocardial infarction Rheumatic cardiac disease
Cardiomyopathy Cardiomyopathies result from genetic and/or environmental factors and will result in heart failure. MI and rheumatic diseases may lead to heart failure, but the mechanism is different.
A client's ECG reveals that he is suffering from a myocardial infarction. Prompt interventions are chosen to minimize further myocardial harm. What damage is the care team trying to prevent? Cellular atrophy Cellular hypoxia Oxidative stress-induced damage Apoptotic tissue damage
Cellular hypoxia The care team will implement interventions to prevent cellular hypoxia. Oxidative stress cannot be avoided in this situation, and apoptosis does not apply to tissues. Oxygen deprivation does not cause cellular atrophy.
A client who experienced an ST elevation myocardial infarction (STEMI) received fibrinolytic therapy with streptokinase. Which manifestation alerts the nurse to a developing complication? Decreased level of consciousness Hypoglycemia Symmetrical joint pain Diarrhea
Decreased level of consciousness Fibrinolytic therapy is most effective in treating STEMI when administered within 30 minutes after the onset of symptoms. It can still be beneficial up to 12 hours after the onset of ischemic pain. Clients who should not receive fibrinolytic therapy are those with a history of intracranial hemorrhage or significant trauma within the preceding 3 months. The primary complication of fibrinolytic treatment is intracranial bleeding that usually occurs within the first 24 hours following treatment. This would be evident with a change in mental status or level of consciousness (LOC).
The nursing instructor is talking about myocardial infarctions (MI) to her junior nursing class. What would the instructor tell the students is the most common cause of an MI? Coronary thrombosis Venous stasis Arteriosclerosis Stroke
Coronary thrombosis The most common cause of MI is coronary thrombosis, the consequence of a blood clot located within a coronary artery. Therefore, options B, C ,and D are incorrect.
A client comes to the emergency department reporting chest pain. An electrocardiogram (ECG) reveals myocardial ischemia and an anterior-wall myocardial infarction (MI). Which ECG characteristic does the nurse expect to see? Prolonged PR interval Absent Q wave Elevated ST segment Widened QRS complex
Elevated ST segment Ischemic myocardial tissue changes cause elevation of the ST segment, an inverted T wave, and a pathological Q wave. A prolonged PR interval occurs with first-degree heart block, the least dangerous atrioventricular heart block; this disorder may arise in healthy people but sometimes results from drug toxicity, electrolyte or metabolic disturbances, rheumatic fever, or chronic degenerative disease of the conduction system. An absent Q wave is normal; an MI may cause a significant Q wave. A widened QRS complex indicates a conduction delay in the His-Purkinje system.
A 65-year-old man who just had a heart attack is placed on aspirin, 81 mg daily. The nurse is explaining the purpose of this medication to the client and his wife. What would be the nurses bestexplanation? The aspirin is being prescribed because it reduces the prostaglandins in your body. The aspirin is being prescribed because it will protect your heart. The aspirin is being prescribed because it reduces your risk of a second heart attack. The aspirin is being prescribed to relieve the pain from the heart attack.
The aspirin is being prescribed because it reduces your risk of a second heart attack. Because of its antiplatelet and anti-inflammatory effects, low-dose aspirin (81 mg daily) is useful in preventing or reducing the risk of transient ischemic attacks (TIAs), MI, and ischemic cerebral vascular accident (stroke). It is also indicated for clients with a previous MI, chronic or unstable angina, and those undergoing angioplasty or other revascularization procedures.
A 45-year-old adult male patient is admitted to emergency after he developed unrelieved chest pain that was present for approximately 20 minutes before he presented to the emergency department. The patient has been subsequently diagnosed with a myocardial infarction (MI). To minimize cardiac damage, what health care provider's order will the nurse expect to see for this patient? Thrombolytics, oxygen administration, and bed rest Morphine sulfate, oxygen administration, and bed rest Oxygen administration, anticoagulants, and bed rest Bed rest, albuterol nebulizer treatments, and oxygen administration
Morphine sulfate, oxygen administration, and bed rest Morphine sulfate reduces preload and decreases workload of the heart, along with increased oxygen from oxygen therapy and bed rest. With decreased cardiac demand, this provides the best chance of decreasing cardiac damage. Thrombolytics and anticoagulants are contraindicated in patients who are bleeding or have a bleeding disorder. Albuterol is a medication used to manage asthma and respiratory conditions and will increase the heart rate.
A client who has just recently completed his second series of radiation therapy for lung cancer was admitted yesterday to an acute care facility with ascites. He begins to have jugular vein distention, pedal edema, and dyspnea upon exertion as well as fatigue. What should the nurse suspect? He is having a myocardial infarction. He has developed constrictive pericarditis. He is suffering side effects of the radiation. He is showing signs of acute renal failure.
He has developed constrictive pericarditis. Longstanding inflammation from mediastinal radiation, cardiac surgery and infection is usually the cause of constrictive pericarditis. Ascites is the early finding and can be followed by pedal edema, dyspnea upon exertion, fatigue and jugular vein distention.
A client returns for a follow-up visit to the cardiologist 4 days after a trip to the ED for sudden shortness of breath and abdominal pain. The nurse realizes the client had a myocardial infarction because the results from the blood work drawn in the hospital shows: elevated troponin levels. decreased LDH levels. decreased myoglobin levels. increased C-reactive protein levels.
elevated troponin levels. Troponin is present only in myocardial tissue; therefore, it is the gold standard for determining heart damage in the early stages of an MI. LDH1 and LDH2 may be elevated in response to cardiac or other organ damage during an MI. Myoglobin is a biomarker that rises in 2 to 3 hours after heart damage during an MI. C-reactive protein, erythrocyte sedimentation rate, and the WBC count increase on about the third day following MI because of the inflammatory response that the injured myocardial cells triggered. These levels would not be elevated during the MI event.
A patient with a history of angina, calls the clinic and reports chest pain. The patient states "I'm scared that I am going to die and I've been pacing up and down my driveway." After calming the patient, the initial instruction by the nurse to best manage the situation would be to: ask the patient to call 911 and wait outside for the ambulance to arrive. ask the patient to place a nitroglycerin tablet under the tongue immediately. have the patient take the pulse for 1 minute. have the patient go into the house and sit or lie down.
have the patient go into the house and sit or lie down. The nurse should instruct the patient to sit or lie down before taking nitroglycerin to prevent dizziness or fainting. The nurse should then inform the patient to place the tablet under the tongue and that the patient can take another tablet in 5 minutes and again in 10 minutes if the pain has not subsided. However, if the pain still has not subsided, the patient should call 911 because the patient may be experiencing a myocardial infarction. The nurse may stay on the phone with the patient while the patient is taking the medication if the patient is overly anxious. The nurse may ask the patient after the medication administration to check the patient's pulse to help determine the patient's level of anxiety and cardiac function.
A client is recovering from an acute myocardial infarction (MI). During the first week of the client's recovery, the nurse should stay alert for which abnormal heart sound? opening snap Graham Steell's murmur ejection click pericardial friction rub
pericardial friction rub A pericardial friction rub, which sounds like squeaky leather, may occur during the first week following an MI. Resulting from inflammation of the pericardial sac, this abnormal heart sound arises as the roughened parietal and visceral layers of the pericardium rub against each other. Certain stenosed valves may cause a brief, high-pitched opening snap heard early in diastole. Graham Steell's murmur is a high-pitched, blowing murmur with a decrescendo pattern; heard during diastole, it indicates pulmonary insufficiency, such as from pulmonary hypertension or a congenital pulmonary valve defect. An ejection click, associated with mitral valve prolapse or a rigid, calcified aortic valve, causes a high-pitched sound during systole.
A client presents to the ED with a myocardial infarction. Prior to administering a prescribed thrombolytic agent, the nurse must determine whether the client has which absolute contraindication to thrombolytic therapy? prior intracranial hemorrhage recent consumption of a meal shellfish allergy use of heparin
prior intracranial hemorrhage History of a prior intracranial hemorrhage is an absolute contraindication for thrombolytic therapy. An allergy to iodine, shellfish, radiographic dye, and latex are of primary concern before a cardiac catheterization but not a known contraindication for thrombolytic therapy. Administration of a thrombolytic agent with heparin increases risk of bleeding; the primary healthcare provider usually discontinues the heparin until thrombolytic treatment is completed.
A client with a history of an anterior wall myocardial infarction is being transferred from the coronary care unit (CCU) to the cardiac step-down unit (CSU). While giving a report to the CSU nurse, the CCU nurse says, "His pulmonary artery wedge pressures have been in the high normal range." What additional assessment information would be important for the CSU nurse to obtain? hypertension high urine output dry mucous membranes pulmonary crackles
pulmonary crackles High pulmonary artery wedge pressures are diagnostic for left-sided heart failure. With left-sided heart failure, pulmonary edema can develop causing pulmonary crackles. In left-sided heart failure, hypotension may result and urine output will decline. Dry mucous membranes aren't directly associated with elevated pulmonary artery wedge pressures.
The nurse is caring for a client post myocardial infarction (MI). Orders include strict bed rest and a clear, liquid diet. What is the nurse's best response to the client who is inquiring about the purpose of the new diet? to improve the gastric acidity of the stomach to reduce the metabolic workload of digestion to address the fluctuation in blood sugar to reduce the amount of fecal elimination
to reduce the metabolic workload of digestion Acute care of the client with an MI is aimed at reducing the cardiac workload. Clear liquids are easily digested to help reduce this workload. Sympathetic nervous system involvement causes decreased peristalsis and gastric secretion, so limiting food intake helps prevent gastric distension and cardiac workload. A clear diet will not reduce gastric acidity or blood glucose, and fecal elimination will still occur, so these are incorrect choices.
The nurse is administering a stool softener to a client who experienced a myocardial infarction. The client says, "I had a heart attack; I don't have a problem with constipation." What explanation will the nurse use to answer the client's question? "If you strain to have a bowel movement, you can cause a drop in your heart rate that can be dangerous." "The heart attack sets you up for limited activity, so constipation is often a problem for clients after a heart attack." "Please talk this over with your healthcare provider for further information." "The prescribed stool softener will decrease stress with a bowel movement and protect your heart from further injury."
"If you strain to have a bowel movement, you can cause a drop in your heart rate that can be dangerous." When straining during defication, the client bears down, which momentarily may cause the heart to slow and cause fainting or syncope in the client. The stool softner will allow easier pass of stool by increasing the amount of water the stool absorbs in the gut, making the stool softer and easier to pass. The client will not have prescribed limited activty after a myocardial infarction. The nurse needs to explain the medication and not refer the client back to the healthcare provider. Stool softenrs do not decrease stress.
A client who has been admitted to the ICU with a diagnosis of pericardial effusion begins to experience severe tachycardia. Upon assessment, the nurse finds that his central venous pressure is increased, he has jugular vein distention, his systolic blood pressure has dropped, and there is a narrow pulse pressure. His heart sounds appear to be very muffled. Which diagnosis should the nurse suspect the physician will make? Pericarditis Cardiac tamponade Myocardial infarction Thrombosis
Cardiac tamponade Pericardial effusion can lead to a condition called cardiac tamponade in which there is compression of the heart. It can be life-threatening and symptoms include tachycardia, elevated central venous pressure, jugular vein distention, and fall in systolic blood pressure with narrowed pulse pressure. Pericarditis is inflammation of the pericardium. A myocardial infarction does not have these symptoms nor does a thrombus.
A client has been diagnosed with a recent myocardial infarction. What collaborative problem would be the priority for the nurse to address? PC: Decreased Cardiac Output related to cardiac tissue damage PC: Disturbed Body Image related to decreased activity tolerance PC: Activity Intolerance related to decreased oxygenation capacity PC: Fear related to new diagnosis of myocardial infarction
PC: Decreased Cardiac Output related to cardiac tissue damage All these collaborative problems may be indicated for a client with a recent myocardial infarction; however, priority must be given to life-threatening issues. Decreased cardiac output is the only life-threatening problem among the answer options, so it must be the priority.
A client has a myocardial infarction in the left ventricle and develops crackles bilaterally; 3-pillow orthopnea; an S3 heart sound; and a cough with pink, frothy sputum. The nurse obtains a pulse oximetry reading of 88%. What do these signs and symptoms indicate for this client? The development of chronic obstructive pulmonary disease (COPD) The development of left-sided heart failure The development of right-sided heart failure The development of corpulmonale
The development of left-sided heart failure When the left ventricle fails, the heart muscle cannot contract forcefully enough to expel blood into the systemic circulation. Blood subsequently becomes congested in the left ventricle, left atrium, and finally the pulmonary vasculature. Symptoms of left-sided failure include fatigue; paroxysmal nocturnal dyspnea; orthopnea; hypoxia; crackles; cyanosis; S3 heart sound; cough with pink, frothy sputum; and elevated pulmonary capillary wedge pressure. COPD develops over many years and does not develop after a myocardial infarction. The development of right-sided heart failure would generally occur after a right ventricle myocardial infarction or after the development of left-sided heart failure. Corpulmonale is a condition in which the heart is affected secondarily by lung damage.
A client comes to the emergency room with all the symptoms of a myodardial infarction. Which lab value, known to have a high specificity for myocardial tissue considered the primary biomarker test for diagnosing an MI, does the nurse suspect the physician will order? Potassium Phosphorous Troponin assays Creatine kinase
Troponin assays The troponin assays have high specificity for myocardial tissue and have become the primary biomarker for the diagnosis of myocardial infarction. Creatine kinase is an intracellular enzyme found in muscle cells. The troponin level identifies necrosis in cardiac muscles earlier than creatine kinase. The others are not necessarily used when suspecting a myocardial infarction.
