Chapter 23

अब Quizwiz के साथ अपने होमवर्क और परीक्षाओं को एस करें!

The client asks the nurse to explain the difference between arteriosclerosis and atherosclerosis. Which is the best explanation the nurse can give to the client? "Arteriosclerosis is a loss of elasticity of the arteries that accompanies the aging process, whereas atherosclerosis is a condition in which the arteries fill with plaque." "Both terms refer to the same disorder and can be used interchangeably." "Both are disorders in which the lining of the vessels become narrowed due to plaque." "Arteriosclerosis is when the vessels become dilated and weakened, whereas atherosclerosis is the deposit of fatty substances in the vessel lining."

"Arteriosclerosis is a loss of elasticity of the arteries that accompanies the aging process, whereas atherosclerosis is a condition in which the arteries fill with plaque." Arteriosclerosis refers to the loss of elasticity or hardening of the arteries that accompanies the aging process, whereas atherosclerosis is a condition in which the lumen of arteries fills with fatty deposits called plaque.

The nurse has completed a teaching session on self-administration of sublingual nitroglycerin. Which client statement indicates that the teaching has been effective? "I can take nitroglycerin before sex so I won't develop chest pain". "After taking two tablets with no relief, I should call EMS." "I can put the nitroglycerin tablets in my daily pill dispenser with my other medications". "Side effects of nitroglycerin include flushing, throbbing headache, and hypertension".

"I can take nitroglycerin before sex so I won't develop chest pain". Nitroglycerin can be taken in anticipation of any activity that may produce pain. Because nitroglycerin increases tolerance for exercise and stress when taken prophylactically (i.e., before an angina-producing activity such as exercise, stair-climbing, or sexual intercourse), it is best taken before pain develops. The client is instructed to take three tablets 5 minutes apart; if the chest pain is not relieved, emergency medical services should be contacted. Nitroglycerin is very unstable; it should be carried securely in its original container (e.g., a capped dark glass bottle), and tablets should never be removed and stored in metal or plastic pillboxes. Side effects of nitroglycerin include flushing, throbbing headache, hypotension, and tachycardia

A client is ordered a nitroglycerine transdermal patch for treatment of CAD and asks the nurse why the patch is removed at bedtime. Which is the best response by the nurse? "Nitroglycerine causes headaches, but removing the patch decreases the incidence." "You do not need the effects of nitroglycerine while you sleep." "Removing the patch at night prevents drug tolerance while keeping the benefits." "Contact dermatitis and skin irritations are common when the patch remains on all day."

"Removing the patch at night prevents drug tolerance while keeping the benefits." Tolerance to antianginal effects of nitrates can occur when taking these drugs for long periods of time. Therefore, to prevent tolerance and maintain benefits, it is a common regime to remove transdermal patches at night. Common adverse effects of nitroglycerin are headaches and contact dermatitis but not the reason for removing the patch at night. It is true that while the client rests, there is less demand on the heart but not the primary reason for removing the patch

When providing discharge instructions for a client who has been prescribed sublingual nitroglycerin for angina, the nurse should plan to include which instructions? "See if rest relieves the chest pain before using the nitroglycerin." "Call 911 if you develop a headache following nitroglycerin use." "Place the nitroglycerin tablet between cheek and gum." "Only take one nitroglycerin tablet for each episode of angina."

"See if rest relieves the chest pain before using the nitroglycerin." Decreased activity may relieve chest pain; sitting will prevent injury should the nitroglycerin lower BP and cause fainting. The client should expect to feel dizzy or flushed or to develop a headache following sublingual nitroglycerin use. The client should place one nitroglycerin tablet under the tongue if 2-3 minutes of rest fails to relieve pain. Clients may take up to three nitroglycerin tablets within 5 minutes of each other to relieve angina. However, they should call 911 if the three tablets fail to resolve the chest pain.

A client in the emergency department reports squeezing substernal pain that radiates to the left shoulder and jaw. The client also reports nausea, diaphoresis, and shortness of breath. What is the nurse's priority action? Complete the client's registration information, perform an electrocardiogram, gain I.V. access, and take vital signs. Administer oxygen, attach a cardiac monitor, and notify the health care provider. Gain I.V. access, give sublingual nitroglycerin, and alert the cardiac catheterization team. Administer oxygen, attach a cardiac monitor, take vital signs, and alert the cardiac catheterization team.

-administer oxygen, attach a cardiac monitor, and notify the health care provider Cardiac chest pain is caused by myocardial ischemia. Therefore the nurse should administer supplemental oxygen to increase the myocardial oxygen supply, attach a cardiac monitor to help detect life-threatening arrhythmias, and take vital signs to ensure that the client isn't hypotensive before giving sublingual nitroglycerin for chest pain. Registration information may be delayed until the client is stabilized. Alerting the cardiac catheterization team or the health care provider before completing the initial assessment is premature.

The nurse is caring for a client who is demonstrating signs of acute coronary syndrome (ACS). Which assessment findings indicate to the nurse that the client is experiencing stimulation of the sympathetic nervous system? Select all that apply. Anxiety Crackles Diaphoresis Tachycardia Cool, clammy skin

-anxiety -diahporesis -tachycardia -cool, clammy skin Acute coronary syndrome (ACS) is an emergent situation characterized by an acute onset of myocardial ischemia that results in myocardial death if definitive interventions do not occur promptly. Stimulation of the sympathetic nervous system in ACS causes anxiety, diaphoresis, tachycardia, and cool, clammy skin. Crackles may develop in response to pulmonary congestion from inadequate cardiac functioning, not from stimulation of the sympathetic nervous system

The nurse is providing education about the nutrient content of the Therapeutic Lifestyle Changes (TLC) diet to a community group. What information will the nurse provide? Select all that apply. Cholesterol should be less than 1 gram per day. Carbohydrates should make up 50% to 60% of the total calories. Dietary fiber should be 20 to 30 grams per day. Protein should make up approximately 15% of total calories. Total fat should make up only 5% of the total calories.

-carbs should make up 50-60 percent of total calories -dietary fiber should be 20-30 grams per day -protein should make up approx 15% of total calories According to the nutrient content of the TLC diet, cholesterol should make up less than 200 mg/day, carbohydrates should make up 50% to 60% of the total calories, dietary fiber should be 20 to 30 grams per day, protein should make approximately 15% of the total calories, and fat should make up 25% to 30% of the total calories.

A client who has been diagnosed with Prinzmetal's angina will present with which symptom? chest pain that occurs at rest and usually in the middle of the night radiating chest pain that lasts 15 minutes or less prolonged chest pain that accompanies exercise chest pain of increased frequency, severity, and duration

-chest pain that occurs at rest and usually in the middle of the night A client with Prinzmetal's angina will complain of chest pain that occurs at rest, usually between 12 and 8:00 AM, is sporadic over 3-6 months, and diminishes over time. Clients with stable angina generally experience chest pain that lasts 15 minutes or less and may radiate. Clients with Cardiac Syndrome X experience prolonged chest pain that accompanies exercise and is not always relieved by medication. Clients with unstable angina experience chest pain of increased frequency, severity, and duration that is poorly relieved by rest or oral nitrates.

The nurse is educating a patient diagnosed with angina pectoris about the difference between the pain of angina and a myocardial infarction (MI). How should the nurse describe the pain experienced during an MI? (Select all that apply.) It is relieved by rest and inactivity. It is substernal in location. It is sudden in onset and prolonged in duration. It is viselike and radiates to the shoulders and arms. It subsides after taking nitroglycerin.

-it is substernal in location -sudden onset and prolonged in duration -viselike and radiates to the hsoulders and arms Chest pain that occurs suddenly, continues despite rest and medication, is substernal, and is sometimes viselike and radiating to the shoulders and arms is associated with an MI. Angina pectoris pain is generally relieved by rest and nitroglycerin.

what is the range for hemoglobin?

12-18

Following a percutaneous transluminal coronary angioplasty, a client is monitored in the postprocedure unit. The client's heparin infusion was stopped 2 hours earlier. There is no evidence of bleeding or hematoma at the insertion site, and the pressure device is removed. With regards to partial thromboplastin time (PTT), when should the nurse plan to remove the femoral sheath? 50 seconds or less. 75 seconds or less. 100 seconds or less. 125 seconds or less.

50 seconds or less Heparin causes an elevation of the PTT and, thereby, increases the risk for bleeding. With a large cannulation such as a sheath used for angioplasty, the PTT should be 50 seconds or less before the sheath is removed. Removing the sheath before the PTT drops below 50 seconds can cause bleeding at the insertion site.

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.

levels to remember

A fasting lipid profile should demonstrate the following values (Alberti et al., 2009): ; total cholesterol less than 200 mg/dL, triglycerides less than 150 mg/dL, LDL cholesterol less than 100 mg/dL (less than 70 mg/dL for very high-risk patients); HDL and greater than 50 mg/dL for females; cholesterol greater than 40 mg/dL for males

Which method to induce hemostasis after sheath removal after percutaneous transluminal coronary angioplasty (PTCA) is most effective? Application of a vascular closure device such as Angio-Seal or VasoSeal Direct manual pressure Application of a pneumatic compression device (e.g., FemoStop) Application of a sandbag to the area

Application of a vascular closure device such as Angio-Seal or VasoSeal Application of a vascular closure device has been demonstrated to be very effective. Direct manual pressure to the sheath introduction site and application of a pneumatic compression device after PTCA have been demonstrated to be effective; the former was the first method used to induce hemostasis after PTCA. Several nursing interventions frequently used as part of the standard of care, such as applying a sandbag to the sheath insertion site, have not been shown to be effective in reducing the incidence of bleeding.

Which is a diagnostic marker for inflammation of vascular endothelium? C-reactive protein (CRP) Low-density lipoprotein (LDL) High-density lipoprotein (HDL) Triglyceride

CRP CRP is a marker for inflammation of the vascular endothelium. LDL, HDL, and triglycerides are not markers of vascular endothelial inflammation. They are elements of fat metabolism.

A nurse teaches a client with angina pectoris that he or she needs to take up to three sublingual nitroglycerin tablets at 5-minute intervals and immediately notify the health care provider if chest pain doesn't subside within 15 minutes. What symptoms may the client experience after taking the nitroglycerin? Nausea, vomiting, depression, fatigue, and impotence. Sedation, nausea, vomiting, constipation, and respiratory depression. Headache, hypotension, dizziness, and flushing. Flushing, dizziness, headache, and pedal edema.

H/A, hypotension, dizziness, flushing Headache, hypotension, dizziness, and flushing are classic adverse effects of nitroglycerin, a vasodilator. Vasodilators, beta-adrenergic blockers, and calcium channel blockers are three major classes of drugs used to treat angina pectoris. Nausea, vomiting, depression, fatigue, and impotence are adverse effects of propranolol, a beta-adrenergic blocker. Sedation, nausea, vomiting, constipation, and respiratory depression are common adverse effects of morphine, an opioid analgesic that relieves pain associated with acute myocardial infarction. Flushing, dizziness, headache, and pedal edema are common adverse effects of nifedipine, a calcium channel blocke

Understanding atherosclerosis, the nurse identifies which of the following to be both a risk factor for the development of the disorder and an outcome? Hyperlipidemia Hypertension Glucose intolerance Obesity

HTN Increases in diastolic and systolic blood pressure are associated with an increased incidence of atherosclerosis, often an inherited factor. Elevation of blood pressure results when the vessels cannot relax and impairs the ability of the artery to dilate. Hyperlipidemia, diabetes, and obesity are all risk factors for atherosclerosis but do not result from the disorder.

A client admitted to the coronary care unit (CCU) diagnosed with a STEMI is anxious and fearful. Which medication will the nurse administer to relieve the client's anxiety and decrease cardiac workload? IV morphine IV nitroglycerin Atenolol Amlodipine

IV morphine IV morphine is the analgesic of choice for the treatment of an acute MI. It is given to reduce pain and treat anxiety. It also reduces preload and afterload, which decreases the workload of the heart. IV nitroglycerin is given to alleviate chest pain. Administration of atenolol and amlodipine are not indicated in this situatio

what is the range for hematocrit?

M: 45%-52% F: 37%-48%

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.

PCI percutaneous coronary artery intervention 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.

The nurse is caring for a client presenting to the emergency department (ED) reporting chest pain. Which electrocardiographic (ECG) finding would be most concerning to the nurse? ST elevation Isolated premature ventricular contractions (PVCs) Sinus tachycardia Frequent premature atrial contractions (PACs)

ST elevation The first signs of an acute MI are usually seen in the T wave and the ST segment. The T wave becomes inverted; the ST segment elevates (it is usually flat). An elevated ST segment in two contiguous leads is a key diagnostic indicator for MI (i.e., ST-elevation MI). This client requires immediate invasive therapy or fibrinolytic medications. Although the other ECG findings require intervention, elevated ST elevations require immediate and definitive interventions.

The laboratory values for a client diagnosed with coronary artery disease (CAD) have just come back from the lab. The client's low-density lipoprotein (LDL) level is 112 mg/dL. The nurse recognizes that this value is below the optimal range. above the optimal range. within the optimal range. extremely high.

above the optimal range If the fasting LDL level ranges from 100 mg/dL to 130 mg/dL, it is considered above the optimal range. The ideal is to decrease the LDL level below 100 mg/dL (< 70 mg/dL for very high-risk patients).

The nurse is caring for a ventilated client after coronary artery bypass graft surgery. What are the criterions for extubation for the client? Select all that apply. adequate cough and gag reflexes inability to speak acceptable arterial blood gas values labile vital signs breathing without assistance of the ventilator

adequate cough and gag reflexes acceptable arterial blood gas values breathing without assistance of the ventilator Before being extubated, the client should have cough and gag reflexes and stable vital signs; be able to lift the head off the bed or give firm hand grasps; have adequate vital capacity, negative inspiratory force, and minute volume appropriate for body size; and have acceptable arterial blood gas levels while breathing without the assistance of the ventilator

A nurse is reevaluating a client receiving IV fibrinolytic therapy. Which finding requires immediate intervention by the nurse? Altered level of consciousness Minimal oozing of blood from the IV site Presence of reperfusion dysrhythmias Chest pain 2 of 10 (on a 1-to-10 pain scale)

altered LOC A client receiving fibrinolytic therapy is at risk for complications associated with bleeding. Altered level of consciousness may indicate hypoxia and intracranial bleeding, and the infusion should be discontinued immediately. Minimal bleeding requires manual pressure. Reperfusion dysrhythmias are an expected finding. A chest pain score of 2 is low and indicates the client's chest pain is subsiding, an expected outcome of this therap

A client has had a 12-lead ECG completed as part of an annual physical examination. The nurse notes an abnormal Q wave on an otherwise unremarkable ECG. The nurse recognizes that this finding indicates an old MI. an evolving MI. variant angina. a cardiac dysrhythmia.

an old MI An abnormal Q wave may be present without ST-segment and T-wave changes, which indicates an old, not acute, MI.

The nurse is caring for a client diagnosed with coronary artery disease (CAD). What condition most commonly results in CAD? atherosclerosis diabetes mellitus myocardial infarction renal failure

atherosclerosis Atherosclerosis (plaque formation) is the leading cause of CAD. Diabetes mellitus is a risk factor for CAD, but it isn't the most common cause. Myocardial infarction is a common result of CAD. Renal failure doesn't cause CAD, but the two conditions are related

The nurse is assisting with a bronchoscopy at the bedside in a critical care unit. The client experiences a vasovagal response. What should the nurse do next? Prepare to administer intravenous fluids. Suction the airway. Check blood pressure. Assess pupils for reactiveness.

check BP During a bronchoscopy, a vasovagal response may be caused by stimulating the pharynx, and it in turn may cause stimulation of the vagus nerve. The client may, therefore, experience a sudden drop in heart rate, leading to syncope. The nurse will need to assess blood pressure to assure circulation

A client comes to the emergency department (ED) reporting precordial chest pain. In describing the pain, the client describes it as pressure with a sudden onset. What disease process would the nurse suspect in this client? Coronary artery disease Raynaud syndrome Cardiogenic shock Venous occlusive disease

coronary artery disease The classic symptom of CAD is chest pain (angina) or discomfort during activity or stress. Such pain or discomfort typically is manifested as sudden pain or pressure that may be centered over the heart (precordial) or under the sternum (substernal). Raynaud syndrome in the hands presents with symptoms of hands that are cold, blanched, and wet with perspiration. Cardiogenic shock is a complication of an MI. Venous occlusive disease occurs in the veins, not the arteries.

A client is admitted for treatment of Prinzmetal angina. When developing this client's care plan, the nurse should keep in mind that this type of angina is a result of what trigger? Activities that increase myocardial oxygen demand. An unpredictable amount of activity. Coronary artery spasm. The same type of activity that caused previous angina episodes.

coronary artery spasms Prinzmetal angina results from coronary artery spasm. Activities that increase myocardial oxygen demand may trigger angina of effort. An unpredictable amount of activity may precipitate unstable angina. Worsening angina is brought on by the same type or level of activity that caused previous angina episodes; anginal pain becomes increasingly severe

A nurse records a client's history and discovers several risk factors for coronary artery disease (CAD). Which cardiac risk factors can the client control? Diabetes, hypercholesterolemia, and heredity Diabetes, age, and gender Age, gender, and heredity Diabetes, hypercholesterolemia, and hypertension

diabetes, hypercholesterolemia HTN Controllable risk factors for CAD include hypertension, hypercholesterolemia, obesity, lack of exercise, smoking, diabetes mellitus, stress, alcohol abuse, and use of hormonal contraceptives. Uncontrollable risk factors for CAD include gender, age, and heredity

The nurse is developing a teaching plan for the client to address modifiable risk factors for coronary artery disease (CAD), the nurse will include which factor(s)? Select all that apply. Elevated blood pressure Alcohol use Obesity Physical inactivity Increasing age Family history

elevated bP, obesity, physical inactivity, Hypertension, obesity, hyperlipidemia, tobacco use, diabetes mellitus, metabolic syndrome, and physical inactivity are modifiable risk factors for CAD. A family history of CAD, increasing age (more than 45 years for men and more than 55 years for women), sex (men develop CAD at an earlier age than women), and race are risk factors for CAD that are nonmodifiable

A nurse is monitoring the vital signs and blood results of a client who is receiving anticoagulation therapy. What does nurse identify as a major indication of concern? blood pressure of 129/72 mm Hg heart rate of 87 bpm hemoglobin of 16 g/dL hematocrit of 30%

hematocrit 30%

Which of the following is inconsistent as a condition related to metabolic syndrome? Hypotension Insulin resistance Abdominal obesity Dyslipidemia

hypotension A diagnosis of metabolic syndrome includes three of the following conditions: insulin resistance, abdominal obesity, dyslipidemia, hypertension, proinflammatory state, and prothrombotic state

A client's elevated cholesterol levels are being managed with atorvastatin daily. What is a common side effect the nurse will teach the client that will require monitoring? hyperuricemia increased liver enzymes hyperglycemia severe muscle pain

increased liver enzymes Myopathy and increased liver enzymes are significant side effects of the statin Lipitor.

A client has been recently placed on nitroglycerin. Which instruction by the nurse should be included in the client's teaching plan? Instruct the client on side effects of flushing, throbbing headache, and tachycardia. Instruct the client to renew the nitroglycerin supply every 3 months. Instruct the client not to crush the tablet. Instruct the client to place nitroglycerin tablets in a plastic pill box.

instruct the client on the SE of flushing, throbbing headache, and tachycardia The client should be instructed about side effects of the medication, which include flushing, throbbing headache, and tachycardia. The client should renew the nitroglycerin supply every 6 months. If the pain is severe, the client can crush the tablet between the teeth to hasten sublingual absorption. Tablets should never be removed and stored in metal or plastic pillboxes. Nitroglycerin is very unstable and should be carried in its original container.

A nurse is teaching a client who receives nitrates for the relief of chest pain. Which instruction should the nurse emphasize? Repeat the dose of sublingual nitroglycerin every 15 minutes for three doses. Store the drug in a cool, well-lit place. Lie down or sit in a chair for 5 to 10 minutes after taking the drug. Restrict alcohol intake to two drinks per da

lie down or sit in a chair for 5-10 minutes after taking the drug Nitrates act primarily to relax coronary smooth muscle and produce vasodilation. They can cause hypotension, which makes the client dizzy and weak. The nurse should instruct the client to lie down or sit in a chair for 5 to 10 minutes after taking the drug. Nitrates are taken at the first sign of chest pain and before activities that might induce chest pain. Sublingual nitroglycerin is taken every 5 minutes for three doses. If the pain persists, the client should seek medical assistance immediately. Nitrates must be stored in a dark place in a closed container because sunlight causes the medication to lose its effectiveness. Alcohol is prohibited because nitrates may enhance the effects of the alcohol.

A nurse reviews a client's medication history before administering a cholinergic blocking agent. Adverse effects of a cholinergic blocking agent may delay absorption of what medication? Amantadine Nitroglycerin Digoxin Diphenhydramine

nitro A cholinergic blocking agent may cause dry mouth and delay the sublingual absorption of nitroglycerin.

The nurse is assessing a client with suspected post-pericardiotomy syndrome after cardiac surgery. What manifestation will alert the nurse to this syndrome? pericardial friction rub hypothermia decreased white blood cell (WBC) count decreased erythrocyte sedimentation rate (ESR)

pericardial friction rub Post-pericardiotomy syndrome is characterized by fever, pericardial pain, pleural pain, dyspnea, pericardial effusion, pericardial friction rub, and arthralgia

A client was chopping firewood and experienced a heaviness in the chest and dyspnea. The client arrives in the emergency department four hours after the heaviness and the health care provider diagnoses an anterior myocardial infarction (MI). What orders will the nurse anticipate? streptokinase, aspirin, and morphine administration morphine administration, stress testing, and admission to the cardiac care unit serial liver enzyme testing, telemetry, and a lidocaine infusion sublingual nitroglycerin, tissue plasminogen activator (tPA), and telemetry

sublingual nitroglycerin, tissue plasminogen activator (tPA), and telemetry The nurse should anticipate an order for sublingual nitroglycerin, tPA, and telemetry, as the client's chest pain began 4 hours before diagnosis. The preferred choice is tPA, which is more specific for cardiac tissue than streptokinase. Stress testing shouldn't be performed during an MI. The client doesn't exhibit symptoms that indicate the use of lidocaine.

In the treatment of coronary artery disease (CAD), medications are often ordered to control blood pressure in the client. Which of the following is a primary purpose of using beta-adrenergic blockers in the nursing management of CAD? To dilate coronary arteries To decrease workload of the heart To decrease homocysteine levels To prevent angiotensin II conversion

to decrease workload of the heart Beta-adrenergic blockers are used in the treatment of CAD to decrease the consumption of myocardial oxygen by reducing heart rate and workload of the heart. Nitrates are used for vasodilation. Anti-lipid drugs (such as statins and B vitamins) are used to decrease homocysteine levels. ACE inhibitors inhibit the conversion of angiotensin.

The nurse is reevaluating a client 2 hours after a percutaneous transluminal coronary angioplasty (PTCA) procedure. Which assessment finding may indicate the client is experiencing a complication of the procedure? Urine output of 40 mL Potassium level of 4.0 mEq/L Heart rate of 100 bpm Dried blood at the puncture site

urine output of 40ml Complications that may occur following a PTCA include myocardial ischemia, bleeding and hematoma formation, retroperitoneal hematoma, arterial occlusion, pseudoaneurysm formation, arteriovenous fistula formation, and acute renal failure. The urine output of 40 mL over a 2-hour period may indicate acute renal failure. The client is expected to have a minimum urine output of 30 mL/h. Dried blood at the insertion site is a finding that warrants no acute intervention. A serum potassium level of 4.0 mEq/L is within the normal range. The heart rate of 100 bpm is within the normal range and indicates no acute distress.

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.


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