Nokea
A patient in the ICU develops acute myocardial infarction (MI) with cardiogenic shock. What intervention should the healthcare team prioritize to manage the patient's shock?
- A. Perform emergent percutaneous coronary intervention (PCI).
- B. Administer inotropic medications to improve cardiac contractility.
- C. Initiate therapeutic hypothermia to reduce myocardial oxygen demand.
- D. Recommend anticoagulant therapy to prevent thromboembolism.
Correct Answer: A
Rationale: In a patient with acute myocardial infarction (MI) complicated by cardiogenic shock, the primary intervention to manage shock is emergent percutaneous coronary intervention (PCI). PCI is a procedure performed to restore blood flow in an occluded coronary artery that is causing the MI. By opening up the blocked artery and restoring blood flow to the heart muscle, PCI can help reduce myocardial damage, improve cardiac function, and stabilize the patient's condition. Prompt reperfusion via PCI is crucial in the setting of cardiogenic shock to improve survival outcomes and reduce the risk of further complications. Administering inotropic medications, initiating therapeutic hypothermia, or recommending anticoagulant therapy may be components of management in specific cases but are not the primary intervention for managing shock in a patient with acute MI and cardiogenic shock.
You may also like to solve these questions
A patient with renal failure presents with confusion, seizures, asterixis, and a sweet odor to the breath. Laboratory findings reveal severe metabolic acidosis, hyperkalemia, and elevated blood urea nitrogen (BUN) and creatinine levels. What is the most likely diagnosis?
- A. Diabetic ketoacidosis (DKA)
- B. Uremic encephalopathy
- C. Hyperosmolar hyperglycemic state (HHS)
- D. Hepatic encephalopathy
Correct Answer: B
Rationale: The patient's presentation with renal failure, confusion, seizures, asterixis, and a sweet odor to the breath, along with laboratory findings of severe metabolic acidosis, hyperkalemia, and elevated BUN and creatinine levels, is consistent with uremic encephalopathy. Uremic encephalopathy is a neurological complication of acute or chronic renal failure resulting from the buildup of uremic toxins in the blood, leading to various neurological symptoms such as confusion and seizures. The sweet odor to the breath can be attributed to the presence of urea, a waste product that accumulates in renal failure. Other metabolic abnormalities like hyperkalemia and severe metabolic acidosis are also common in renal failure. It is crucial to promptly recognize and manage uremic encephalopathy to prevent further neurological complications.
Which procedure has to be done to the patient to establish a definitive diagnosis of lung cancer?
- A. Chest x-ray followed by a CT scan
- B. Cytological study of the sputum
- C. Bronchoscopy
- D. Magnetic resonance imaging
Correct Answer: C
Rationale: Bronchoscopy is a procedure that allows direct visualization of the inside of the airways in the lungs. It is considered the most definitive method to establish a diagnosis of lung cancer as it can directly visualize any abnormal growths or tumors in the bronchial tubes. During bronchoscopy, tissue samples can be collected for biopsy to confirm the presence of cancer cells. This procedure is more accurate compared to other diagnostic methods such as chest x-ray, CT scan, cytological study of sputum, or magnetic resonance imaging in confirming a diagnosis of lung cancer.
Which of the following health interventions. should be included in your teaching plan for Mang Luis?
- A. Be on prolonged corticosteroid therapy.
- B. Lung exercises must be done with longer. inhalation then exhalation.
- C. Reduce risk for infection.
- D. Have a high flow of oxygen administration.
Correct Answer: C
Rationale: In the case of Mang Luis, who has been diagnosed with chronic obstructive pulmonary disease (COPD) and is experiencing exacerbation, the most crucial health intervention to include in the teaching plan is to reduce the risk for infection. COPD exacerbations are commonly triggered by respiratory infections such as pneumonia and bronchitis. Preventing infections is essential in managing COPD as they can lead to worsening of symptoms and increased healthcare utilization. Therefore, educating Mang Luis on strategies to reduce the risk of infection, such as proper hand hygiene, avoiding exposure to sick individuals, getting vaccinated, and managing environmental factors, is paramount in his care plan.
A patient with a history of chronic kidney disease is prescribed erythropoietin-stimulating agents (ESAs) for anemia management. Which parameter should the nurse monitor closely during ESA therapy?
- A. Serum potassium levels
- B. Hemoglobin levels
- C. Serum creatinine levels
- D. White blood cell count
Correct Answer: B
Rationale: When a patient with chronic kidney disease is prescribed erythropoietin-stimulating agents (ESAs) for anemia management, the parameter that should be monitored closely by the nurse is the hemoglobin levels. Hemoglobin levels indicate the patient's response to ESA therapy and are essential in assessing the effectiveness of the treatment in addressing anemia. Monitoring hemoglobin levels helps ensure that the patient's anemia is controlled within the target range to avoid both the risks of under-treatment (resulting in persistent anemia) and over-treatment (increased risk of adverse outcomes such as hypertension, stroke, or cardiovascular events).
A patient is reluctant to undergo a recommended procedure due to fear of pain. What is the nurse's best approach to address this fear?
- A. Dismiss the patient's fear and assure them that the procedure will not be painful.
- B. Provide the patient with accurate information about pain management strategies and options.
- C. Ignore the patient's fear and proceed with scheduling the procedure.
- D. Tell the patient that fear of pain is irrational and unfounded.
Correct Answer: B
Rationale: The nurse's best approach to address the patient's fear of pain is to provide accurate information about pain management strategies and options. In doing so, the nurse can help alleviate the patient's concerns by empowering them with knowledge and potential solutions for managing pain during and after the procedure. By acknowledging the patient's fear and addressing it with practical information, the nurse can build trust, reduce anxiety, and create a more supportive and collaborative environment for the patient. Dismissing, ignoring, or invalidating the patient's fear would not be effective in addressing the underlying concerns and could potentially lead to increased distress and resistance to the recommended procedure.