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1. A 65-year-old man with a history of hypertension,
diabetes, and chronic kidney disease presents to the
emergency department with chest pain, dyspnea, and
diaphoresis. He is diagnosed with an acute myocardial
infarction and is given aspirin, nitroglycerin, morphine, and
oxygen. He is also started on a heparin infusion and is
scheduled for a cardiac catheterization. What are the
nursing priorities for this patient? How would you monitor
his response to the treatment?
Answer: The nursing priorities for this patient are to
maintain his airway, breathing, and circulation; relieve his
pain and anxiety; prevent complications such as
arrhythmias, heart failure, or cardiogenic shock; and
prepare him for the cardiac catheterization. The nurse
would monitor his vital signs, cardiac rhythm, oxygen
saturation, pain level, urine output, and laboratory values
such as troponin, creatinine kinase, blood glucose,
electrolytes, and coagulation studies. The nurse would also
assess his chest pain characteristics, location, radiation,
severity, duration, and precipitating factors; administer
medications as ordered; provide emotional support; and
educate him about the procedure and post-procedure care.
Rationale: This question tests the student's ability to apply
the nursing process to a patient with an acute myocardial
infarction, which is a common and life-threatening
condition in older adults. The student should be able toÂ
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