Cardiac Question #33


A client is brought to the emergency department (ED) by family for unrelieved chest pain for 45 minutes. Which of the following interventions are most important?


  1. Administer oxygen, give a dose of NTG sublingual, and follow with a nonsteroidal anti-inflammatory.
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  2. Begin a heparin drip, administer oxygen, and call the lab for stat troponin levels.
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  3. Apply oxygen, administer morphine sulphate, and place client on bed rest with cardiac monitoring.
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  4. Have the client to chew two aspirin 325 mg each, administer oxygen, and bring the crash cart to the bedside.
    • Rationale:



A patient with suspected myocardial injury should have oxygen available, morphine, and should be on bed rest. Morphine reduces preload and decreases workload of the heart, while bed rest will reduce workload and oxygen needs. These actions will decrease cardiac demand. NTG and aspirin are also used in the ED; however, the selections include giving an NSAID, and having the crash cart moved to the room. The ED area will already be equipped for emergency care if needed. The client may have an anticoagulant provided IV, but the emergent priority is to decrease cardiac demand.

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