CCRN EXAM-with 100% verified solutions

A 59-year-old male is admitted complaining of chest pain and dyspnea. ST elevation and T wave inversion were seen on the EKG in V2, V3 and V4. IV thrombolytic therapywas started in ED. Indications of successful reperfusion would include all of the following except: (A) pain cessation (B) decrease in CK or troponin (C) reversal of ST segment elevation with return to baseline (D) short runs of ventricular tachycardia (B)Coronary artery reperfusion due to PCI or fibrinolysis results in an ELEVATION ofcreatinine kinase (CK) or troponin, not decrease. The theory is that the return of blood flow distal to the occlusion can result in 'reperfusion injury' of the muscle, elevating cardiac biomarkers. The other 3 choices are indicators of reperfusion: Pain cessation, reversal of ST segment elevation with return to baseline, short runs of ventricular tachycardia. Which of the following medication orders should the nurse question for the patient inquestion 1-reperfusion question-patient having an MI? (A) metoprolol (Lopressor) (B) aspirin (C) propranolol (Inderal) (D) heparin (C) The patient in the scenario is having an acute anterior wall MI. A beta blocker isbeneficial for an acute MI as these agents decrease the work of the heart and increase the threshold for ventricular fibrillation. Propranolol, although a betaadrenergic blocker like metoprolol, is NOT a cardio selective beta blocker. It affectsbeta receptors in heart muscle AND lung tissue. Therefore, it is more likely to causebronchoconstriction than a cardio selective beta blocker. The other 3- cardio selective beta blocker, antiplatelet, and anticoagulation-are indicated in an acute MI.