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Within the first 10 minutes, on the basis of the patient showing symptoms suggestive
of myocardial ischemia, what will your first actions include (if not completed by EMS
before arrival)?
o Obtain a 12-lead electrocardiogram (ECG)
o Administer a blood thinner
o Administer aspirin and establish IV access
o Activate the ST-segment elevation myocardial infarction (STEMI) team
o If SPO2 is less than 90%, start oxygen
o Assess airway, breathing, and circulation (ABCs)
o Administer epinephrine 1 mg IV
o Consider nitroglycerin, morphine and a P2Y inhibitor Answer- o Obtain a 12-lead
electrocardiogram (ECG)
o Administer aspirin and establish IV access
o Activate the ST-segment elevation myocardial infarction (STEMI) team
o If SPO2 is less than 90%, start oxygen
o Assess airway, breathing, and circulation (ABCs)
o Consider nitroglycerin, morphine and a P2Y inhibitor
His initial vital signs are HR 120/min, BP 135/88 mm Hg, RR 23/min, SpO2 87%, and
temperature 37.3C. When considering oxygen saturation, what is your course of
action?
o Intubate the patient immediately
o Administer albuterol nebulizer
o Do not start oxygen
o Start oxygen at 4L/min via nasal cannula Answer- o Start oxygen at 4L/min via
nasal cannula
What additional question help you determine next steps?
o Do you take any medication?
o Do you have any allergies?
o When was the last time you went to the doctor?
o When did the symptoms start?
o Have you had any recent falls? Answer- o Do you take any medication?
o Do you have any allergies?
o When did the symptoms start?
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, Your patient continues to say that he has chest discomfort. What treatment can you
repeat as long as it is not contradicted by vital signs?
o Morphine sublingual every 1 to 3 minutes
o Morphine IV every 1 to 3 minutes
o Nitroglycerine sublingual or translingual every 3 to 5 minutes
o Nitroglycerine every 1 to 3 minutes Answer- o Nitroglycerine sublingual or
translingual every 3 to 5 minutes
What is your interpretation of the patient's ECG tracing?
o Anterior ST-segment elevation of myocardial infarction (STEMI)
o Ventricular tachycardia
o Posterior ST-segment elevation myocardial infarction (STEMI)
o Normal sinus rhythm with premature ventricular contractions Answer- o Anterior
ST-segment elevation of myocardial infarction (STEMI)
With the diagnosis of STEMI, what is the most probable treatment?
o Release to home
o Admission to an intensive car unit
o Admission for observation
o Admission for PCI or fibrinolysis Answer- o Admission for PCI or fibrinolysis
What is your goal for PCI when treating this patient?
o Door-to-balloon inflation time of 30 minutes
o First medical contact-to-balloon inflation time of 90 minutes
o Door-to-needle time of 90 minutes
o First medical contact-to-needle time of 30 minutes Answer- o First medical
contact-to-balloon inflation time of 90 minutes
The patient's vital signs show HR 92/min, RR 14/min, BP 130/86 mm Hg, SpO2
97%, and atrial fibrillation on the monitor. What additional assessment and
stabilization activities should be completed with the first 10 minutes after the patient's
arrival?
o Establish IV access
o Order an emergent CT scan or MRI of the brain and review patient history
o Monitor for worsening symptoms
o Activate the stroke team
o Complete neurologic screening
o Check glucose
o Administer O2 Answer- o Establish IV access
o Order an emergent CT scan or MRI of the brain and review patient history
o Activate the stroke team
o Complete neurologic screening
o Check glucose
What needs to be completed for this patient within 20 minutes after hospital arrival?
o Neurologic assessment
o Admission to a monitored bed
o Interpretation of the emergent CT scan or MRI of the brain
o Administration of fibrinolytic therapy Answer- o Neurologic assessment
This study source was downloaded by 884789 from cliffsnotes.com on 04-13-2025 18:25:53 GMT -05:00
https://www.cliffsnotes.com//study-notes/725661