Page 1699 - Saunders Comprehensive Review For NCLEX-RN

vital signs during testing may indicate ischemia.
3. Troponin and cardiac enzyme levels: Findings are
normal in angina.
4. Cardiac catheterization: Provides a definitive
diagnosis by providing information about the patency
of the coronary arteries.

E. Interventions

1. Immediate management
a. Assess pain; institute pain relief
measures.
b. Administer oxygen by nasal cannula as
prescribed.
c. Assess vital signs and provide
continuous cardiac monitoring and
nitroglycerin as prescribed to dilate the
coronary arteries, reduce the oxygen
requirements of the myocardium, and
relieve the chest pain.
d. Ensure that bed rest is maintained,
place the client in semi-Fowler’s
position, and stay with the client.
e. Obtain a 12-lead ECG.
f. Establish an IV access route.

2. Following the acute episode

a. See section VII, D (Coronary Artery
Disease, Interventions).
b. Assist the client to identify angina-
precipitating events.
c. Instruct the client to stop activity and
rest if chest pain occurs; sit down and
take nitroglycerin as prescribed; the
client is usually instructed to call
emergency medical services if the
nitroglycerin does not relieve the pain,
and many PHCPs recommend that the
client also chew an aspirin.
F. Surgical procedures: See section VII, E (Coronary Artery Disease,
Surgical procedures).
G. Medications
1. See section VII, F (Coronary Artery Disease,
Medications).
2. Antiplatelet therapy may be prescribed to inhibit
platelet aggregation and reduce the risk of developing
an acute MI.
IX. Myocardial Infarction

1699