Three Days After an Anterior Wall MI, a Patient Is

question 21

Multiple Choice

Three days after an anterior wall MI, a patient is in the critical care unit.The patient is receiving oxygen at 4 L/min by nasal cannula; nitroglycerin paste, 1-inch q6h; and Lopressor 25 mg PO q12h.The monitor shows that the patient is beginning to have premature ventricular contractions (PVCs) .Over the course of the next several hours, the PVCs increase in frequency to more than 15 per minute, with occasional runs of multifocal bigeminal PVCs.The patient's vital signs follow: heart rate, 84 beats/min; sinus rhythm with described PVCs; blood pressure, 124/68 mm Hg; respirations, 20 breaths/min; and SpO₂, 92%.Laboratory values are blood pH, 7.44; potassium, 4.4 mEq/L; and magnesium, 1.0 mEq/L.Which of the following, if ordered, would be inappropriate for this patient?

• A) Lidocaine 100 mg IV push
• B) Increase oxygen to 6 L/min by nasal cannula
• C) Potassium chloride 40 mEq in 250 mL 0.9% saline IV piggyback over a 4-hour period
• D) Magnesium sulfate 2 g IV piggyback over a 2-hour period

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Definitions:

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A cognitive bias that leads to difficulty in understanding or acknowledging the viewpoint of others, often seen in the early stages of childhood development.

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A Swiss psychologist known for his pioneering work in the study of child development and his theory of cognitive development.

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A psychologist from Russia recognized for his contributions to understanding cognitive growth, especially his theory on the Zone of Proximal Development.