The nurse is assessing a patient scheduled for surgery later today. The patient is complaining of chest and shoulder pain, perspiration, and shortness of breath. Which of the following should be done?


• These symptoms are consistent with an acute myocardial infarction (MI), which is a medical emergency. The hospital or facility should have a protocol in place to assist the nurse for a patient experiencing a suspected MI. The MET team usually has standing orders for blood work, electrocardiogram (EKG), oxygen, nitrogen and/or morphine administration. This workup can begin while the provider is being contacted.

• Using the A-B-C Framework, circulation and thus oxygenation to the heart is impaired, but none of the options are for interventions that address that. The initial assessment has already indicated signs of an MI. Even though it is not stated, oxygen should be administered and the MET team called or other hospital protocol followed while the physician is being notified. 

• Incorrect: Labs, X-rays, and other tests need to be ordered by the physician (or done with standing orders by the MET team staff). The nurse should anticipate that an EKG would be the first test obtained. A chest X-ray does not diagnose an acute MI, but an EKG would.

• Incorrect: The patient should not be sent to the operating room while he is experiencing a suspected MI. The provider will re-evaluate whether or not to continue with surgery after immediate concerns of an MI are identified and treated.

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