This is just patient case study information please read carefully and utilize the information to answer the next questions. SCENARIO 2: IMMEDIATE INTERVENTIONS (0820-0845) Provider Orders – STEMI Alert Activated Oxygen 2-4 L via nasal cannula to maintain SpO₂ >94% Aspirin 325 mg PO chewed immediately Nitroglycerin 0.4 mg SL every 5 minutes × 3 doses (if SBP >90 mmHg) Morphine sulfate 2-4 mg IV push for pain unrelieved by nitroglycerin Heparin bolus 60 units/kg IV (max 4000 units), then infusion 12 units/kg/hr Establish two large-bore IVs Continuous cardiac monitoring Bedrest with HOB at 30 degrees NPO except medications Prepare for emergent cardiac catheterization Repeat troponin in 3-6 hours Notify cardiology STAT – activate cath lab Nurse’s Notes – 0845 Interventions Implemented: Oxygen 3 L/min via nasal cannula applied Aspirin 325 mg chewed and swallowed 18-gauge IV established in R forearm, 20-gauge in L forearm, NS infusing Nitroglycerin 0.4 mg SL administered at 0825 Continuous telemetry monitoring in place Patient positioned with HOB elevated 30 degrees Cardiology notified, cath lab team en route Patient Response at 0845: Pain decreased from 9/10 to 6/10 after first nitroglycerin States “I still feel pressure but it’s a little better” Continues to appear anxious Wife arrived, at bedside Vital Signs – 0845: BP: 142/88 mmHg HR: 96 bpm RR: 20 breaths/min SpO₂: 97% on 3 L O₂ Pain: 6/10
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