A patient reports palpitations, mild nausea, and midsternal chest pressure radiating to the arm, with diaphoresis. Vital signs show BP 100/60, HR 72, RR 22. What should the nurse first anticipate?

A patient reports palpitations, mild nausea, and midsternal chest pressure radiating to the arm, with diaphoresis. Vital signs show BP 100/60, HR 72, RR 22. What should the nurse first anticipate?

• A. Administering morphine sulfate
• B. Initiating long-term statin therapy
• C. Obtaining cardiac biomarkers
• D. Scheduling an exercise treadmill test

Answer: (C)

When a patient presents with chest pressure, palpitations, nausea, and diaphoresis, there is a high suspicion for acute coronary syndrome. The first priority is to determine whether myocardial injury has occurred, so obtaining cardiac biomarkers is the initial essential step. Measuring troponin (and other enzymes) helps confirm myocardial cell death and, with serial testing, tracks changes over time to guide urgent management. An ECG is also critically important, but among the given options, the action that best represents the first diagnostic step is drawing and testing cardiac biomarkers. Morphine may be used for pain relief but isn’t the first diagnostic action in this acute setting. Initiating long-term statin therapy is important for secondary prevention but does not address the acute event. A treadmill exercise test is inappropriate during an active chest-pain episode and ACS risk, and is used later once the patient is stabilized.

When a patient presents with chest pressure, palpitations, nausea, and diaphoresis, there is a high suspicion for acute coronary syndrome. The first priority is to determine whether myocardial injury has occurred, so obtaining cardiac biomarkers is the initial essential step. Measuring troponin (and other enzymes) helps confirm myocardial cell death and, with serial testing, tracks changes over time to guide urgent management. An ECG is also critically important, but among the given options, the action that best represents the first diagnostic step is drawing and testing cardiac biomarkers.

Morphine may be used for pain relief but isn’t the first diagnostic action in this acute setting. Initiating long-term statin therapy is important for secondary prevention but does not address the acute event. A treadmill exercise test is inappropriate during an active chest-pain episode and ACS risk, and is used later once the patient is stabilized.