• ST-segment monitoring should be used by all nurses who work in areas with cardiac monitoring.

  • Ideally, treatment of acute coronary syndrome is started as soon as changes in coronary blood flow are evident.

  • Nurses can learn to properly monitor rhythm changes to minimize misinterpretation of rhythms.

You are a nurse working in an intensive care unit (ICU), and your patient, a 62-year-old man, has just arrived from the operating room after a cholecystectomy. He is sleepy but arousable and says he has some incisional pain. You start cardiac monitoring with lead II, as is the practice in your area. One hour later, the patient has ventricular fibrillation. After successful defibrillation, 12-lead electrocardiography (ECG) is done. The patient has ST-segment depression in lead III and 4 mm of ST-segment elevation in leads V3 and V4. You note that the patient’s history...

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