A nurse in the emergency department is caring for a client who presents with non-ST elevation myocardial infarction (NSTEMI). Which of the following actions should the nurse take first?

Choice A reason: Attaching leads for continuous cardiac monitoring is the first action in NSTEMI, as it allows real-time assessment of heart rhythm and ischemia. NSTEMI can lead to arrhythmias or worsening ischemia, and monitoring enables rapid detection of life-threatening changes, guiding timely interventions to stabilize the client’s condition. Choice B reason: Initiating oxygen therapy is important if the client is hypoxic, but it is not the first action. Continuous cardiac monitoring takes priority to detect arrhythmias or ischemic changes in NSTEMI, which can be immediately life-threatening. Oxygen can be administered after monitoring is established if indicated. Choice C reason: Inserting an IV catheter is necessary for administering medications like antiplatelets or anticoagulants in NSTEMI but is not the first action. Continuous cardiac monitoring is prioritized to detect acute rhythm or ischemic changes, which guide treatment decisions and ensure timely management of potentially fatal complications. Choice D reason: Obtaining a blood sample for cardiac biomarkers like troponin is important to confirm NSTEMI severity but is not the first action. Continuous cardiac monitoring takes precedence, as it provides immediate data on heart rhythm and ischemia, enabling rapid response to life-threatening changes in the client’s condition.