The nurse is reviewing the client's medical record. A nurse is reviewing the client's diagnostic results and vital signs. Which of the following actions should the nurse take? Select all that apply.

Rationale: A. Anticipate client to be prepped for cardiac catheterization: The client has ST-segment elevation on ECG, markedly elevated troponin levels, and echocardiogram confirmation of myocardial infarction. ST-elevation myocardial infarction requires urgent reperfusion therapy, most commonly via percutaneous coronary intervention. Preparation for cardiac catheterization is consistent with current management to restore coronary blood flow and limit myocardial necrosis. B. Assist with a continuous heparin infusion: Anticoagulation is a standard component of acute myocardial infarction management to prevent further thrombus propagation within the coronary arteries. Elevated cardiac biomarkers and ECG changes indicate active myocardial injury, increasing the risk of clot extension. A continuous heparin infusion reduces additional clot formation while definitive reperfusion strategies are implemented. C. Encourage the client to ambulate: During the acute phase of myocardial infarction, the myocardium is ischemic and vulnerable to increased oxygen demand. Ambulation elevates heart rate and myocardial workload, which can worsen ischemia and precipitate dysrhythmias. Activity restriction is recommended initially to reduce cardiac stress. D. Anticipate an increased dosage of metoprolol: The client’s blood pressure at 1200 is 110/62 mm Hg, showing a significant decrease from earlier readings. Increasing beta-blocker dosage in the setting of lower blood pressure could precipitate hypotension and reduce coronary perfusion. Beta-blockers are titrated carefully based on hemodynamic stability. E. Obtain a prescription for client to be NPO: Clients with confirmed myocardial infarction who may undergo cardiac catheterization or other invasive procedures are typically kept NPO to reduce aspiration risk. The need for urgent intervention requires preparation for possible sedation and procedural access. Maintaining NPO status supports procedural readiness and patient safety. F. Request a prescription for an antibiotic: The diagnostic findings support acute myocardial infarction rather than an infectious process. White blood cell count is within normal limits, and chest x-ray shows clear lungs. There is no clinical evidence of infection warranting antibiotic therapy.