A STEMI develops sudden difficulty in breathing, mental status change. The nurse should anticipate:

• A. Administer oxygen
• B. Administer morphine
• C. Administer diuretic
• D. Prepare for endotracheal intubation and mechanical ventilation

Answer: (D)

When a STEMI patient suddenly has trouble breathing and a change in mental status, protecting the airway and ensuring ventilation becomes the top priority. Deterioration in consciousness means the patient may not reliably maintain their airway or cough to clear secretions, increasing the risk of aspiration and hypoxemia. Securing the airway with endotracheal intubation and providing mechanical ventilation ensures controlled and adequate oxygenation and carbon dioxide removal, which is essential in this acute situation.

Oxygen alone helps with hypoxemia but does not guarantee airway protection or adequate ventilation if the patient cannot respond or is rapidly decompensating. Morphine can depress respiration and lower blood pressure, which is harmful in an acute myocardial infarction. A diuretic might help reduce pulmonary edema over time, but it does not address the immediate need to secure the airway and support ventilation.