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階段六 — 評估結果。回顧 PCI 術後 6 小時的監測趨勢，並回答兩個評估問題。

Trend

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Time	Data
Hour 0 (post-PCI)	HR 82, BP 128/80, SpO2 98%, ST elevation resolving to 0.5 mm, troponin I 1.2 ng/mL, urine output 52 mL/h. Client reports pain decreased to 2 out of 10.HR 82、BP 128/80、SpO2 98%、ST 上升 0.5 mm 漸消退、troponin I 1.2 ng/mL、尿量 52 mL/h。病人主訴疼痛由 10 降至 2 分。
Hour 2	HR 72, BP 118/74, SpO2 98%, ST elevation 0.1 mm (near resolution), troponin I 15.4 ng/mL (expected washout rise), urine output 56 mL/h.HR 72、BP 118/74、SpO2 98%、ST 上升 0.1 mm (近消退)、troponin I 15.4 ng/mL (預期 washout 上升)、尿量 56 mL/h。
Hour 4	HR 68, BP 112/70, SpO2 99%, ST resolved, troponin I 48.2 ng/mL (peak washout), urine output 60 mL/h. Pain 0 out of 10.HR 68、BP 112/70、SpO2 99%、ST 消退、troponin I 48.2 ng/mL (peak washout)、尿量 60 mL/h。疼痛 0 分。
Hour 6	HR 66, BP 110/68, SpO2 99%, ST resolved, troponin I 39.8 ng/mL (beginning to decline), urine output 58 mL/h. Oriented and resting comfortably.HR 66、BP 110/68、SpO2 99%、ST 消退、troponin I 39.8 ng/mL (開始下降)、尿量 58 mL/h。定向感正常、舒適休息。

Q1. How is the client responding after primary PCI?原發性 PCI 後病人之反應如何?

Clinically improving — expected post-reperfusion trends臨床改善 — 預期之再灌流後趨勢 Deteriorating — troponin rise indicates ongoing re-infarction惡化 — troponin 上升提示再梗塞 Stable but not improving穩定但無改善

Q2. The nurse notes troponin I has risen from 1.2 to 48.2 ng/mL. What is the most appropriate response?Troponin I 由 1.2 升至 48.2。最適當之回應為?

Notify the provider immediately — this indicates reinfarction or failed PCI立即通知醫師 — 再梗塞或 PCI 失敗 Continue routine post-PCI monitoring — troponin washout after successful reperfusion is expected and troponin is beginning to decline at hour 6維持例行 post-PCI 監測 — 成功再灌流後 troponin washout 為預期且於 6 小時開始下降 Prepare for emergency re-catheterization given the marked troponin elevation因顯著 troponin 上升準備緊急再導管 Withhold antiplatelet medications due to perceived bleeding risk from troponin elevation因 troponin 上升而停用抗血小板

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