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第6階段 — 評估結果。檢視經皮冠狀動脈介入治療(PCI)後的趨勢，並選擇最佳的判讀和後續計畫。

Trend

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Time	Data
ED arrival	Pain 9/10; BP 152/94; HR 102; SpO2 93 percent on room air; inferior ST elevation 2 to 3 mm疼痛9/10分；血壓152/94 mmHg；心率102次/分；室內空氣下血氧飽和度93%；下壁ST段抬高2至3毫米
Before PCI	V4R ST elevation 1 mm; BP 138/86; HR 96; lungs clear; catheterization laboratory already activatedV4R ST段抬高1毫米；血壓138/86 mmHg；心率96次/分；肺部清澈；心導管室已啟動
PCI result	Proximal RCA 100 percent occluded; drug-eluting stent placed; TIMI grade 3 flow restored近端右冠狀動脈(RCA)100%阻塞；置入塗藥支架；恢復TIMI 3級血流
30 minutes after PCI	Pain 1/10; inferior ST elevation decreased by more than 50 percent; BP 118/72; HR 54 sinus rhythm; PR 220 ms; alert without dizziness; radial site soft and dry; troponin continues to rise疼痛1/10分；下壁ST段抬高下降超過50%；血壓118/72 mmHg；心率54次/分，竇性心律；PR間期220毫秒；意識清楚無頭暈；橈動脈穿刺部位柔軟乾燥；心肌肌鈣蛋白持續上升

Q1. How should the nurse interpret the response to PCI?護理師應如何判讀個案對PCI的反應？

Reperfusion is successful based on TIMI 3 flow, pain relief, and ST resolution despite the ongoing troponin rise儘管心肌肌鈣蛋白持續上升，但根據TIMI 3級血流、疼痛緩解和ST段下降，再灌流是成功的。 PCI has failed because any post-procedure troponin increase proves persistent coronary occlusionPCI已失敗，因為任何術後心肌肌鈣蛋白增加都證明冠狀動脈持續阻塞。 The response is indeterminate until troponin returns to the reference range在心肌肌鈣蛋白恢復到參考範圍之前，反應是不確定的。

Q2. What is the best next plan?最佳的後續計畫是什麼？

Continue rhythm, AV-conduction, hemodynamic, recurrent-ischemia, bleeding, and access-site monitoring; continue prescribed DAPT and secondary prevention繼續監測心律、房室傳導、血流動力學、復發性缺血、出血和穿刺部位；繼續執行醫囑的雙重抗血小板治療(DAPT)和二級預防。 Give atropine immediately for asymptomatic sinus bradycardia and mild PR prolongation despite stable perfusion儘管灌流穩定，但對於無症狀竇性心動過緩伴輕度PR間期延長，應立即給予阿托品。 Stop the P2Y12 inhibitor because pain and ST elevation improved after stent placement停止P2Y12抑制劑，因為支架置入後疼痛和ST段抬高已改善。 Start routine oxygen solely because the arrival saturation was 93 percent even though the current saturation is 95 percent僅因為入院時血氧飽和度為93%，即使目前血氧飽和度為95%，也應開始常規給氧。

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