NUR390 Nursing Care of the Adult 1
EKG Rhythm Interpretation Packet
Failure to complete all components of assignment can result in up to a 50% point reduction
Instructions – First complete the questions below, then complete the EKG packet!
Please read the following areas of your text to help you answer the questions below:
Harding, M.M., Kwong, J., Hagler, D., & Reinisch, C. (2023). Lewis’s medical-surgical nursing:
Assessment and management of clinical problems (12th ed.). Elsevier.
The following sections of Chapter 37:
● Diagnostic Studies: Cardiac Catheterization (Starting on pg. 836)
● Acute Coronary Syndrome (Starting on pg. 840)
Also- don’t forget in your Didactic Shell, you have a “EKG Powerpoint” embedded in the Week 5
announcement. This will help you with both the below questions and your EKG packet.
Question Student Answer
Describe nursing care of the post angioplasty Continuous cardiac monitoring for dysrhythmias
patient. Monitor VS per protocol (every 15 min initially)
Assess chest pain (may indicate re-occlusion)
Assess insertion site for bleeding, bruit, hematoma
Maintain affected extremity straight (if femoral
access) (Harding, et al., 2023)
Monitor distal pulses (compare bilaterally)
Assess skin temperature, color, cap refill
Monitor urine output (contrast nephropathy risk)
Encourage fluids (if not contraindicated) to flush
contrast (Harding, et al., 2023)
Administer antiplatelet therapy
Educate patient on activity restrictions and signs of
complications
(Harding, et al., 2023)
Identify possible complications and their causes Acute stent thrombosis
following coronary stent placement and nursing Restenosis
care designed to prevent these complications. Bleeding at insertion site
Hematoma
Retroperitoneal bleed (femoral access)
Contrast-induced nephropathy
Dysrhythmias
Coronary artery dissection
(Harding, et al., 2023)
Nursing prevention would include steps taken above
post-angio, but also monitor creatinine levels (ATI,
2023)
Describe administration, pharmacokinetics and Administration: Sublingual, topical, IV
the desired effect of nitroglycerin. Pharmacokinetics: rapid onset, short half-life, liver
metabolized
Desired effects: vasodilation of coronary, relief of
chest pain
, NUR390 Nursing Care of the Adult 1
EKG Rhythm Interpretation Packet
Failure to complete all components of assignment can result in up to a 50% point reduction
What should be included in a complete Pedal pulses (dorsalis pedis, posterior tibial)
neurovascular assessment to the lower Color
extremities following a cardiac catheterization? Temperature
Capillary refill
Sensation
Movement
Pain
Compare bilaterally
Make sure to report any abnormal findings such
as absent pulse, cool limb, pallor (ATI, 2023)
What are signs and symptoms of a myocardial Crushing chest pain, radiating to arm/jaw/back
infarction? Pain not relieved by resting or nitroglycerin
Diaphoresis
Nausea/vomiting
SOB
For atypical (women) presentation:
Fatigue, indigestion, back pain, dyspnea,
lightheaded (Harding, et al., 2023)
What laboratory values and trends reflect a Troponin I or T – elevates 3-6 hours, peaks 12/24
positive myocardial infarction? hrs, remains elevated (ATI, 2023)
CK-MB - elevates 3-6 hours, peaks 12/24 hrs,
returns to normal
Describe drug eluting stents and the rationale These stents are coated with medication that
for their use. doesn’t allow muscle cells to multiply and can help
reduce restenosis
Describe the ECG changes that may occur with a The book gives us examples of both the STEMI and
myocardial infarction. NSTEMI. In STEMI, there will be ST elevation where
the infarct is, and T wave changes. NSTEMI the ST
will be depressed, T wave inversion and not ST
elevation (Harding, et al., 2023)
EKG Rhythm Interpretation Packet
Failure to complete all components of assignment can result in up to a 50% point reduction
Instructions – First complete the questions below, then complete the EKG packet!
Please read the following areas of your text to help you answer the questions below:
Harding, M.M., Kwong, J., Hagler, D., & Reinisch, C. (2023). Lewis’s medical-surgical nursing:
Assessment and management of clinical problems (12th ed.). Elsevier.
The following sections of Chapter 37:
● Diagnostic Studies: Cardiac Catheterization (Starting on pg. 836)
● Acute Coronary Syndrome (Starting on pg. 840)
Also- don’t forget in your Didactic Shell, you have a “EKG Powerpoint” embedded in the Week 5
announcement. This will help you with both the below questions and your EKG packet.
Question Student Answer
Describe nursing care of the post angioplasty Continuous cardiac monitoring for dysrhythmias
patient. Monitor VS per protocol (every 15 min initially)
Assess chest pain (may indicate re-occlusion)
Assess insertion site for bleeding, bruit, hematoma
Maintain affected extremity straight (if femoral
access) (Harding, et al., 2023)
Monitor distal pulses (compare bilaterally)
Assess skin temperature, color, cap refill
Monitor urine output (contrast nephropathy risk)
Encourage fluids (if not contraindicated) to flush
contrast (Harding, et al., 2023)
Administer antiplatelet therapy
Educate patient on activity restrictions and signs of
complications
(Harding, et al., 2023)
Identify possible complications and their causes Acute stent thrombosis
following coronary stent placement and nursing Restenosis
care designed to prevent these complications. Bleeding at insertion site
Hematoma
Retroperitoneal bleed (femoral access)
Contrast-induced nephropathy
Dysrhythmias
Coronary artery dissection
(Harding, et al., 2023)
Nursing prevention would include steps taken above
post-angio, but also monitor creatinine levels (ATI,
2023)
Describe administration, pharmacokinetics and Administration: Sublingual, topical, IV
the desired effect of nitroglycerin. Pharmacokinetics: rapid onset, short half-life, liver
metabolized
Desired effects: vasodilation of coronary, relief of
chest pain
, NUR390 Nursing Care of the Adult 1
EKG Rhythm Interpretation Packet
Failure to complete all components of assignment can result in up to a 50% point reduction
What should be included in a complete Pedal pulses (dorsalis pedis, posterior tibial)
neurovascular assessment to the lower Color
extremities following a cardiac catheterization? Temperature
Capillary refill
Sensation
Movement
Pain
Compare bilaterally
Make sure to report any abnormal findings such
as absent pulse, cool limb, pallor (ATI, 2023)
What are signs and symptoms of a myocardial Crushing chest pain, radiating to arm/jaw/back
infarction? Pain not relieved by resting or nitroglycerin
Diaphoresis
Nausea/vomiting
SOB
For atypical (women) presentation:
Fatigue, indigestion, back pain, dyspnea,
lightheaded (Harding, et al., 2023)
What laboratory values and trends reflect a Troponin I or T – elevates 3-6 hours, peaks 12/24
positive myocardial infarction? hrs, remains elevated (ATI, 2023)
CK-MB - elevates 3-6 hours, peaks 12/24 hrs,
returns to normal
Describe drug eluting stents and the rationale These stents are coated with medication that
for their use. doesn’t allow muscle cells to multiply and can help
reduce restenosis
Describe the ECG changes that may occur with a The book gives us examples of both the STEMI and
myocardial infarction. NSTEMI. In STEMI, there will be ST elevation where
the infarct is, and T wave changes. NSTEMI the ST
will be depressed, T wave inversion and not ST
elevation (Harding, et al., 2023)
