10/19/23, 12:00 PM Medical Surgical Nursing Midterm Exam
MIDTERM EXAM 2
Myocardial Infarction
Myocardial Infarction (MI) happens when the myocardial tissue is gravely deprived of
oxygen. In layman’s term, this is called as heart attack and because there is a limited blood
supply to the heart muscle tissues, this eventually dies and becomes necrotic.
When there is a blockage in the coronary artery which supplies blood to the heart
muscles, as a result of a ruptured plaque that has been formed, and this attracts platelets
thus the occurrence of thrombus formation. This causes a complete occlusion to the arteries
resulting to ischemia or a decreased supply of oxygen. Now, because of the decreased
blood supply due to the blockage, the decreased oxygen supply leads the heart muscle to be
necrotic.
A person who constantly smokes and uses drugs, is obese, has sedentary lifestyle,
and with excessive intake of saturated fats, are at great risk of having an infarction.
In treating myocardial infarction, I remembered the acronym ONMA which stands for,
oxygen, nitroglycerin, morphine, and aspirin. The oxygen by means of a nasal cannula can
increase the blood oxygenation, giving nitroglycerin or nitrates helps to relieve the chest
pain, the morphine is given because it is an analgesic meaning it helps to decrease the pain
because this increases the heart rate and causes vasoconstriction, and lastly is the aspirin
which inhibits the platelet aggregation.
Heart Failure
Heart failure happens when the heart cannot pump enough blood to meet the
metabolic needs of the body. Depending of the cause of this syndrome, it may be still
reversible, however, the person with heart failure should change and manage his or her
lifestyle as well as the help of prescribed medications.
Heart failure occurs before the signs and symptoms are manifested where it includes
shortness of breath, edema because of the fluid retention, and fatigue.
Since there is a decreased cardiac output and decreased renal perfusion which is
caused by vasoconstriction, the kidney releases renin which then activates the
angiotensinogen I. The angiotensin converting enzyme (ACE) converts Angiotensin I into
Angiotensin II wherein it causes vasoconstriction thus increasing the blood pressure and
heart rate. Also, it releases aldosterone which is responsible for the sodium and water
retention, which results to one of the signs and symptoms which is edema.
The treatment or medication that are being prescribed for patients with heart failure
includes the cardiac glycosides in which it inhibits the sodium potassium pump and helps to
increase the number of calcium intracellularly. When this is administered, this causes the
heart muscles to contract efficiently. Another is the vasodilators, this helps to decrease the
venous blood return and decreases the oxygen demand of the heart. Also, angiotensin
converting enzymes or ACE inhibitors are prescribed for heart failure because not just it
about:blank 1/6
, 10/19/23, 12:00 PM Medical Surgical Nursing Midterm Exam
helps to reduce the fluid and sodium retention, but it also improves the blood flow by dilating
the vessels. Diuretics are considered as treatment for reducing the fluid volume and is also
prescribed.
Angina
Angina Pectoris also called as chest pain, it is an episode of pressure and pain to the
chest.
This condition happens when the atherosclerosis or the abnormal accumulation of
lipid or fatty substances in the lining of the blood vessels, it will result to an obstruction.
When there is a plaque formation, it will cause a decreased blood flow into the heart which
will result to a decreased level of oxygen supply. Other factors associated with the angina
pectoris are physical exertion which increases the oxygen demand in the heart muscle, as
well as the exposure to cold because this causes vasoconstriction, eating heavy meal and
stress because it results to the release of catecholamine which causes to have an increased
heart rate and blood pressure.
When studying this condition, it is important to remember the PQRST of angina
pectoris. The P which stands for precipitating factor, the person experiences chest pain and
describes the quality as crushing and as if there are hollow blocks on the chest, however the
intensity of this pain is not affected by respiration. Also, it radiates to other parts of the body
such as on shoulder, left arms, jaw, neck, and back. The patient may also rate his or her pain
ranging from one to five (1 to 5), number one being the lowest. Lastly, the crushing pain may
last for about five minutes and can be relieved with rest. Aside from those, the patient may
also experience shortness of breath, weakness, and dizziness.
For the antianginal drugs, it helps in increasing the blood flow. The treatment for this
condition includes the use of beta blockers which it blocks the beta adrenergic stimulation of
the heart thus reducing the oxygen consumption of the heart. Next is the calcium channel
blockers, this dilates the walls of the coronary arteries hence helps to increase the oxygen
supply to the heart. Another is heparin which prevents the new blood clots from forming.
Coronary Artery Disease
Coronary artery disease is considered as the most prevalent disease of the heart in
adults. The formation or development of atherosclerosis or the accumulation of lipids causes
the narrowing and obstruction to the one or more coronary arteries—which is responsible for
delivering supply of blood.
Factors such as the smoking, high blood pressure, and hyperlipidemia results to an
injury which causes the attraction of macrophages. These ingest the lipids causing plaque
formation and are transported to arterial wall. When the plaque formation grows, this can
rupture and results to blocking and narrowing of the vessels thus resulting to a reduced
blood flow.
The person with CAD is usually asymptomatic but can experience chest pain during
an activity and describes it as a feeling of heaviness as well as shortness of breath.
The treatment for this includes the use of antiplatelets which helps to prevent clot
from forming and nitrates which helps to dilate the vessels to allow more blood to flow into
the heart.
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MIDTERM EXAM 2
Myocardial Infarction
Myocardial Infarction (MI) happens when the myocardial tissue is gravely deprived of
oxygen. In layman’s term, this is called as heart attack and because there is a limited blood
supply to the heart muscle tissues, this eventually dies and becomes necrotic.
When there is a blockage in the coronary artery which supplies blood to the heart
muscles, as a result of a ruptured plaque that has been formed, and this attracts platelets
thus the occurrence of thrombus formation. This causes a complete occlusion to the arteries
resulting to ischemia or a decreased supply of oxygen. Now, because of the decreased
blood supply due to the blockage, the decreased oxygen supply leads the heart muscle to be
necrotic.
A person who constantly smokes and uses drugs, is obese, has sedentary lifestyle,
and with excessive intake of saturated fats, are at great risk of having an infarction.
In treating myocardial infarction, I remembered the acronym ONMA which stands for,
oxygen, nitroglycerin, morphine, and aspirin. The oxygen by means of a nasal cannula can
increase the blood oxygenation, giving nitroglycerin or nitrates helps to relieve the chest
pain, the morphine is given because it is an analgesic meaning it helps to decrease the pain
because this increases the heart rate and causes vasoconstriction, and lastly is the aspirin
which inhibits the platelet aggregation.
Heart Failure
Heart failure happens when the heart cannot pump enough blood to meet the
metabolic needs of the body. Depending of the cause of this syndrome, it may be still
reversible, however, the person with heart failure should change and manage his or her
lifestyle as well as the help of prescribed medications.
Heart failure occurs before the signs and symptoms are manifested where it includes
shortness of breath, edema because of the fluid retention, and fatigue.
Since there is a decreased cardiac output and decreased renal perfusion which is
caused by vasoconstriction, the kidney releases renin which then activates the
angiotensinogen I. The angiotensin converting enzyme (ACE) converts Angiotensin I into
Angiotensin II wherein it causes vasoconstriction thus increasing the blood pressure and
heart rate. Also, it releases aldosterone which is responsible for the sodium and water
retention, which results to one of the signs and symptoms which is edema.
The treatment or medication that are being prescribed for patients with heart failure
includes the cardiac glycosides in which it inhibits the sodium potassium pump and helps to
increase the number of calcium intracellularly. When this is administered, this causes the
heart muscles to contract efficiently. Another is the vasodilators, this helps to decrease the
venous blood return and decreases the oxygen demand of the heart. Also, angiotensin
converting enzymes or ACE inhibitors are prescribed for heart failure because not just it
about:blank 1/6
, 10/19/23, 12:00 PM Medical Surgical Nursing Midterm Exam
helps to reduce the fluid and sodium retention, but it also improves the blood flow by dilating
the vessels. Diuretics are considered as treatment for reducing the fluid volume and is also
prescribed.
Angina
Angina Pectoris also called as chest pain, it is an episode of pressure and pain to the
chest.
This condition happens when the atherosclerosis or the abnormal accumulation of
lipid or fatty substances in the lining of the blood vessels, it will result to an obstruction.
When there is a plaque formation, it will cause a decreased blood flow into the heart which
will result to a decreased level of oxygen supply. Other factors associated with the angina
pectoris are physical exertion which increases the oxygen demand in the heart muscle, as
well as the exposure to cold because this causes vasoconstriction, eating heavy meal and
stress because it results to the release of catecholamine which causes to have an increased
heart rate and blood pressure.
When studying this condition, it is important to remember the PQRST of angina
pectoris. The P which stands for precipitating factor, the person experiences chest pain and
describes the quality as crushing and as if there are hollow blocks on the chest, however the
intensity of this pain is not affected by respiration. Also, it radiates to other parts of the body
such as on shoulder, left arms, jaw, neck, and back. The patient may also rate his or her pain
ranging from one to five (1 to 5), number one being the lowest. Lastly, the crushing pain may
last for about five minutes and can be relieved with rest. Aside from those, the patient may
also experience shortness of breath, weakness, and dizziness.
For the antianginal drugs, it helps in increasing the blood flow. The treatment for this
condition includes the use of beta blockers which it blocks the beta adrenergic stimulation of
the heart thus reducing the oxygen consumption of the heart. Next is the calcium channel
blockers, this dilates the walls of the coronary arteries hence helps to increase the oxygen
supply to the heart. Another is heparin which prevents the new blood clots from forming.
Coronary Artery Disease
Coronary artery disease is considered as the most prevalent disease of the heart in
adults. The formation or development of atherosclerosis or the accumulation of lipids causes
the narrowing and obstruction to the one or more coronary arteries—which is responsible for
delivering supply of blood.
Factors such as the smoking, high blood pressure, and hyperlipidemia results to an
injury which causes the attraction of macrophages. These ingest the lipids causing plaque
formation and are transported to arterial wall. When the plaque formation grows, this can
rupture and results to blocking and narrowing of the vessels thus resulting to a reduced
blood flow.
The person with CAD is usually asymptomatic but can experience chest pain during
an activity and describes it as a feeling of heaviness as well as shortness of breath.
The treatment for this includes the use of antiplatelets which helps to prevent clot
from forming and nitrates which helps to dilate the vessels to allow more blood to flow into
the heart.
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