med surg 2 exam 2 (cardiac)\\\ Med-Surg 2
Exam 2: Cardiovascular System Study Notes &
Practice Questions 2026
Stable (exertional) angina
occurs with exercise or emotional stress and is relieved by rest or nitroglycerin
unstable (pre-infarction) angina
occurs with exercise or at rest, but increases in occurrence, severity, and duration over time
variant (prinzmetal's) angina
occurs due to a coronary artery spasm, often occurring during periods of rest
ST-segment elevation myocardial infarction (STEMI)
a life-threatening type of heart attack that occurs when a coronary artery is completely blocked, cutting
off oxygen-rich blood to the heart
non-ST segment elevation (NON-STEMI)
a type of heart attack that occurs when a part of the heart isn't getting enough oxygen
nursing actions for cardiac catheter
o Assess vital signs every 15 min × 4, every 30 min × 2, every hour × 4, and then every 4 hr. (Follow
facility protocol.)
o Assesses the catheter access site frequently for bleeding or hematoma formation
o Assesses for arrhythmias using cardiac monitoring
o Maintain bed rest in supine position with extremity straight for prescribed time( range from 2 to 8
hours).
o Assesses peripheral perfusion of the involved limb, including peripheral pulses, capillary refill, and
neurovascular status per institution policy until discharge,
o Instructs the patient to report chest pain and bleeding or sudden discomfort from the catheter
insertion sitesimmediately
o Assesses for contrast agent-induced renal failure by monitoring for an increase in creatinine levels
- IV hydration is used to flush the contrast agent from the urinary tract; accurate intake and output are
recorded.
o Administer antiplatelet or thrombolytic agents as prescribed to prevent clot formation and restenosis.
o Ensures patient safety by instructing the patient to ask for help when getting out of bed the first time.
o Provides patients with additional instructions at time of discharge:
- For the next 24 hours, do not bend at the waist, strain, or lift heavy objects.
- If the radial artery was used, avoid sleeping on the affected arm for 24 hours and refrain from
repetitive movement of the affected extremity for 24-48 hours.
, - Avoid tub baths, but shower as desired.
- Ask your provider about when you may resume your usual activities.
- Call your provider if you have any bleeding, swelling, new bruising, or pain from your procedure
puncture site, or a temperature of 101.5°F (38.6°C) or more
what is coronary artery disease (CAD)
disease of the arteries surrounding the heart
manifestations of coronary artery disease (CAD)
occurs d/t an imbalance between myocardial O2 supply and demand which is caused by atherosclerosis
risk factors for coronary artery disease (CAD)
non-modifiable = age, gender, ethnicity, genetics
modifiable = hyperlipidemia, HTN, DM, smoking, inactivity/obesity
signs and symptoms for coronary artery disease (CAD)
- Anxiety, feeling of impending doom
- Chest pain: substernal or precordial
· Can radiate down the shoulder or arm, or present as jaw pain
· Can be described as a crushing or aching pressure
- Nausea
- Dizziness
- Females can experience atypical angina (pain between the shoulders, ache in the jaw, or sensation of
choking with exertion)
- Pallor and cool, clammy skin
- Tachycardia and heart palpitations
- Tachypnea and SOB
- Diaphoresis
- Decreased LOC
management for coronary artery disease (CAD)
- GOAL: decrease O2 demand and increase O2 supply
- nitrates: nitroglycerin (give SL, Q5min up to 3 doses, and education
- beta blockers
- calcium channel blockers
- antiplatelet & anticoagulants
nursing interventions for coronary artery disease (CAD)
- monitor ECG and blood lab biomarkers
- encourage exercise and medication compliance
- prepare pt for pharmacologic or exercise stress test, nuclear scan, or invade procedures (ex. cardiac
cath, coronary artery angiography)
Exam 2: Cardiovascular System Study Notes &
Practice Questions 2026
Stable (exertional) angina
occurs with exercise or emotional stress and is relieved by rest or nitroglycerin
unstable (pre-infarction) angina
occurs with exercise or at rest, but increases in occurrence, severity, and duration over time
variant (prinzmetal's) angina
occurs due to a coronary artery spasm, often occurring during periods of rest
ST-segment elevation myocardial infarction (STEMI)
a life-threatening type of heart attack that occurs when a coronary artery is completely blocked, cutting
off oxygen-rich blood to the heart
non-ST segment elevation (NON-STEMI)
a type of heart attack that occurs when a part of the heart isn't getting enough oxygen
nursing actions for cardiac catheter
o Assess vital signs every 15 min × 4, every 30 min × 2, every hour × 4, and then every 4 hr. (Follow
facility protocol.)
o Assesses the catheter access site frequently for bleeding or hematoma formation
o Assesses for arrhythmias using cardiac monitoring
o Maintain bed rest in supine position with extremity straight for prescribed time( range from 2 to 8
hours).
o Assesses peripheral perfusion of the involved limb, including peripheral pulses, capillary refill, and
neurovascular status per institution policy until discharge,
o Instructs the patient to report chest pain and bleeding or sudden discomfort from the catheter
insertion sitesimmediately
o Assesses for contrast agent-induced renal failure by monitoring for an increase in creatinine levels
- IV hydration is used to flush the contrast agent from the urinary tract; accurate intake and output are
recorded.
o Administer antiplatelet or thrombolytic agents as prescribed to prevent clot formation and restenosis.
o Ensures patient safety by instructing the patient to ask for help when getting out of bed the first time.
o Provides patients with additional instructions at time of discharge:
- For the next 24 hours, do not bend at the waist, strain, or lift heavy objects.
- If the radial artery was used, avoid sleeping on the affected arm for 24 hours and refrain from
repetitive movement of the affected extremity for 24-48 hours.
, - Avoid tub baths, but shower as desired.
- Ask your provider about when you may resume your usual activities.
- Call your provider if you have any bleeding, swelling, new bruising, or pain from your procedure
puncture site, or a temperature of 101.5°F (38.6°C) or more
what is coronary artery disease (CAD)
disease of the arteries surrounding the heart
manifestations of coronary artery disease (CAD)
occurs d/t an imbalance between myocardial O2 supply and demand which is caused by atherosclerosis
risk factors for coronary artery disease (CAD)
non-modifiable = age, gender, ethnicity, genetics
modifiable = hyperlipidemia, HTN, DM, smoking, inactivity/obesity
signs and symptoms for coronary artery disease (CAD)
- Anxiety, feeling of impending doom
- Chest pain: substernal or precordial
· Can radiate down the shoulder or arm, or present as jaw pain
· Can be described as a crushing or aching pressure
- Nausea
- Dizziness
- Females can experience atypical angina (pain between the shoulders, ache in the jaw, or sensation of
choking with exertion)
- Pallor and cool, clammy skin
- Tachycardia and heart palpitations
- Tachypnea and SOB
- Diaphoresis
- Decreased LOC
management for coronary artery disease (CAD)
- GOAL: decrease O2 demand and increase O2 supply
- nitrates: nitroglycerin (give SL, Q5min up to 3 doses, and education
- beta blockers
- calcium channel blockers
- antiplatelet & anticoagulants
nursing interventions for coronary artery disease (CAD)
- monitor ECG and blood lab biomarkers
- encourage exercise and medication compliance
- prepare pt for pharmacologic or exercise stress test, nuclear scan, or invade procedures (ex. cardiac
cath, coronary artery angiography)
