NURS 2245 SECOND TEST QUESTIONS
WITH VERIFIED ANSWERS
What are types of Acute Coronary Syndromes? - ANSWER Angina, Unstable
Angina, Non ST elevation MI (NSTEMI), ST elevation MI (STEMI)
WHat is angina? - ANSWER it is a lack of O2 to the heart, it is accompanied by
symptoms of nausea, pressure on the chest.
WHat is UNstable Angina? - ANSWER it is angina that is occurring more
frequently and not usually accompanied by physical activity.
What is NSTEMI? - ANSWER damage to heart and the ST segment does not
elevate in in the telemetry.
What is STEMI? - ANSWER damage to heart and the ST segment DOES elevate in
the telemetry.
WHat is the pathiophys of CAD? - ANSWER trauma to the endothelial -----> fatty
streak formation ---------> Thickening of arterial wall -----> formation of fibrous
cap over lipid core -----> branches to either stable/unstable plaque-----STABLE
LEADS TO INCREASED GROWTH and then STENOSIS.....unstable leads to a
plaque rupture and Acute Coronary Syndrome.
WHat is the progression of atherosclerosis? - ANSWER extensive lipid
accumulation; a thin, weakened fibrous cap; and a greater inflammatory
component can pose the threat of plaque rupture. WHen the lipid cap bursts
platelets go to the site causing a thrombus.
What are actue pain interventions? - ANSWER Aspirin, Oxygen, Nitro, and
morphine.
When giving aspirin for pain interventions what are some things to be mindful
of? - ANSWER You need to make sure no allergy, Chew non enteric coated
around 160 to 325mg, You also want to make sure there is no recent GI bleeding.
Rapid anti-platelet effect reduces occlusion and re-occlusion.
What are things to know about Oxygen when giving for Pain intervention? -
ANSWER You would give if O2sat is <94%, give 4L titrate, and monitor for
hypoventilation esp. with COPD and or Lung disease.
, What do you need to know about Nitroglycerin? - ANSWER you give it until you
have pain relief, unless SBP is <90 or HR<50 or >100 Bpm. You also would hold it
for RV MI. DOSING **** 1 tab SL every 3-5 minutes x3 until relief or hypotension.
WHat are the ECG changes occuring during a STEMI? - ANSWER the ST
segment elevates >1mm in 2 or more contigous ECG leads. indicates a large
occlusion and that rapid reperfusion is required. THE ST should normally be
around the P wave level.
What are indications for fibrinolytics? - ANSWER A STEMI onset greater than or
equal to 12 hours.
What are side effects related to fibrinolytics? - ANSWER bleeding.
What are contraindications related to fibrinolytics? - ANSWER recent major
bleeding and pregnancy. also relative hypertension due to stroke risk where in
SBP >180 and DBP >110
What are examples of fibrinolytics? - ANSWER rtPA (activase), reteplase
(Retavase), tenecteplase (TNKase)
This is superior to fibrinolytics if performed by skilled providers. - ANSWER What
is reperfusion Therapy.
We should caution in reperfusion therapy if? - ANSWER Pt. has allergy to
contrast, metformin hydrochloride, renal impairment, or patient is on
anticoagulants.
What are the ECG changes with a NSTEMI or UA? - ANSWER the ST is
depressed, there is a T wave inversion, and patient will have chest pain. There is
also transient ST elevation.
When would you give Nitrogylcerin as a tissue perfusion intervention ? -
ANSWER if pt is experiencing chest pain, hypertension, or has pulmonary
edema.
How long would you give Nitro? - ANSWER give until chest pain goes away as
long as the SBP > 90.
you would also want to limit a drop in BP of 30 in HTN or 10% in normotensive.
What info do you need to know about Heparin when using as a Tissue Perfusion
INtervention? - ANSWER it indirectly inhibits thrombin, give as a Bolus 4000
units IV then infusion at 1000 units per hour to maintian aPTT 50-70 seconds.
WITH VERIFIED ANSWERS
What are types of Acute Coronary Syndromes? - ANSWER Angina, Unstable
Angina, Non ST elevation MI (NSTEMI), ST elevation MI (STEMI)
WHat is angina? - ANSWER it is a lack of O2 to the heart, it is accompanied by
symptoms of nausea, pressure on the chest.
WHat is UNstable Angina? - ANSWER it is angina that is occurring more
frequently and not usually accompanied by physical activity.
What is NSTEMI? - ANSWER damage to heart and the ST segment does not
elevate in in the telemetry.
What is STEMI? - ANSWER damage to heart and the ST segment DOES elevate in
the telemetry.
WHat is the pathiophys of CAD? - ANSWER trauma to the endothelial -----> fatty
streak formation ---------> Thickening of arterial wall -----> formation of fibrous
cap over lipid core -----> branches to either stable/unstable plaque-----STABLE
LEADS TO INCREASED GROWTH and then STENOSIS.....unstable leads to a
plaque rupture and Acute Coronary Syndrome.
WHat is the progression of atherosclerosis? - ANSWER extensive lipid
accumulation; a thin, weakened fibrous cap; and a greater inflammatory
component can pose the threat of plaque rupture. WHen the lipid cap bursts
platelets go to the site causing a thrombus.
What are actue pain interventions? - ANSWER Aspirin, Oxygen, Nitro, and
morphine.
When giving aspirin for pain interventions what are some things to be mindful
of? - ANSWER You need to make sure no allergy, Chew non enteric coated
around 160 to 325mg, You also want to make sure there is no recent GI bleeding.
Rapid anti-platelet effect reduces occlusion and re-occlusion.
What are things to know about Oxygen when giving for Pain intervention? -
ANSWER You would give if O2sat is <94%, give 4L titrate, and monitor for
hypoventilation esp. with COPD and or Lung disease.
, What do you need to know about Nitroglycerin? - ANSWER you give it until you
have pain relief, unless SBP is <90 or HR<50 or >100 Bpm. You also would hold it
for RV MI. DOSING **** 1 tab SL every 3-5 minutes x3 until relief or hypotension.
WHat are the ECG changes occuring during a STEMI? - ANSWER the ST
segment elevates >1mm in 2 or more contigous ECG leads. indicates a large
occlusion and that rapid reperfusion is required. THE ST should normally be
around the P wave level.
What are indications for fibrinolytics? - ANSWER A STEMI onset greater than or
equal to 12 hours.
What are side effects related to fibrinolytics? - ANSWER bleeding.
What are contraindications related to fibrinolytics? - ANSWER recent major
bleeding and pregnancy. also relative hypertension due to stroke risk where in
SBP >180 and DBP >110
What are examples of fibrinolytics? - ANSWER rtPA (activase), reteplase
(Retavase), tenecteplase (TNKase)
This is superior to fibrinolytics if performed by skilled providers. - ANSWER What
is reperfusion Therapy.
We should caution in reperfusion therapy if? - ANSWER Pt. has allergy to
contrast, metformin hydrochloride, renal impairment, or patient is on
anticoagulants.
What are the ECG changes with a NSTEMI or UA? - ANSWER the ST is
depressed, there is a T wave inversion, and patient will have chest pain. There is
also transient ST elevation.
When would you give Nitrogylcerin as a tissue perfusion intervention ? -
ANSWER if pt is experiencing chest pain, hypertension, or has pulmonary
edema.
How long would you give Nitro? - ANSWER give until chest pain goes away as
long as the SBP > 90.
you would also want to limit a drop in BP of 30 in HTN or 10% in normotensive.
What info do you need to know about Heparin when using as a Tissue Perfusion
INtervention? - ANSWER it indirectly inhibits thrombin, give as a Bolus 4000
units IV then infusion at 1000 units per hour to maintian aPTT 50-70 seconds.
