NURS 2245 SECOND TEST | Macomb Community College | Questions with 100% Verified Answers | Latest Update

NURS 2245 SECOND TEST | Macomb Community College | Questions with
100% Verified Answers | Latest Update

Question: What are types of Acute Coronary Syndromes?
Answer:
Angina, Unstable Angina, Non ST elevation MI (NSTEMI), ST elevation MI (STEMI)

Question: WHat is angina?
Answer:
it is a lack of O2 to the heart, it is accompanied by symptoms of nausea, pressure on the chest.

Question: WHat is UNstable Angina?
Answer:
it is angina that is occurring more frequently and not usually accompanied by physical activity.

Question: What is NSTEMI?
Answer:
damage to heart and the ST segment does not elevate in in the telemetry.

Question: What is STEMI?
Answer:
damage to heart and the ST segment DOES elevate in the telemetry.

Question: 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.

Question: 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.

,Question: What are actue pain interventions?
Answer:
Aspirin, Oxygen, Nitro, and morphine.

Question: 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.

Question: 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.

Question: 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.

Question: 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.

Question: What are indications for fibrinolytics?
Answer:
A STEMI onset greater than or equal to 12 hours.

Question: What are side effects related to fibrinolytics?
Answer:
bleeding.

, Question: 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

Question: What are examples of fibrinolytics?
Answer:
rtPA (activase), reteplase (Retavase), tenecteplase (TNKase)

Question: This is superior to fibrinolytics if performed by skilled
providers.
Answer:
What is reperfusion Therapy.

Question: We should caution in reperfusion therapy if?
Answer:
Pt. has allergy to contrast, metformin hydrochloride, renal impairment, or patient is on
anticoagulants.

Question: 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.

Question: When would you give Nitrogylcerin as a tissue perfusion
intervention ?
Answer:
if pt is experiencing chest pain, hypertension, or has pulmonary edema.

Question: 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.