MSN 377 Exam 2 QUESTIONS WITH COMPLETE SOLUTIONS

unstable angina (NSTEMI) correct answer: upredictable increases in frequency occurs without increase in activity prinzmetal angina correct answer: coronary artery spasm common in reynauds disease/migranes treatment: CCBs acute coronary syndrome (ACS) correct answer: NSTEMI/ STEMI (MI). dislodgment of a once-stable plaque. myocardial infarction correct answer: sustained ischemia = tissue death time is muscle correct answer: irreversible damage after 20 min of ischemia! faster intervention is better penumbra correct answer: area of moderately ischemic cardiac tissue surrounding an area of severe ischemia. metabolic activity still occurs but there is less blood flow. STEMI correct answer: ST segment elevation MI. INJURY (jump up if you're hurt). emergency, want to dissolve clot via fibrinolgytic in cath lab. ONLY use thrombolytics for STEMIs NSTEMI correct answer: Non ST segment elevation MI; a heart attack that is not diagnosed on the EKG but is diagnosed by an elevated troponin on blood test. ST segment depression or T wave inversion correct answer: myocardial ISCHEMIA (blockage of 70% or greater) (depressed if no oxygen) significant Q wave correct answer: seen 2-3 days after an MI; permanent. at least 1/4 the heigh of the entire QRS or at least 0.04 seconds long [dip before Q]. what are the 2 biggest risks of MIs? correct answer: dysrhythmias and heart failure s/s of an MI correct answer: *not all patients have these -emerge with 50% blockage -chest pain (anaerobic metabolism, lactic acid irritates nerve endings) -fever -n/v (vasovagal reflex) -SNS releases catecholamines, glycogen: cool/clammy/ashen/sweating -crackles (blood in lungs) -tachycardia -hypertensive then later hypotensive -low creatinine and urine output syndrome x correct answer: microvascular angina results in ischemia, spasm of distal/smaller coronary arteries. pulse pressure correct answer: difference between systolic and diastolic pressure. normal is 30-40 complications of an MI correct answer: -narrowed pulse pressure -pericardial effusion -dressler syndrome (4-6wk post) -left ventricular aneurysm -papillary muscle dysfunction -cardiogenic shock(emergent) -pericarditis -