vSim: Medical Scenario 4 Carl Shapiro

The nurse recognizes that ST elevation on the 12-lead ECG typically indicates which of the following? - When a patient is experiencing angina, the nurse administers nitroglycerin sublingually at what frequency? - Answer- every 5 minutes, maximum 3 doses When a pt is experiencing acute angina, it's recommended that the pt allow 1 sublingual tablet to dissolve under the tongue (or spray nitroglycerin under the tongue) and repeat every 5 min for maximum of 3 doses When administering medication to pt w/ suspected MI, the nurse understands that morphine has which of the following beneficial effects? - Answer- decreases anxiety decreases pain decreases preload decreases afterload Morphine is drug of choice to reduce pain, thereby reducing anxiety. it also reduces preload and afterload, decreasing work of heart. pt must be monitored closely for SEs of hypotension and respiratory depression Which of the following are cardiac markers assessed in the pt experiencing angina potential myocardial injury? - Answer- troponin CK-MB cardiac enzymes and biomarkers, which include troponin, CK, and myoglobin, are used to diagnose an acute MI. of the 3 CK isoenzymes, CK-myocardial bound (MB) is specific to heart muscle. CK-MM is specific to skeletal muscle and is not an indicator of MI. hemoglobin is used to determine amount of O2 in the blood. creatinine is elevated in renal failure, not in myocardial injury. the nurse recognizes that ST elevation on the 12-lead ECG typically indicates which of the following? - Answer- myocardial injury (causes ST segment and T-wave changes on ECG) the nurse knows that which factors may increase pt's risk of developing coronary artery disease? - Answer- cigarette smoking metabolic syndrome family history non-modifiable risk factors for CAD include family hx and increasing age (> 55 y/o for women). cigarette smoking and metabolic syndrome are modifiable risk factors for CAD. a diagnosis of metabolic syndrome includes 3 of following: insulin resistance, central obesity, dyslipidemia, BP persistently > 130/85, high levels of C-reactive proteins, and high fibrinogen level. Any activity based on pt's capability is encouraged. whMyocardial injury When administering medication to the patient with suspected myocardial infarction, the nurse understands that morphine has which of the following beneficial effects? (Select all that apply.) - When a patient is experiencing angina, the nurse administers nitroglycerin sublingually at what frequency? - Answer- every 5 minutes, maximum 3 doses When a pt is experiencing acute angina, it's recommended that the pt allow 1 sublingual tablet to dissolve under the tongue (or spray nitroglycerin under the tongue) and repeat every 5 min for maximum of 3 doses When administering medication to pt w/ suspected MI, the nurse understands that morphine has which of the following beneficial effects? - Answer- decreases anxiety decreases pain decreases preload decreases afterload Morphine is drug of choice to reduce pain, thereby reducing anxiety. it also reduces preload and afterload, decreasing work of heart. pt must be monitored closely for SEs of hypotension and respiratory depression Which of the following are cardiac markers assessed in the pt experiencing angina potential myocardial injury? - Answer- troponin CK-MB cardiac enzymes and biomarkers, which include troponin, CK, and myoglobin, are used to diagnose an acute MI. of the 3 CK isoenzymes, CK-myocardial bound (MB) is specific to heart muscle. CK-MM is specific to skelet