Exam 2 NR 545 Questions With Complete Solutions

Chest Pain AKA Angina Patho Correct Answers Patho: Chest pain associated with decreased blood flow or ischemia to the myocardial tissue. Chest pain PA Correct Answers Physical Assessment: chest heaviness Pressure Squeezing Fullness Pain radiates to left shoulder, arm, or jaw. Elevation of blood pressure during attack Chest pain Pharm Correct Answers Pharm: Nitroglycerin- relaxes and widens blood vessels Dosing: 0.3-0.6mg every 5 minutes for max of 3 doses Long-term treatment to consider: ACE Inhibitors & Beta-Blockers Chest pain risks Correct Answers Risks and complications: Acute Coronary Syndrome Myocardial Infarction Correct Answers blood flow to the heart is minimized. Buildup of cholesterol MI Patho Correct Answers imbalance between myocardial oxygen supply and demand Prolonged for greater than 30 minutes can lead to cardiac tissue death. MI PA Correct Answers Pain at rest Not relieved with nitro Lightheaded Impending doom Nausea Diaphoresis Wheezing MI Dx Correct Answers Troponins elevated, often stay elevated for one week after infarction. EKG- ST elevation or new left bundle branch block Atherosclerosis Correct Answers when blood vessels that carry oxygen to organs and tissues is restricted. Hardening of vessels from buildup of fats, cholesterol in the artery walls Happens gradually. Formed plaque can break off and burst, triggering a blood clot. Atherosclerosis patho Correct Answers inflammatory process that begins with damage to the endothelium often result of HTN, smoking, high cholesterol, or other risk factors. Fatty streak to fibrous plaque and then complicated lesion Atherosclerosis PA Correct Answers modifiable risk factors Fluid retention Fatigue Neck vein distension Edema Calf pain Atherosclerosis Dx Correct Answers Dx: Stress tests Chest Xray EKG Ankle-Brachial Index to assess blood pressure in the extremities. Atherosclerosis Pharm Correct Answers Pharm: Antiplatelets (Aspirin) Statins- reduce inflammation. ACE Inhibitor- relax blood pressure and reduce work and pressure on heart. Can be treated with lifestyle management. Heart Failure Correct Answers complex clinical syndrome that results from structural or functional impairment of ventricular or ejection of blood, which in turn leads to the cardinal clinical symptoms of dyspnea and fatigue, edema, and rales. Heart Failure PA Correct Answers Pre-existing conditions such as diabetes, liver failure, renal disease, anemia. Dyspnea on exertion, orthopnea, paroxysmal nocturnal dyspnea (PND), nocturnal angina, Cheyne-Stokes respirations (ask families or caretaker) Fatigue, lethargy, decreased functional capacityPatient takes medications as directed, observing, and adhering to dietary requirements. Alcohol or tobacco use History of rheumatic heart disease or Chaga's disease Discomfort when laying down.