NGN CARDIOVASCULAR FORM A NGN QUESTION
1. NSTEMI
Answer: No ST elevation in the ECG; caused by a non occlusivethrombus;non-
emergent situation (still concerning but not as emergent)
2. What are some assessment findings indicative of myocardialinfarction?-
Answer: • Pain (multiple ocations including; mid sternum, jaw line, neck, axillae,
epigastric,and intrascapular)
3. How may a person describe pain from a myocardial infarction?
Answer: • Persistent, heavy, pressure, tight crushing; unrelieved by position, rest, or
nitrate administration.
4. What are some exceptions to myocardial infarction pain?Answer:
• Women canhave atypical discomfort
• Diabetics may have "silent" MI's due to cardiac neuropathy
• Older adults may have mental status changes or dizziness.
5. Recognize assessment findings indicative of myocarial infarction
general:
Answer: Initial heart rate and blood pressure increase , then eventual
pressure decrease.
(Initial increases in response to catecholamine release; then, a drop due to de- creased
cardiac output. Nausea and vomiting can occur in response to severe painor vasovagal
reflex stimulation.)
6. Recognize assessment findings indicative of myocarial
infarction General:
Answer:
• Initial heart rate and blood pressure increase, then eventual bloodpressuredecrease.
• Nausea and vomiting
• Fever: increase to 100.4 F (38 C) and can persist for 4 to 5 days
• Skin: diaphoretic, ashen, cool , clammy with peripheral edema
• Lung sounds and breathing; crackles, tachypnea; dyspnea (due to
left side ofheart not working correctly)
• Jugular venous distention (Right sided problem)
,7. Why does skin changes occur in myocardial infarction?
Answer: Due to the releaseof catecholamine release and peripheralblood vessel
vasoconstriction.
8. What are some definitive signs of myocardial infarction?Answer:
• ECG changes:STEMI or NSTEMI
• Serum cardiac biomarkers: elevated troponin, elevated creatininekinase
muscle/brain (CK-MB)
9. Troponin
Answer: Elevates 3 to 6 hours after MI, peaks between 10 and 24hours, andreturns
to baseline over 10 to 14 days
10. What are some nursing considerations forTroponin laboratorytest?
Answer: Ex-plain to client that serial tropinin testing will beperformed (e.g.,
every 6 hours x3)
11. Creatine Kinase MB (CK-MB)
Answer: Elevates 4 to 6 hours after MI peaks at 24hours, returns tobaseline within 48
to 72 hours
12. What are some nursing considerations for Creatine kinase MB
Answer: Explain purpose of serial sampling, which is often done inconjunction with
serial troponinsand ECGs.
13. How do we determine if there is a STEMI?Answer:
Cardiac stress testing
14. What is the goal for acute management of a myocardialinfarction?
Answer: • Toreduce angina pain and improve coronary blood flow
15. Initial assessment with focus on type and location of pain:
Answer: • Traet painwith IV nitroglycerin, if unrelieved, treat withmorphine sulfate
IV.
16. Acute managment of myocardial infarctionAnswer:
• Frequent vital sign monitoring
, • Lung sounds and heart rhythm (look for evidence of crackles dueto left
sidedfailure)
• 12-lead ECG monitoring (STEMI or NYSTEMI)
• O2 by nasal cannula to keep O2 saturation above 93%
• IV placement
• Laboratory testing
• Chest x-ray (infiltrates, lung fields)
• Chewable aspirin 164 to 325 mg
• High dose "statin" medication (e.g., atorvastatin, simvastatin)
• Prepare for PCI:
Informed Consent
Hair clipped at access site
17. What is the long-term management goal of MIs?
Answer: To prevent any future MIsand restore the client to optimalhealth.
• Cardiac rehabilitation
• Teaching: diet, exercise, medications, lifestyle
• Psychosocial: reduce anxiety and fears, aware of depression andoverall moodin
recovery process
18. Beta Blocker
Answer: Increase cardiac output, slow the heart rate down, getmaximumcardiac output.
19. A client is started on warfarin.The nurse teaches the client tohave
blood-workdone regurlary. What does the bloodwork measure?
Answer: Prothrombin Time
20. Diuretics
Answer: • Increase urine output and remove excess fluids frombody
21. Diuretics Use
Answer:
• Hypertension
• Fluid removal with heart failure
• Cirrhosis
• Kidney disease
1. NSTEMI
Answer: No ST elevation in the ECG; caused by a non occlusivethrombus;non-
emergent situation (still concerning but not as emergent)
2. What are some assessment findings indicative of myocardialinfarction?-
Answer: • Pain (multiple ocations including; mid sternum, jaw line, neck, axillae,
epigastric,and intrascapular)
3. How may a person describe pain from a myocardial infarction?
Answer: • Persistent, heavy, pressure, tight crushing; unrelieved by position, rest, or
nitrate administration.
4. What are some exceptions to myocardial infarction pain?Answer:
• Women canhave atypical discomfort
• Diabetics may have "silent" MI's due to cardiac neuropathy
• Older adults may have mental status changes or dizziness.
5. Recognize assessment findings indicative of myocarial infarction
general:
Answer: Initial heart rate and blood pressure increase , then eventual
pressure decrease.
(Initial increases in response to catecholamine release; then, a drop due to de- creased
cardiac output. Nausea and vomiting can occur in response to severe painor vasovagal
reflex stimulation.)
6. Recognize assessment findings indicative of myocarial
infarction General:
Answer:
• Initial heart rate and blood pressure increase, then eventual bloodpressuredecrease.
• Nausea and vomiting
• Fever: increase to 100.4 F (38 C) and can persist for 4 to 5 days
• Skin: diaphoretic, ashen, cool , clammy with peripheral edema
• Lung sounds and breathing; crackles, tachypnea; dyspnea (due to
left side ofheart not working correctly)
• Jugular venous distention (Right sided problem)
,7. Why does skin changes occur in myocardial infarction?
Answer: Due to the releaseof catecholamine release and peripheralblood vessel
vasoconstriction.
8. What are some definitive signs of myocardial infarction?Answer:
• ECG changes:STEMI or NSTEMI
• Serum cardiac biomarkers: elevated troponin, elevated creatininekinase
muscle/brain (CK-MB)
9. Troponin
Answer: Elevates 3 to 6 hours after MI, peaks between 10 and 24hours, andreturns
to baseline over 10 to 14 days
10. What are some nursing considerations forTroponin laboratorytest?
Answer: Ex-plain to client that serial tropinin testing will beperformed (e.g.,
every 6 hours x3)
11. Creatine Kinase MB (CK-MB)
Answer: Elevates 4 to 6 hours after MI peaks at 24hours, returns tobaseline within 48
to 72 hours
12. What are some nursing considerations for Creatine kinase MB
Answer: Explain purpose of serial sampling, which is often done inconjunction with
serial troponinsand ECGs.
13. How do we determine if there is a STEMI?Answer:
Cardiac stress testing
14. What is the goal for acute management of a myocardialinfarction?
Answer: • Toreduce angina pain and improve coronary blood flow
15. Initial assessment with focus on type and location of pain:
Answer: • Traet painwith IV nitroglycerin, if unrelieved, treat withmorphine sulfate
IV.
16. Acute managment of myocardial infarctionAnswer:
• Frequent vital sign monitoring
, • Lung sounds and heart rhythm (look for evidence of crackles dueto left
sidedfailure)
• 12-lead ECG monitoring (STEMI or NYSTEMI)
• O2 by nasal cannula to keep O2 saturation above 93%
• IV placement
• Laboratory testing
• Chest x-ray (infiltrates, lung fields)
• Chewable aspirin 164 to 325 mg
• High dose "statin" medication (e.g., atorvastatin, simvastatin)
• Prepare for PCI:
Informed Consent
Hair clipped at access site
17. What is the long-term management goal of MIs?
Answer: To prevent any future MIsand restore the client to optimalhealth.
• Cardiac rehabilitation
• Teaching: diet, exercise, medications, lifestyle
• Psychosocial: reduce anxiety and fears, aware of depression andoverall moodin
recovery process
18. Beta Blocker
Answer: Increase cardiac output, slow the heart rate down, getmaximumcardiac output.
19. A client is started on warfarin.The nurse teaches the client tohave
blood-workdone regurlary. What does the bloodwork measure?
Answer: Prothrombin Time
20. Diuretics
Answer: • Increase urine output and remove excess fluids frombody
21. Diuretics Use
Answer:
• Hypertension
• Fluid removal with heart failure
• Cirrhosis
• Kidney disease
