NURS 3730 Exam 3 Questions with
Verified Answers
Unstable angina Acute Coronary Syndrome - ANSWER-unpredictable pain
may occur at rest
pain increases with time
ranges from angina to myocardial infarction
-most common in men
UNSTABLE ANGINA
chain of events: - ANSWER-Atherosclerosis abnormal accumulation of lipids &
fibrous tissue in vessels--> Plaque protrudes into vessel lumen, narrowing it &
obstructing blood flow (ischemia + injury = angina) --> §Thrombus obstructs blood
flow > tissue death (myocardial cell death / infarction = myocardial infarction - MI)
angina pectoris - ANSWER-CP r/t decreased coronary blood flow and/or; increased
O2 demand and decreased O2 supply=PAIN
unstable angina - ANSWER-(preinfraction/crescendo) CP frequent & longer that
stablw not relieved with rest
unstable angina assessment findings - ANSWER-mid sternal chest pain
left jaw and left arm pain related to ischemia of the heart
ST elevation
treatments: unstable angina - ANSWER-decrease O2 demand of myocardium
oxygen: 2lmp- initiated onset of CP to increase O2 to mycardium and decrease pain
antianginals medications: unstable angina - ANSWER-§Nitroglycerin: dilates vessels
& â O2 consumption - decreases blood flow to heart
Sublingual #1 - ↓ pain ↓ within 5 min, repeat x3 prn (Take Nitro > call 911 > Nitro >
Nitro), topical - fast and convenient, IV - unstable (not give if systolic below 90)
Carry nitro at all times (protect from light); evaluate BP and CP after each nitro,
watch for a flushing HA and tingling tongue
§Beta Blockers - Propranolol (Inderal), metoprolol (Toprol), atenolol (Tenormin)
decreases HR; do not stop abruptly, can worsen angina r/t increase HR
§Calcium Channel Blockers - (used if can't tolerate BB) Procardia (poorly tolerated),
amlodipine (Norvasc), Cardizem
Antiplatelet & Anticoagulants medications: unstable angina - ANSWER-§ASA - â
PLT activation & â r/f MI & death; risk for GI upset & bleeding; SE = GI upset and GI
bleed
§Plavix & Ticlid—taken if allergic to ASA or risk for MI; SE = GI upset & â neutrophils
,§Heparin / Lovenox- prevents formation of new blood clots; Heparin Nomogram
revascularization procedures: unstable angina - ANSWER-PTCA
intracoronary stents
atherectomy
coronary artery bypass graft (CABG)
Nursing Care For Unstable Angina that can lead to an MI: - ANSWER-#1 Assess -
Full Head to Toe first to know appropriate interventions - VS (fully assess chest
pain), observe for RR distress, evaluate ST segment via 12-lead EKG
#1 Intervention - Reposition and apply O2 to increase O2 to heart and decrease
ischemia and possible infarct
§Immediate action for chest pain - stop activity, sit or rest in bed then reassess
angina
Support r/t anxiety & fear of death
Education: balance activity with rest; coping mechanisms, no heavy exertion
What statement is correct regarding unstable versus stable angina?
a.Stable angina occurs at rest.
b.Unstable angina is relieved with exertion.
c.You will see EKG changes with stable angina.
d.Unstable angina occurs with either exertion or rest. - ANSWER-d.Unstable angina
occurs with either exertion or rest.
acute myocardial infraction - ANSWER-the condition in which a portion of the
myocardium dies as a result of oxygen starvation; often called a heart attack by
laypersons
acute myocardial infraction
chain of events: - ANSWER-Atherosclerosis - abnormal accumulation of lipids &
fibrous tissue in vessels -->
Plaque protrudes into vessel lumen, narrowing it & obstructing blood flow (ischemia
+ injury = angina) -->
Thrombus obstructs blood flow > tissue death (myocardial cell death / infarction =
myocardial infarction - MI)
Myocardial cells in heart permanently destroyed from embolus/thrombus
Ischemia—injury—infarction (die)
causes of acute myocardial infraction - ANSWER-atherosclerosis, embolism,
genetics, decreased O2 r/t anemia, blood loss, decreased BP; increased demand
from increased HR, cocaine
Hallmark cardiac marker - ANSWER-tropine
, CK-MB - ANSWER-indication damage to the heart cells
GOAL, treatments:
acute myocardial infraction - ANSWER-MINIMIZE TISSURE DEATH, PRESERVE
MYOCARDIAL FUNCTION; AND PREVENT COMPLICATION
medications:
acute myocardial infraction - ANSWER-same meds as unstable angina plus...
analgesics: MORPHINE IV- GIVE FIRTS: decrease pain &anxiety; decrease preload
(decrease workload of heart); & relax bronchiole= increase O2 exchange
anti-anginal:
nitroglycerin
beta blockers
calcium channel blockers
Thrombolytics: tissue plasminogen activator (t-PA) avoid IM & multiply IV sticks,
check for ST elevation and decrease BP, check bleeding labs NOT GIVEN with
bleeding, recent surgery, pregnant, stop infusion with any abnormal S&S
ACE inhibitors:
give after MI to decrease r/f HF
Angiotensin receptor blockers (ARBs): decrease BP, vasodilator, reduces myocardial
remodeling (cardiac adversities)
CARDIAC REHAB: physical activity to lower HR and BP
Which finding on the ECG is most conclusive for infarction?
●
A.Q waves- represents dead muscle
B.Inverted T waves
C.Tall, peaked T waves
D.ST-segment depression - ANSWER-A.Q waves- represents dead muscle
acute coronary syndromes:
surgical interventions - ANSWER-minimally invasive procedures- catheter based
atherectomy
acute coronary syndromes:
surgical interventions - ANSWER-'drills' / 'grinds' to break up and remove plaque
Brachytherapy
acute coronary syndromes:
surgical interventions - ANSWER-radiation therapy (XRT) remove
plaque/obstruction, sometimes done prior to PTCA or stent
Verified Answers
Unstable angina Acute Coronary Syndrome - ANSWER-unpredictable pain
may occur at rest
pain increases with time
ranges from angina to myocardial infarction
-most common in men
UNSTABLE ANGINA
chain of events: - ANSWER-Atherosclerosis abnormal accumulation of lipids &
fibrous tissue in vessels--> Plaque protrudes into vessel lumen, narrowing it &
obstructing blood flow (ischemia + injury = angina) --> §Thrombus obstructs blood
flow > tissue death (myocardial cell death / infarction = myocardial infarction - MI)
angina pectoris - ANSWER-CP r/t decreased coronary blood flow and/or; increased
O2 demand and decreased O2 supply=PAIN
unstable angina - ANSWER-(preinfraction/crescendo) CP frequent & longer that
stablw not relieved with rest
unstable angina assessment findings - ANSWER-mid sternal chest pain
left jaw and left arm pain related to ischemia of the heart
ST elevation
treatments: unstable angina - ANSWER-decrease O2 demand of myocardium
oxygen: 2lmp- initiated onset of CP to increase O2 to mycardium and decrease pain
antianginals medications: unstable angina - ANSWER-§Nitroglycerin: dilates vessels
& â O2 consumption - decreases blood flow to heart
Sublingual #1 - ↓ pain ↓ within 5 min, repeat x3 prn (Take Nitro > call 911 > Nitro >
Nitro), topical - fast and convenient, IV - unstable (not give if systolic below 90)
Carry nitro at all times (protect from light); evaluate BP and CP after each nitro,
watch for a flushing HA and tingling tongue
§Beta Blockers - Propranolol (Inderal), metoprolol (Toprol), atenolol (Tenormin)
decreases HR; do not stop abruptly, can worsen angina r/t increase HR
§Calcium Channel Blockers - (used if can't tolerate BB) Procardia (poorly tolerated),
amlodipine (Norvasc), Cardizem
Antiplatelet & Anticoagulants medications: unstable angina - ANSWER-§ASA - â
PLT activation & â r/f MI & death; risk for GI upset & bleeding; SE = GI upset and GI
bleed
§Plavix & Ticlid—taken if allergic to ASA or risk for MI; SE = GI upset & â neutrophils
,§Heparin / Lovenox- prevents formation of new blood clots; Heparin Nomogram
revascularization procedures: unstable angina - ANSWER-PTCA
intracoronary stents
atherectomy
coronary artery bypass graft (CABG)
Nursing Care For Unstable Angina that can lead to an MI: - ANSWER-#1 Assess -
Full Head to Toe first to know appropriate interventions - VS (fully assess chest
pain), observe for RR distress, evaluate ST segment via 12-lead EKG
#1 Intervention - Reposition and apply O2 to increase O2 to heart and decrease
ischemia and possible infarct
§Immediate action for chest pain - stop activity, sit or rest in bed then reassess
angina
Support r/t anxiety & fear of death
Education: balance activity with rest; coping mechanisms, no heavy exertion
What statement is correct regarding unstable versus stable angina?
a.Stable angina occurs at rest.
b.Unstable angina is relieved with exertion.
c.You will see EKG changes with stable angina.
d.Unstable angina occurs with either exertion or rest. - ANSWER-d.Unstable angina
occurs with either exertion or rest.
acute myocardial infraction - ANSWER-the condition in which a portion of the
myocardium dies as a result of oxygen starvation; often called a heart attack by
laypersons
acute myocardial infraction
chain of events: - ANSWER-Atherosclerosis - abnormal accumulation of lipids &
fibrous tissue in vessels -->
Plaque protrudes into vessel lumen, narrowing it & obstructing blood flow (ischemia
+ injury = angina) -->
Thrombus obstructs blood flow > tissue death (myocardial cell death / infarction =
myocardial infarction - MI)
Myocardial cells in heart permanently destroyed from embolus/thrombus
Ischemia—injury—infarction (die)
causes of acute myocardial infraction - ANSWER-atherosclerosis, embolism,
genetics, decreased O2 r/t anemia, blood loss, decreased BP; increased demand
from increased HR, cocaine
Hallmark cardiac marker - ANSWER-tropine
, CK-MB - ANSWER-indication damage to the heart cells
GOAL, treatments:
acute myocardial infraction - ANSWER-MINIMIZE TISSURE DEATH, PRESERVE
MYOCARDIAL FUNCTION; AND PREVENT COMPLICATION
medications:
acute myocardial infraction - ANSWER-same meds as unstable angina plus...
analgesics: MORPHINE IV- GIVE FIRTS: decrease pain &anxiety; decrease preload
(decrease workload of heart); & relax bronchiole= increase O2 exchange
anti-anginal:
nitroglycerin
beta blockers
calcium channel blockers
Thrombolytics: tissue plasminogen activator (t-PA) avoid IM & multiply IV sticks,
check for ST elevation and decrease BP, check bleeding labs NOT GIVEN with
bleeding, recent surgery, pregnant, stop infusion with any abnormal S&S
ACE inhibitors:
give after MI to decrease r/f HF
Angiotensin receptor blockers (ARBs): decrease BP, vasodilator, reduces myocardial
remodeling (cardiac adversities)
CARDIAC REHAB: physical activity to lower HR and BP
Which finding on the ECG is most conclusive for infarction?
●
A.Q waves- represents dead muscle
B.Inverted T waves
C.Tall, peaked T waves
D.ST-segment depression - ANSWER-A.Q waves- represents dead muscle
acute coronary syndromes:
surgical interventions - ANSWER-minimally invasive procedures- catheter based
atherectomy
acute coronary syndromes:
surgical interventions - ANSWER-'drills' / 'grinds' to break up and remove plaque
Brachytherapy
acute coronary syndromes:
surgical interventions - ANSWER-radiation therapy (XRT) remove
plaque/obstruction, sometimes done prior to PTCA or stent
