NR 545 Exam 2 with Accurate
Solutions
Angina, or angina pectoris, is often described as chest pain usually precipitated by
stress or exertion and relieved rapidly with rest or nitrates. Those with angina report
varying symptoms including chest pain categorized as squeezing while others describe
the pain like a heavy weight being placed on the chest. Angina is relatively common,
and usually due to atherosclerotic heart disease. - ANS-What is Angina?
Angina is chest pain that is associated with decreased blood flow or ischemia to the
myocardial tissue. The decreased blood flow may be the result of atherosclerosis or
coronary artery spasm. Neural pain receptors are stimulated by accelerated cellular
metabolism, chemical changes, and imbalances - ANS-What is the Patho of Angina?
- chest heaviness
- chest pressure
- squeezing or fullness Sometimes this pain radiates to the left shoulder and arm while
others report pain in the jaw.
Generally, the attack length can range anywhere between three minutes to twenty
minutes. Attacks reported at greater than thirty minutes are concerning and could
indicate the development of acute coronary syndrome. - ANS-What are signs and
symptoms of Angina?
- Troponin
- CK-MB: to evaluate for acute coronary symptoms as well as for anemia which might
be contributing to ischemic chest pain.
- An ECG should also be obtained to rule out acute coronary syndrome. - ANS-What lab
test are needed for angina?
Nitroglycerin (Drug of choice):
Nitroglycerin relaxes and widens the blood vessel promoting easier blood flow to the
heart muscle. Dosing of nitroglycerin is 0.3-0.6 mg by translingual spray or sublingual
tablet every five minutes, as indicated with a max of 3 doses in 15 minutes.
Beta-Blockers and ACE inhibitors - ANS-What are pharmacological remedies for
Angina?
(Heart Attack)
, A myocardial infarction (MI) occurs when blood flow to the heart is minimized. The
blockage is most often caused by a buildup of cholesterol, which forms a plaque in the
arteries that circulate oxygenated blood flow to the myocardium. When the plaque
breaks away it can form a clot, interrupting or completely blocking blood flow and
destroying a part of the heart muscle. Unlike with an episode of angina, those
experiencing a myocardial
infarction often report symptoms of pain at rest. - ANS-What is a myocardial infarction?
During a myocardial infarction there is an imbalance between myocardial oxygen supply
and demand. Prolonged ischemia (>30 minutes) from the lack of circulating blood flow
to the myocardium results in cellular death, further impacting the heart's ability to
function. Depending on the extent of the cell death, the heart might have decreased
contractility resulting in wall function abnormalities further placing the patient at risk for
decompensation. - ANS-What is the patho of a Myocardial Infarction?
- Sharp radiating pain (Even at rest)
- Light-headed or have increased feelings of anxiety or impending doom.
- Nausea (more common in right coronary artery occlusion)
- Vomiting
- Diaphoresis
- Syncope
- Dyspnea
- Orthopnea
- Wheezing - ANS-What are the symptoms of a Myocardial Infraction?
- Troponins
- CK-MB
- An ECG will often demonstrate ST-segment elevation or new left bundle
branch block. - ANS-What lab test are needed for a Myocardial Infraction?
Patients presenting with acute myocardial infarction will need reperfusion therapy or
fibrinolytic therapy. To decrease mortality rates, reperfusion through PCI needs to be
completed within 90 minutes of presentation to the emergency room. - ANS-How do you
manage a Myocardial Infraction?
a disease of the arteries characterized by the deposition of plaques of fatty material on
their inner walls. - ANS-What is Atherosclerosis?
Atherosclerosis is an inflammatory process that begins with damage to the endothelium
often the result of hypertension, smoking, high cholesterol or other risk factors. The
endothelium develops a fatty streak which further develops into a fibrous plaque and
then complicated lesion. - ANS-What is the path of Atherosclerosis?
Family medical history and personal medical history should be reviewed for risk factors,
including level of physical activity, tobacco, use, and dietary habits. A review of
symptoms including recent and increasing fatigue, as well as fluid retention should be
Solutions
Angina, or angina pectoris, is often described as chest pain usually precipitated by
stress or exertion and relieved rapidly with rest or nitrates. Those with angina report
varying symptoms including chest pain categorized as squeezing while others describe
the pain like a heavy weight being placed on the chest. Angina is relatively common,
and usually due to atherosclerotic heart disease. - ANS-What is Angina?
Angina is chest pain that is associated with decreased blood flow or ischemia to the
myocardial tissue. The decreased blood flow may be the result of atherosclerosis or
coronary artery spasm. Neural pain receptors are stimulated by accelerated cellular
metabolism, chemical changes, and imbalances - ANS-What is the Patho of Angina?
- chest heaviness
- chest pressure
- squeezing or fullness Sometimes this pain radiates to the left shoulder and arm while
others report pain in the jaw.
Generally, the attack length can range anywhere between three minutes to twenty
minutes. Attacks reported at greater than thirty minutes are concerning and could
indicate the development of acute coronary syndrome. - ANS-What are signs and
symptoms of Angina?
- Troponin
- CK-MB: to evaluate for acute coronary symptoms as well as for anemia which might
be contributing to ischemic chest pain.
- An ECG should also be obtained to rule out acute coronary syndrome. - ANS-What lab
test are needed for angina?
Nitroglycerin (Drug of choice):
Nitroglycerin relaxes and widens the blood vessel promoting easier blood flow to the
heart muscle. Dosing of nitroglycerin is 0.3-0.6 mg by translingual spray or sublingual
tablet every five minutes, as indicated with a max of 3 doses in 15 minutes.
Beta-Blockers and ACE inhibitors - ANS-What are pharmacological remedies for
Angina?
(Heart Attack)
, A myocardial infarction (MI) occurs when blood flow to the heart is minimized. The
blockage is most often caused by a buildup of cholesterol, which forms a plaque in the
arteries that circulate oxygenated blood flow to the myocardium. When the plaque
breaks away it can form a clot, interrupting or completely blocking blood flow and
destroying a part of the heart muscle. Unlike with an episode of angina, those
experiencing a myocardial
infarction often report symptoms of pain at rest. - ANS-What is a myocardial infarction?
During a myocardial infarction there is an imbalance between myocardial oxygen supply
and demand. Prolonged ischemia (>30 minutes) from the lack of circulating blood flow
to the myocardium results in cellular death, further impacting the heart's ability to
function. Depending on the extent of the cell death, the heart might have decreased
contractility resulting in wall function abnormalities further placing the patient at risk for
decompensation. - ANS-What is the patho of a Myocardial Infarction?
- Sharp radiating pain (Even at rest)
- Light-headed or have increased feelings of anxiety or impending doom.
- Nausea (more common in right coronary artery occlusion)
- Vomiting
- Diaphoresis
- Syncope
- Dyspnea
- Orthopnea
- Wheezing - ANS-What are the symptoms of a Myocardial Infraction?
- Troponins
- CK-MB
- An ECG will often demonstrate ST-segment elevation or new left bundle
branch block. - ANS-What lab test are needed for a Myocardial Infraction?
Patients presenting with acute myocardial infarction will need reperfusion therapy or
fibrinolytic therapy. To decrease mortality rates, reperfusion through PCI needs to be
completed within 90 minutes of presentation to the emergency room. - ANS-How do you
manage a Myocardial Infraction?
a disease of the arteries characterized by the deposition of plaques of fatty material on
their inner walls. - ANS-What is Atherosclerosis?
Atherosclerosis is an inflammatory process that begins with damage to the endothelium
often the result of hypertension, smoking, high cholesterol or other risk factors. The
endothelium develops a fatty streak which further develops into a fibrous plaque and
then complicated lesion. - ANS-What is the path of Atherosclerosis?
Family medical history and personal medical history should be reviewed for risk factors,
including level of physical activity, tobacco, use, and dietary habits. A review of
symptoms including recent and increasing fatigue, as well as fluid retention should be
