Exam (elaborations)
Acute Coronary Syndrome (Carl Shapiro)
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Acute Coronary Syndrome (Carl Shapiro)
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Acute Coronary Syndrome (Carl Shapiro)When a patient is experiencing angina, the nurse administers nitroglycerin
sublingually at what frequency?
A. every 15 minutes, 3 doses max
B. Every 3 min, no restriction on # of doses
C. Every 5 min, 3 dose max
D. Once only, then administer morphine
C. every 5 min, 3 dose max
when a patient is experiencing acute angina, it is recommended that the patient
allow one sublingual tablet to dissolve under the tongue (or spray nitroglycerin
under the tongue) and repeat every 5 minutes for a max of 3 doses.
When administering medication to the patient with suspected myocardial
infarction, the nurse understands that morphine has which of the following
beneficial effects? (SATA)
A. decreases preload
B. decreases respiratory rate
C. decreases pain
D. decreases after-load
E. decreases anxiety
A, C, D, E
morphine is the drug of choice to reduce pain, thereby reducing anxiety. It also
reduces preload and afterload, decreasing the work of the heart.
****The patient must be monitored closely for the side effects of hypotension and
respiratory depression.
Which of the following are cardiac markers assessed in the patient experiencing
angina to determine potential myocardial injury? (SATA)
A. CK-MB
B. Hemoglobin
C. CK-MM
, D. Creatinine
E. Troponin
A, E
Cardiac enzymes and biomarkers, which include troponn, creatine kinase (CK)
and myoglobin are used to diagnose an acute MI. Of the 3 CK isoenzymes, CK
myocardial bound (MB) is specific to the heart muscle.
The nurse recognizes that ST elevation on the 12 lead ECG typically indicates
which of the following?
A. myocardial injury
B. myocardial ischemia
C. this is a normal finding
D. hyperkalemia
A. myocardial injury
myocardial injury causes ST-segment and T-wave changes on an ECG
The nurse knows that which factors may increase the patient's risk of developing
coronary artery disease? (SATA)
A. cigarette smoking
B. metabolic syndrome
C. activity limited to walking
D. female less than age 55
E. family history
A, B, E
Non-modifiable risk factors for CAD include family history and increasing age
(more than 55 yrs. for women). Cigarette smoking and metabolic syndrome are
modifiable risk factors for CAD. A diagnosis of metabolic syndrome includes 3 of
the following conditions:
*Insulin resistance
*Central obesity
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