NUR 313 EXAM 3 PRACTICE
QUESTIONS AND CORRECT ANSWERS
hyperlipidemia management
Should be treated with __ ___ and ___ ___ drugs. Like drugs that restrict lipoprotein
production, drugs that increase lipoprotein removal, and drugs that decrease cholesterol
absorption. Or as well will complementary & alternative therapies like garlic, ___,
omega-3 fatty acids, __, psyllium, plant steroids, red yeast rice. ✅dietary changes, lipid
lowering, flaxseed, soy
A lipid profile test aka lipid panel. Look at cholesterol total, triglycerides, LDLs, and
HDLs. Normal ranges are <___ mg/dL for cholesterol, < ___ mg/dL for triglycerides,
<___ mg/dL for LDLs, and > ___ mg/dL for HDLs. ✅200, 150, 100, 40
Risk factors for CAD
Modifiable: 1st ___, 2nd ___ __ /HTN, 3rd ___ use, 4th physical ___, obesity, diabetes,
metabolic syndrome, psychologic type, elevated homocysteine.
Nonmodifiable: Age, gender, ethnicity (___ caucasian __), family history, genetic
inheritance. ✅hld, elevated bp, tobacco, inactivity, white, men
Hyperlipidemia / Dyslipidemia: An abnormally high
concentration of fats or lipids in the blood. Either from the ___ making too much
fat/lipids or you could be ___ too many lipids ✅liver, eating
___ ___ ___ : happens when the arteries that supply blood to the heart muscle
becomes hardened and narrowed. ✅Coronary artery disease (definition)
___ ___ angina: When the demand for myocardial oxygen exceeds the ability of the
coronary arteries to supply the heart with oxygen, myocardial ischemia occurs leading
to chest pain. If they decide to exercise or be active they are going to exert themselves
and oxygen demand goes up which causes ___ pain and when they stop the oxygen
demand goes down so chest pain ___ ___. ✅chronic stable, chest, goes away
Collaborative care for chronic stable angina.
Goal is to decrease oxygen demand and/or increase oxygen supply by ___ precipitating
cause. Emphasis on decreasing risk factors. Taking ___ lowering drugs. Antiplatelet
drugs (ASA). Addition of ___, beta blockers, ___ (these optimize myocardial perfusion.
✅stopping, cholesterol, nitrates, CCB
,Chest pain that occurs in chornic stable angina its intermittent over a long period with
the same patterns of ___, ___, and ___ of symptoms. ✅onset, duration, intensity
Common characteristics of chest pain in chronic stable angina
- Duration usually is ___-___ minutes long
- Subsides when precipitating factor is relieved
- Pain is usually ___, found at the neck and it can radiate to jaw, shoulders, down arms,
between shoulder blades.
- Pain described as ___, tightness, ___, "indigestion".
- In ECG reading there could be ST segment depression and/or T wave inversion only
during the chest pain is happening. ✅5-15, substernal, squezzing, heaviness
___ is irreversible cell death. The cell is dead now and cannot come back.
___ is inadequate blood supply to an organ in this case to the heart and if it persists for
4-6 hours the whole heart muscle could become necrotic leading to infarction.
✅infarction, ischemia (definitions)
PQRST assessment for chest pain:
P- ____ events: what caused it?
Q - ___ of pain: describe the pain
R- ___ of pain: where is the pain located? Does it radiate to other areas?
S- ___of pain: how severe is it? On a scale of 0-10
T- ___/duration: how long does it last? (5-15 minutes in chronic stable angina.
✅precipitating, quality, radiation, severity, timing
___ ___ ___ (PCI): finding lesions and fixing it at the same time. Like putting in a stent
is an example of a PCI. Done in chronic stable angina and acute coronary syndrome.
✅percutaneous coronary intervention (definition)
___ ___: cath with inflatable balloon tip inserted into appropriate coronary artery. When
blockage is located, the cath tip is passed through and balloon is inflated and the
atherosclerotic plaque is compressed. It results in vessel dilation. ✅Balloon
angioplasty
,___ ___: stents usually put in at same time as balloon angioplasty. The stent is
expanable mesh-like structure designed to maintain vessel patency by compressing
arterial wall and resisting vasoconstriction. ✅Intracoronary stents
People with acute coronary syndrome can have ___ angina, ___-__ -segment elevation
MI Or __-segment elevation MI. ✅unstable, non-st, st
acute coronary syndrome: ___ ___ is a ruptured plaque. That causes injury to the
endothelium which stimulates platelet aggregation and local vasoconstriction, which
leads to thrombus formation and leads to a partially occluded artery that could lead to a
____, or if the artery becomes completely occluded it could lead to a ___ ✅unstable
angina, NSTEMI, STEMI
NSTEMI has ___ obstruction of arteries. STEMI has ___ occlusion of arteries.
✅partial, full
STEMI EKG results : ___ ___ is way above. Also, a pathologic ___ wave can be seen
with something having a STEMI or someone who had one in the past because once you
get it once it never goes away ✅st segment, Q
An abnormally high ST segment and a pathological Q wave (due to current MI or could
be due to passed MI) are seen in the EKG findings of someone having a ____ MI
✅STEMI (EKG results)
NSTEMI EKG findings: ST segment is ___ (after QRS) and ___ ___ is inverted/upside
down ✅below, t wave
an ST segment this is abnormally below following the QRS and has an upside down T
wave is seen on the EKG of someone who is having an ____ MI ✅NSTEMI (ekg
results)
A survival method or technique body uses ___ ___. Some blood still gets by to heart
even if there's complete blockage and slows down the infarction process because a
new/alternative passageway of blood vessels has happened. ✅collateral circulation
(definitiont)
___ ____ ____ ___ surgery : A form of bypass surgery that can create new routes
around narrowed and blocked coronary arteries, permitting increased blood flow to
deliver oxygen and nutrients to the heart muscle. ✅Coronary artery bypass graft
(definition)
___ ___ machine (CPB): Heart is not pumping during the CABG so therefore, this
machine is used to circulate blood to the entire body during the surgery. Done by putting
drains in IVC and SVC to go through an oxygenator to give blood oxygen to get to the
aorta and pump out to the body. ✅Cardiopulmonary bypass
, (definition)
Continued care in ICU/CCU after acute coronary syndrome surgery
Drug therapy: IV ___ (initial tx), morphine sulfate, __-___, ACE inhibitors, ____ drugs,
cholesterol-lowering drugs, and ___ ___ ✅NTG, beta-blockers, antidysrhythmic, stool
softners
MD orders NTG drip at 22mcg/min. You receive a bag from the pharmacy with 25 mg
NTG in 250 mL D5W.
step 1: convert mcg/min to mcg/hr. done by multiplying mcg/min X 60 min/hr = mcg/hr
step 2 convert mcg/hr to mg/hr. done by dividing mcg/hr / 1000mcg/mg= mg/hr
step 3: finding rate of infusion. Done by taking volume ml/ dose 25 (given from
pharmacy) X(multiply) mg/hr (from step 2) = ml/hr
what will you set the pump at? ✅13.2 ml/hr
Complications of an MI
___: most common and most common death following an MI. (v-fib in particular)
✅Dysrhythmias (common cause of death)
Complications of an MI: HF and CS
HF occurs due to loss of ___ function.
___ ___: occurs when O2 and nutrients supplied to the tissues is inadequate due to
severe LVF. ✅ventricular, cardiogenic shock
___ ___ ___: occurs if the infarcted area affected papillary muscles that attach to the
mitral valve. Causes mitral valve regurgitation, which increases blood volume in the left
atrium (which aggravates LA even more). Will need immediate surgery to replace the
mitral valve, its life threatening. May hear new systolic murmur. ✅Papillary muscle
dysfunction (definition)
____ inflammation of the pericardium. Cardiac compression may decrease ventricular
filling and emptying.
Chest pain associated with ___, coughing, and movement of the ___ body.
A fever may be present and assessment may reveal pericardial rub.
Treated w/pain relief and ASA or corticosteroids for ___.
