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NUR 546 EXAM I ACS & Delegation Questions And Answer 2024/2025
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NUR 546 EXAM I ACS & Delegation Questions And Answer 2024/2025
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NUR 546 EXAM I ACS & DelegationQuestions And Answer 2024/2025
Describe the underlying pathophysiology and clinical manifestations of stable angina ANS✔✔
Pathophysiology:
- pain usually occurs during activity which results in ischemia (increased O2 demand, decreased supply),
and it's relieved by rest or nitrates.
Clinical manifestations of chronic stable angina:
- EKG: possible ST-depression and/or T-wave inversion= ischemia
- EKG returns to normal when symptoms subside
- "The usual chest pain"
- Negative cardiac enzymes
Describe the underlying pathophysiology and clinical manifestations of unstable angina ANS✔✔
Pathophysiology:
- Unstable angina is ACS and it results from ischemia. Stable atherosclerotic plaques rupture. This causes
platelet aggregation and the formation of a thrombus, manifesting as a UA. There is an imbalance
between myocardial oxygen supply and demand due to ischemia.
Clinical manifestations of unstable angina:
- Unpredictable. Chest pain that is new in onset, occurs at rest, or occurs with increased frequency,
duration, or less effort than the patient's chronic stable angina pattern. In patients with chronic stable
angina, they describe a significant change in pattern of angina, which occurs with increased frequency
and with less exertion than previously.
- "squeezing," "burning," "heavy," "tight," "smothering," "choking," "pressure."
- Frequently substernal, left pectoral, or epigastric; may radiate to jaw, L shoulder or L arm.
, - May also have dyspnea, lightheadedness, diaphoresis
- Women may feel SOB, anxiety, fatigue
- Diabetics may be asymptomatic due to neuropathy
- Often more severe pain requiring more frequent nitrate therapy, may occur at rest.
- Crescendo nature
- ECG may show ST depression, T-wave inversion, or no changes
- Increased risk of MI
- Negative cardiac enzymes
Define Acute Coronary Syndrome (ACS) ANS✔✔ ACS includes the spectrum of UA, NSTEMI, & STEMI.
ACS develops when chest pain from ischemia is prolonged and not immediately reversible.
Describe the clinical manifestations and related pathophysiology of NSTEMI (Non-ST Segment Elevation
Myocardial Infarction) ANS✔✔ Patho:
- Partial occlusion of coronary artery causing cell death
- No ST elevation (possible ST depression & T-wave inversion)
- Positive cardiac enzymes troponin
Manifestations:
- Chest pain, Unstable angina related clinical manifestations. Sympathetic NS stimulation (diaphoresis,
increased HR & BP, ashen skin, cool & clammy skin), cardiovascular manifestations (high BP & HR
initially, decreased BP due to decreased CO, edema and fluid overload due to impaired LV dysfunction, &
abnormal heart sounds), Nausea and vomiting, and fever.
Describe the clinical manifestations and related pathophysiology of STEMI (ST-Elevation Myocardial
Infarction) ANS✔✔ Patho:
- Total occlusion of coronary artery causing cell death
- ST elevation
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