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NR 545 Exam With 110 EXAM QUESTIONS & CORRECT ANSWERS
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NR 545 Exam With 110 EXAM QUESTIONS & CORRECTANSWERS
What is Angina? - ANSWER-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.
What is the Patho of Angina? - ANSWER-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
What are signs and symptoms of Angina? - ANSWER-- 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.
What lab test are needed for angina? - ANSWER-- 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.
What are pharmacological remedies for Angina? - ANSWER-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
What is a myocardial infarction? - ANSWER-(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.
What is the patho of a Myocardial Infarction? - ANSWER-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.
, What are the symptoms of a Myocardial Infraction? - ANSWER-- 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
What lab test are needed for a Myocardial Infraction? - ANSWER-- Troponins
- CK-MB
- An ECG will often demonstrate ST-segment elevation or new left bundle
branch block.
How do you manage a Myocardial Infraction? - ANSWER-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.
What is Atherosclerosis? - ANSWER-a disease of the arteries characterized by the
deposition of plaques of fatty material on their inner walls.
What is the path of Atherosclerosis? - ANSWER-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
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