QUESTION Risk factors for (ACS) Acute coronary syndrome Answer: age > 55 years family history of CAD tobacco use diabetes HTN hyperlipidemia vascular atherosclerosis obesity unhealthy diet inactivity COVID -19 QUESTION ACS subjective findings Answer: mid-substernal chest pain that may or may not radi - ate to the neck, arms, or back retrosternal pressure "elephant on the shoulder" with associated symptoms nausea and vomiting fatigue -may report falling asleep while watching tv or reading cold sweats weakness light-headedness or syncope dyspnea cough apprehension sense of impending doom Midterm Exam: N R571/ NR 571 (2023/ 2024 New Update) Complex Diagnosis & Management in Acute Care Practicum Exam Review |W eeks 1-4 | Questions and 100% Correct Verified Answers - Chamberlain QUESTION ACS objective findings Answer: dysrhythmias S4 wheezing pulmonary crackles low-grade fever (during the first 24 -48h) tachycardia QUESTION dx tools used for ACS in acute care setting? Answer: 12 lead EKG troponin Troponin every 8hr BNP to assess for heart failure CBC provides information needed for thrombolytic therapy (H/H and platelet base - line) PTT, PT/INR to assess baseline coagulation status BMP to assess renal function and electrolytes TSH, magnesium, and phosphorus as imbalances can cause dysrhythmias QUESTION How is unstable angina dx? Answer: 12 lead EKG - nonspecific EKG irregularities *WITH* ACS symptoms *AND* normal troponin levels 37. STEMI Dx requires with 3 factors Answer: new ST elevation in 2 contiguous leads of > 0.1 mV in all leads other than V2 -V3 (the presence of reciprocal ST depression helps confirm the diagnosis) leads V2 -V3 findings: > 0.2 mV in men > 40 years > 0.25 mV in men < 40 years > 0.15 mV in women *AND* elevated troponin QUESTION What is the goal of treatment for ACS? Answer: The standard of care for ACS (unstable angina, STEMI, and NSTEMI) evolves around *stabilizing rupture and restoring flow to the coronary arteries to rescue myocardial QUESTION what are the 7 treatment interventions for unstable angina & NSTEMI? Answer: un- stable angina & NSTEMI are treated the same! 1.Dual Antiplatelet Therapy (DAPT) 2.Full -dose Anticoagulation 3.High -Intensity Statin 4.Beta -Blockers 5.Nitrates 6.Oxygen 7.Pain medication QUESTION 1. Dual Antiplatelet Therapy (DAPT) for unstable angina & NSTEMI? Answer: ASA (325 mg chewed loading dose + 81 mg daily) *AND* P2Y2 inhibitor (clopidogrel 600mg load plus 75mg daily or ticagrelor 180mg load plus 90mg daily etc.) QUESTION 2. Full -dose Anticoagulation for unstable angina & NSTEMI? Answer: -heparin is preferred if the patient will undergo angiography within the next 48hrs or if eGFR is low -heparin loading dose 50 -70 units/kg (60u/kg) IV bolus followed by a heparin drip at 12 units/kg/h to target PTT of 1.5 -2.5 times the patient's baseline -SQ Lovenox 1mg/kg BID QUESTION 3. High -Intensity Statin for unstable angina & NSTEMI?
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