NSG-320 Exam 2-Questions with Correct Answers/ Verified/ Latest Update
2024/2025
angina - ✔️✔️The clinical manifestation of myocardial ischemia; caused by either an
increased demand for oxygen or a decreased supply of oxygen; an acute emergency; can
progress into MI if not treated promptly
Client complains of:
-Squeezing in the chest
-Pressure, an elephant sitting on the chest
-Pain from chest radiating to jaw, neck, left arm
-Anxiety, sense of impending doom
-Nausea, vomiting
-Dizziness
-Pale, cool, & clammy skin, diaphoresis
-Tachycardia, palpitations
-Tachypnea & shortness of breath
-Decreasing LOC
chronic stable angina - ✔️✔️-Intermittent chest pain that occurs over a long period with
the same pattern of onset, duration, and intensity of symptoms
-Few minutes in duration and commonly subsides when the precipitating factor is resolved
(resting, calming down, using sublingual NTG)
-ST segment depression and/or T-wave inversion
-Control with drugs
-Often provoked by physical exertion, stress, or emotional upset
-Some patients may deny feeling pain but describe a pressure, heaviness, or discomfort in
the chest that is squeezing, heavy, tight, or suffocating (rarely described as sharp or
stabbing)
-Other symptoms: dyspnea and fatigue
-Pain at rest is unusual
,-Progresses and gets worse over time
Prinzmetal's angina (variant) - ✔️✔️Occurs anytime, including at rest; caused by coronary
artery spasms
microvascular angina - ✔️✔️Caused by small/distal coronary arteries, ADLs, more common
in women
unstable angina - ✔️✔️-Chest pain that occurs while a person is exercising or at rest
-Caused by the rupture of plaque
-Increases with severity/frequency/duration over time
-Not relieved with rest/nitro
-Lasts longer than 10 minutes
cardiac lab testing - ✔️✔️-Coagulation (PT/INR, aPTT): the amount of time it takes for
different parts of the clotting system to form a clot
-Cardiac Enzymes (CK-MBs, Troponins, BNP): enzyme(s) excreted by the heart when it's in
distress
-Lipid Panel (Cholesterol, Triglycerides, HDL, LDL): measures the different types of fat that
float around in our blood
-Digoxin Level: this measures the amount of a medication, Digoxin, that is in the blood to
determine if the amount is too high or too low
-D-Dimer: this measures fragments of fibrin that are left over after a clot has formed
-CRP - C Reactive Protein: tells us about inflammation in general
angina interventions - ✔️✔️Acute:
,-Vitals q5min
-PQRST for pain assessment
-LOC
-O2 administration
-IV access
-Energy conservation
-Anxiety management
-Cardiac monitor
-ECGs
-Blood work
-Urine output
Chronic:
-Smoking cessation
-HTN control
-Lower cholesterol/triglycerides if elevated
-Diet low in saturated fat and salt
-Regular physical activity
ONA-M - ✔️✔️-Interventions for angina
-Oxygenation
-Nitroglycerin tablets, sublingual (tablets 0.4mg Q15min, SL Q5min x 3 doses)
-Aspirin 81mg up to 325mg
-Morphine
angina drug therapy - ✔️✔️-Antiplatelet: aspirin is drug of choice
-Nitrates: dilation of coronary vessels. Don't take Viagra if taking NTG regularly
-Beta-blockers (metoprolol): slows heart, dec BP and SNS. Instruct them to get up slowly
(hypotension)
, -Calcium channel blockers: instruct not to eat grapefruit
-Lipid-lowering drugs
percutaneous coronary intervention (PCI) - ✔️✔️-Balloon-tipped catheter is inserted into a
coronary artery to open the artery; stents are put in place
-Client is NPO
-Stent is an expandable meshlike structure designed to keep the vessel open
Complications:
-Bleeding from the catheter insertion site
-Damage to the kidneys
-Abrupt closure from coronary artery dissection
-Vascular injury at the artery access site (femoral or radial)
-Stent embolization
-Acute MI
-Coronary spasm
-Dye allergy
-Renal compromise
-Bleeding (e.g., retroperitoneal)
-Infection
-Stroke
-Dysrhythmias
Client Teaching After PCI:
Tell your doctor if you have any of the following:
-Fever or chills
-Increased pain, redness, swelling, bleeding, or other drainage from the insertion site
-Coolness, numbness or tingling, or other changes in the affected arm or leg
