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NRSG 2500 Test 5 (Units 9 & 10) Multiple Questions Fully Solved. $9.99   Add to cart

Exam (elaborations)

NRSG 2500 Test 5 (Units 9 & 10) Multiple Questions Fully Solved.

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LCA (left coronary artery) - Answer -supplies left ventricle anterior wall, intraventricular septum, bundle of his *LAD (left anterior descending); circ. or cx (circumflex) RCA (right coronary artery) - Answer -supplies right atria, anterior and posterior right ventricle, SA and AV nodes,...

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  • September 14, 2024
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  • NRSG 2500
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NRSG 2500 Test 5 (Units 9 & 10) Multiple
Questions Fully Solved.
LCA (left coronary artery) - Answer -supplies left ventricle anterior wall, intraventricular septum, bundle
of his

*LAD (left anterior descending); circ. or cx (circumflex)



RCA (right coronary artery) - Answer -supplies right atria, anterior and posterior right ventricle, SA and
AV nodes, bundle of his

*marginal branch RCA; posterior descending branch of RCA



Subendocardial or non-Q wave - Answer -involves layer below the endocardium



Transmural or Q-wave - Answer -affected area includes all layers/walls of the heart



Pathological Q wave sign on previous MI - Answer -necrosis of cardiac muscle begins 20-30mins after
total occlusion; necrosis will usually stay but with early reperfusion may occasionally disapper

*sign on previous MI; absence of electrical activity

**they rarely go away



STEMI vs. NSTEMI - Answer *NSTEMI and unstable angina can both have ST segment depression or t-
wave inversion



Acute Coronary Syndrome - Answer -any condition characterized by s/s of sudden myocardial ischemia

-MI-STEMI (st segment elevation myocardial infarction) results from a fully occluded coronary artery;
NSTEMI (non st segment...) and unstable angina normally both result from a partially or intermittently
occluded coronary artery

, Acute Myocardial Infarction (MI) - Answer -death of the myocardial tissue as a result of insufficient
oxygen supplied to the tissue

-typical clinical manifestations-chest pain, dyspnea/SOB, N, V, diaphoresis

-atypical clinical manifestations

*diabetics-may not experience any pain or discomfort

*elderly-jaw pain, fainting, no pain

*females-chest discomfort in neck, back, arm, shoulder, jaw, or throat; SOB, N, V, indigestion
UNRELIEVED with antacids, upper abd pain, dyspnea, fatigue, diaphoresis, dizziness, fainting

-diagnostic studies-12 lead ECG, labs, echocardiogram, exercise stress test (EST)



Anterior (lateral) MI - Answer -look for ST segment elevation in the leads listed (don't need to know?)



Inferior MI - Answer -look for ST segment elevation in the leads listed

*40-50% of all MI's are inferior wall. More favorable prognosis than anterior wall MI



Serum Enzymes and Isoenzymes - Answer -CPK, Troponin, LDH

-other labs-PT/INR, PTT, CBC, BMP, CMP



CPK - Answer -creatine phosphokinase

-in the past, was one of the most sensitive and reliable indicators of all cardiac enzymes in diagnosing an
MI. 50% of CK-MBs rise in the 2-3 hrs after onset of chest pain, peaks in 24hrs, and returns to normal in
next 24-40hrs

*CK-MB--measures damage to heart muscle tissue

*CK-BB--measures damage to brain tissue

*CK-MM--measures damage to skeletal muscle tissues



Troponin - Answer -a protein released by damaged myocardial cells. More sensitive than CK-MB

*Troponin I-rises in 3hrs after an MI, peaks at 14-18hrs, returns to normal in 5-7 days, IS NOT affected by
skeletal muscle damage or kidney disease

*Troponin T-may be present 21 days after an MI, but is sensitive to skeletal muscle damage and kidney
disease

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