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Med Surg 2 - Exam 1 > Week 3: Coronary Artery Syndrome & Gerontology > Flashcards

Week 3: Coronary Artery Syndrome & Gerontology Flashcards

1
Q

How is coronary ischemia pain typically described?

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A
  • Pressure
  • Squeezing
  • Radiation (to L shoulder, down L arm, to neck & lower jaw)
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2
Q

How is the pain associated with an aortic disection typically described?

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A

TEARING
* may migrate to arms, abdomen, back, or legs

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3
Q

How is the pain associated with a pulmonary embolism typically described?

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A

Stabbing pain

  • gripping
  • moderate to severe
  • radiiates to neck & shoulders
  • may be asymptomatic
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4
Q

How is the pain associated with a pneumothorax typically described?

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A

Sudden onset of pain

  • SEVERE chest pain
  • lateral thorax radiating to ipsilateral shoulder
  • sharp or tearing
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5
Q

How is the pain associated with pneumonia typically described?

A

Pain evolves with breathing

  • burning or stabbing pain
  • associated with a cough
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6
Q

Leads II, III, & AVF can show which type of MI?

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A

Inferior wall MI

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7
Q

Leads V2, V3, & V4 can show what type of MI?

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A

Anterior wall MI

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8
Q

What can new onset of S3 gallop / sound lead to?

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A
  • Heart Failure
  • Cardiogenic Shock
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9
Q

Nutritional intervention for a patient with a myocardial infarction (MI) includes which action?

a.) Remove all caffeine from the patient’s diet.
b.) Place the patient on a low-protein diet.
c.) Provide the patient with frequent small snacks.
d.) Ensure the patient’s meals are very hot.

A

c.) Provide the patient with frequent small snacks

small meals place less demands on circulatory system

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10
Q

Which conditions are responsible for older adult patients having a greater risk of drug toxicity? (Select all that apply)

a.) Polypharmacy.
b.) Decreased absorption rates in the GI tract.
c.) Decreased creatinine levels.
d.) Increased respiratoyr reserves.
e.) Increased potential for dehydration.

A

a.) Polypharmacy
e.) Increased potential for dehydration

  • Taking multiple drugs increases the risk of toxicity & drug interactions
  • Thirst mechanisms in older patients are impaired, leading to an increased potential for dehydration & drug toxicity
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11
Q

A patient presents with a thirty minute history of substernal chest pain that radiates to his left jaw. Which of the following EKG changes would you expect in this patient if his troponin level came back positive?

a.) QT prolongation
b.) PR shortening
c.) ST elevation
d.) PR widening
e.) ST depression

A

c.) ST elevation

Substernal chest pain with radiation to the jaw is a classic symptom / sign of mycardial infarction (MI)

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12
Q

List the non-modifiable risk factors associated with Acute Coronary Syndrome.

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A
  • Age
  • Heredity
  • Race
  • Sex
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13
Q

List the modifiable risk factors associated with Acute Coronary Syndrome.

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A
  • Cigarette smoking
  • High cholesterol (hypercholesterolemia)
  • Hypertension
  • Physical inactivity
  • Obesity
  • Diabetes mellitus
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14
Q

Which cardiac biomarker is the most specific? How long does it take for this biomarker to initially elevate?

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A

Troponin; takes 2-4 hours to elevate

  • recheck troponin every 4 - 6 hours
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15
Q

Pneumonic for Assessing Pain

A

OPQRST

    • Onset
  • Provocation / Palliative / Precipitating
  • Quality
  • Region / Radiation / Referral
  • Severity / Scale (0 - 10)
  • Timing
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16
Q

What is stable angina?

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A

stable chest pain pattern relieved by rest or NGT

17
Q

What is unstable angina?

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A

Increase in frequency or duration of chest pain

18
Q

What is variant angina?

KNOW THIS!!!

A

Chest pain associated with coronary artery spasm

19
Q

What is an acute myocardial infarction (MI)?

KNOW THIS!!!

A

Any chest pain exceeding 15 minutes & unrelieved by rest or NGT should be presumed as an infarction until proven otherwise.

20
Q

Match the following symptoms with the description of coronary artery disease (CAD).

  • Chest pain associated with coronary artery spasm.
  • Stable chest pattern relieved by rest or NGT.
  • Any chest pain exceeding 15 minutes & unrelieved by rest or NGT should be presumed as an infarciton until proven otherwise.
  • Increase in frequency or duration of chest pain.

a.) Stable angina
b.) Unstable angina
c.) Variant angina
d.) Myocardial infarction (MI)

KNOW THIS!!!

A

a.) Stable angina = Stable chest pain pattern relieved by rest or NGT

b.) Unstable angina = Increase in frequency or duration of chest pain

c.) Variant angina = Chest pain associated with coronary artery spasm

d.) Myocardial infarction (MI) = Any chest pain exceeding 15 minutes & unrelieved by rest or NGT should be presumed as an infarction until proven otherwise

21
Q

What is the difference in a Type 1 & Type 2 Myocardial Infarction?

A

Type 1: due to acute coronary obstruction (plaque)

Type 2: due to oxygen supply demand mismatch without acute coronary obstruction (issue with oxygen supply/demand; NO plaque)

22
Q

What is Type 1 Myocardial Infarction?

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A

Due to coronary artery obstruction (plaque build up)

23
Q

What is Type 2 Myocardial infarction?

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A

Due to oxygen supply/demand mismatch without acute coronary obstruction (issue with oxygen supply/demand; NO plaque)

24
Q

What is Type 3 myocardial infarction?

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A

Sudden cardiac death due to ischemia which is detected by autopsy.

25
Q

What type of EKG finding / change indicates ischemia in acute coronary syndrome?

KNOW THIS!!!

A

T-Wave Inversion

T-wave goes down instead of up

26
Q

What type of EKG finding / change indicates injury in acute coronary syndrome?

KNOW THIS!!!

A

ST Elevation of 2 mm

27
Q

What EKG finding / change indicates infarction in acute coronary syndrome?

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A

abnormal Q waves

28
Q

Match the following EKG findings in acute coronary syndrome:

  • T-wave inversion
  • Abnormal Q wave
  • Absence of ischemia, injury, or infarction at this time
  • ST segement elevation of 2 mm

a.) Normal
b.) Ischemia
c.) Injury
d.) Infarction

A

a.) Normal = absence of ischemia, injury, or infarction at this time

b.) Ischemia = T-wave Inversion

c.) Injury = ST elevation of 2 mm

d.) Infarction = abnormal Q waves

29
Q

What is the door to drug time when using fibrinolytics in patients with an acute myocardial infarction?

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A

< 30 minutes

30
Q

What is the immediate general treatment for a STEMI?

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A
  • Morphine
  • Oxygen
  • Nitroglycerin
  • Aspirin
31
Q

What is a bundle branch block (BBB)?

A

Block of the entire right or left bundle branch

32
Q

How is a bundle branch block (BBB) diagnosed from an EKG?

KNOW THIS!!!

A

QRS > 0.12 seconds

Med Surg 2 - Exam 1 (5 decks)

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