Week 4 – Acute Coronary Syndrome Flashcards
What are the two risk factors for coronary artery disease that increase the workload of the heart and increase myocardial oxygen demand?
a. Hypertension and cigarette smoking.
b. Obesity and smokeless tobacco use.
c. Elevated serum lipids and diabetes mellitus.
d. Physical inactivity and elevated homocystenine levels.
A. Hypertension and cigarette smoking
increases workload of the heart and smoking increases myocardial o2 demand
The nurse determines that teaching about implementing dietary changes to decrease the risk of CAD has been effective when the patient makes which statement?
a. “I should not eat any red meat such as beer, pork, or lamb”
b. “I should have some type of fish at least 3 times a week”
c. “Most of my fat intake should be from olive oil or the oils in nuts”
d. “If i reduce the fat in my diet to about 5% of my calories, I will be much healthier”.
c. “Most of my fat intake should be from olive oil or the oils in nuts”
(ANY red meat, not realistic,, not any type of fish, and reducing fat into to 5%, is too little.
Chronic stable angina is
a. Irreversible
b. Reversible
c. pain does not matter
d. none of the above
b. Reversible (Temporary)
- primary reason for insufficient blood flow is narrowing of coronary arteries by atherosclerosis build up of plaque
For ischemia to occur, the artery is usually how much stenosed?
a. 50%
b. 20%
c. 90%
d. 75%
d. 75%
The left anterior descending artery is one that commonly gets occluded? T/F?
TRUE
In Chronic stable angina the chest pain usually lasts how long?
a. 30 minutes
b. never goes away
c. 3 to 5 minutes
d. 1 hour
c. 3- 5 minuets
can be resolved, that is the major difference
The ECG reveals what for chronic stable angina
a. ST segment depression
b. pro-longed P waves
c. ST segment elevation
d. no P waves
a. ST segment depression (reversible)
ID: 7102916495
The community health nurse is planning health promotion teaching targeted at preventing coronary artery disease (CAD). Which of the following ethnic groups would the nurse select as the highest priority for this intervention?
a. White male b. South Asian female c. Black male d. Aboriginal female
a. White male
The incidence of coronary artery disease (CAD) and myocardial infarction (MI) is highest among White, middle-aged men
Which one of the following individuals would the nurse identify as having the highest risk for coronary artery disease (CAD)?
a. A 45-year-old depressed male with a high-stress job b. A 60-year-old male with below-normal homocysteine levels c. A 54-year-old female vegetarian with elevated high-density lipoprotein (HDL) levels d. A 62-year-old female who has a sedentary lifestyle and body mass index (BMI) of 23 kg/m2
a. A 45-year-old depressed male with a high-stress job
Studies demonstrate that depression and stressful states can contribute to the development of CAD. Elevated HDL levels and low homocysteine levels actually help to prevent CAD. Although a sedentary lifestyle is a risk factor, a BMI of 23 kg/m2 depicts normal weight, and thus the patient with two risk factors is at greatest risk for developing CAD.
After teaching a patient with chronic stable angina about nitroglycerin, the nurse recognizes the need for further teaching when the patient states
a. “I will replace my nitroglycerin supply every six months.”
b. “I can take up to five tablets every three minutes for relief of my chest pain.”
c. “I will take acetaminophen (Tylenol) to treat the headache caused by nitroglycerin.”
d. “I will take the nitroglycerin 10 minutes before planned activity that usually causes chest pain.
b. “I can take up to five tablets every three minutes for relief of my chest pain.”
The recommended dose of nitroglycerin is one tablet taken sublingually (SL) or one metered spray for symptoms of angina. If symptoms are unchanged or worse after five minutes, the patient should be instructed to activate the emergency medical services (EMS) system.
When planning emergent care for a patient with a suspected myocardial infarction (MI), the nurse will anticipate administration of
a. oxygen, nitroglycerin, acetylsalisylic acid (aspirin), and morphine sulphate.
b. oxygen, furosemide (Lasix), nitroglycerin, and meperidine.
c. Acetylsalisylic acid (aspirin), nitroprusside (Nipride), dopamine, and oxygen.
d. nitroglycerin, lorazepam (Ativan), oxygen, and warfarin (Coumadin).
a. oxygen, nitroglycerin, acetylsalisylic acid (aspirin), and morphine sulphate.
MONA
Emergency care of the patient with chest pain includes the administration of oxygen, nitroglycerin, aspirin, and morphine sulphate. These interventions serve to relieve chest pain, improve oxygenation, decrease myocardial workload, and prevent further platelet aggregation.
When evaluating a patient’s knowledge regarding a low-sodium, low-fat cardiac diet, the nurse recognizes additional teaching is needed when the patient selects which of the following food choices?
a. Baked flounder b. Angel food cake c. Baked potato with margarine d. Canned chicken noodle soup
d. Canned chicken noodle soup
Canned soups are very high in sodium content. Patients need to be taught to read food labels for sodium and fat content.
The nurse is providing teaching to a patient recovering from a myocardial infarction (MI). Discussion regarding resumption of sexual activity should be
a. delegated to the primary care provider. b. discussed along with other physical activities. c. avoided because it is embarrassing to the patient. d. accomplished by providing the patient with written material.
b. discussed along with other physical activities.
it is a necessary component of patient teaching. It is helpful to consider sex as a physical activity and to discuss or explore feelings in this area when other physical activities are discussed. Although providing the patient with written material is appropriate, it should not replace a verbal dialogue that can address the individual patient’s questions and concerns.
Postoperative care of a patient undergoing coronary artery bypass graft (CABG) surgery includes monitoring for which of the following common complications?
a. Dehydration b. Paralytic ileus c. Atrial dysrhythmias d. Acute respiratory distress syndrome
c. Atrial dysrhythmias
Postoperative dysrhythmias, specifically atrial dysrhythmias, are common in the first three days following CABG surgery. Although the other complications could occur, they are not common complications.
A patient was admitted to the emergency department 24 hours earlier with complaints of chest pain that were subsequently attributed to ST-segment–elevation myocardial infarction (STEMI). Which of the following complications of MI should the nurse anticipate?
a. Unstable angina b. Cardiac tamponade c. Sudden cardiac death d. Cardiac dysrhythmias
d. Cardiac dysrhythmias
The most common complication after MI is dysrhythmias, which are present in 80% of patients. Unstable angina is considered a precursor to MI rather than a complication. Cardiac tamponade is a rare event, and sudden cardiac death is defined as an unexpected death from cardiac causes; cardiac dysfunction in the period following an MI would not be characterized as sudden cardiac death.
