Med/Surg: Evolve Chapter 33

In caring for the patient with angina the patient states, "I walked to the bathroom. While I was having a bowel movement, I started having the worst chest pain ever. It was similar to the pain I had at home. The pain went away rather quickly." What further assessment data should the nurse obtain from the patient?

"In what areas did you feel this pain?"

The nurse teaches a student nurse about diagnostic studies used for acute coronary syndrome. Which statement made by the student nurse indicates effective learning?

"Serum cardiac markers are proteins that are released from necrotic heart muscle."

The nurse provides information about thrombolytic therapy to a group of student nurses. Which statement made by a student nurse indicates the need for further teaching?

"Significant facial trauma within the past 3 months is a relative contraindication."

A patient receives morphine sulfate to relieve chest pain. The nurse should monitor this patient for which complications associated with the medication? Select all that apply.

*Bradypnea *Hypotension

A patient is admitted to the intensive care unit with a diagnosis of myocardial infarction. The patient is in stable condition. The nurse recognizes what common medications that are used to treat this condition? Select all that apply.

*Dual antiplatelet therapy Correct 5 *intravenous (IV) nitroglycerin Correct 6 *Low molecular weight heparin (LMWH)

The nurse is caring for a patient that is scheduled for an angioplasty with placement of a drug-eluting stent. The nurse recalls that the steps of the stent procedure occur in what order?

1. Blockage is identified. 2. Stent is placed into the coronary artery. 3. Balloon is placed inside and inflated. 4. Improved blood flow occurs. 5. Cells line the blood vessels to grow through and around the stent, to help secure it.

A patient that is being discharged from the hospital after acute coronary syndrome will be participating in cardiac rehabilitation. What information should the nurse provide about the early recovery phase of rehabilitation?

Activity level is increased gradually with supervision by the rehabilitation team and with ECG monitoring.

A patient reports heaviness and burning sensation in the substernal and retrosternal region. Assessment findings include a fasting blood glucose of 190 mg/dL and blood pressure of 145/90 mm Hg. The nurse recognizes that which other finding indicates sympathetic nervous system stimulation?

Ashen, clammy, and cool skin

The nurse is caring for a patient with a myocardial infarction. The health care provider prescribes an intravenous infusion of alteplase. What is the priority nursing intervention during the administration of this medication?

Assess neurologic status.

The nurse is providing postoperative care to a patient that underwent coronary artery bypass graft (CABG) surgery. The nurse should monitor the patient for what common complication?

Atrial dysrhythmias

The nurse provides a list of health-promoting regular physical activity examples to a patient with coronary artery disease (CAD). Which activity is appropriate to be included on the list?

Brisk walking (3 to 4 miles per hour)

The nurse is providing teaching to a patient recovering from a myocardial infarction (MI). How should resumption of sexual activity be discussed?

Discussed along with other physical activities

The nurse is caring for a patient one month after the patient's cardiac surgery. The patient is hospitalized with a three-day history of chest pain, joint pain, and a body temperature of 101°F. The patient's lab results include a white blood cell count of 15,000/mcL and an erythrocyte sedimentation rate of 30 mm/hr. Which condition does the nurse suspect?

Dressler Syndrome

The nurse recognizes that which type of myocardial infarction (MI) may occur due to blockage of the right coronary artery?

Inferior wall MI

A patient with Prinzmetal's angina who takes a short-acting nitrate reports feeling dizzy while changing positions. What prescription does the nurse anticipate?

Intravenous fluid bolus

The nurse provides a student nurse with information related to management of a patient following cardiac catheterization. The nurse should explain that which intervention is the specific responsibility of the nurse, rather than that of Unlicensed Assistive Personnel (UAP)?

Monitoring neurovascular changes

The nurse assesses a patient with papillary muscle dysfunction. Which observation supports the patient's diagnosis?

Murmur at the cardiac apex

Cardiac biomarker levels are being evaluated for a patient who is suspected of having a myocardial infarction (MI). The nurse recognizes that which biomarker lacks specificity and that its role in diagnosing an MI is limited?

Myoglobin

The nurse recognizes indications of unstable angina if a patient experiences what symptoms?

Nausea, indigestion, and shortness of breath

When planning emergent care for a patient with a suspected myocardial infarction (MI), what should the nurse anticipate administrating?

Oxygen, nitroglycerin, aspirin, and morphine

The nurse provides basic physical activity guidelines for a patient that is being discharged following acute coronary syndrome (ACS). The nurse recommends following the FITT formula, which includes which guidelines?

Physical activity that is regular, rhythmic, and repetitive

A patient asks the nurse about resuming sexual activity after acute coronary syndrome (ACS). What should the nurse include in the patient's teaching plan?

Taking a prophylactic nitrate may decrease chest pain during sexual activity.

A patient tells the nurse, "I had severe chest pain six days ago." The nurse identifies that which cardiac biomarker will be most helpful in determining whether the patient had a myocardial infarction at the time the patient experienced chest pain?

Troponin