Acute Coronary Syndrome -

A patient has been diagnosed with acute coronary syndrome. Which assessment findings would the nurse expect to see?

Pain occurs at rest. The pain from acute coronary syndrome may occur while the patient is active or at rest, asleep or awake. Pain may radiate to other areas. The pain from acute coronary syndrome may radiate to the neck, lower jaw, and arms or to the back. Severe, immobilizing chest pain. Pain from acute coronary syndrome usually lasts for 20 minutes or longer, is more severe than usual chest pain, and may be described as immobilizing.

Which patients are more likely to require off-pump coronary artery bypass (OPCAB) surgery instead of coronary artery bypass graft (CABG) surgery?

Patient with renal complications whose urine output is 50 mL per day Patient with left ventricular heart failure, obesity, and poor wound healing Patient with history of an ischemic stroke who has difficulty using the right arm

Unstable angina is considered an emergency because of which pathophysiological occurrence?

Platelet aggregation blocks the artery. Unstable angina results from a ruptured plaque that causes platelet aggregation, which forms a thrombus. The thrombus can partially block blood flow to the heart resulting in myocardial injury, making this a medical emergency.

The Emergency Medical Service (EMS) was called to assess a person who had collapsed. The patient's electrocardiogram (ECG) has been transmitted to the emergency department for interpretation and intervention. Which results would require the patient's immediate transport for diagnostic cardiac catheterization?

ST elevation

A patient comes to the emergency department with complaints of chest pain, and heart monitoring is initiated. The nurse notes T-wave inversion on the electrocardiogram (ECG). The patient questions the nurse about what this means. Which is the nurse's best response?

"You are having decreased blood flow to part of the heart."

A patient comes to the emergency department with complaints of chest pain. The initial ECG shows ST-segment elevation in more than three leads. Which intervention should the nurse perform first?

Administer oxygen and nitrates.

A patient is being discharged with prescriptions for aspirin and clopidogrel after percutaneous coronary intervention (PCI) to treat acute coronary syndrome. The patient wants to know why these medications need to be taken if the artery is open after the stent was placed. Which is the best response?

Aspirin and clopidogrel can prevent another clot from forming.

The nurse administers morphine as ordered to a patient experiencing chest pain of 9 on a scale of 10 that is unrelieved by three doses of nitroglycerin. Which assessment finding would be most concerning?

Distended neck veins

A patient is complaining of angina that has increased in intensity. The patient's vital signs are as follows: blood pressure 94/52, heart rate 122, respiratory rate 20, temperature 99.9, and oxygenation saturation 93%. An electrocardiogram for the patient shows elevated ST segment in leads II and III. Which intervention has the highest priority in the nursing management of this patient?

Notification of the health care provider

A male patient diagnosed with acute ST-segment-elevation myocardial infarction (STEMI) is receiving thrombolytic therapy. Which assessment finding by the nurse would require immediate intervention?

The skin is pale and cool with bilateral pedal pulses faintly palpable. Bleeding is a complication associated with thrombolytic therapy. Skin that is pale and cool, in association with faint peripheral pulses, can indicate low blood pressure related to major bleeding, which requires immediate intervention.

Which statement describes how unstable angina differs from chronic stable angina?

Unstable angina has a random onset. Unstable angina differs from chronic stable angina because it is not predictable and can have a random onset.