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The nurse instructs a 68-year-old woman with hypercholesterolemia about natural lipid-lowering therapies. The nurse determines further teaching is necessary if the patient makes which statement?

"I will take garlic instead of my prescription medication to reduce my cholesterol."

a second 12 lead preformed on a patient 4 hours after the onset of chest pain reveals ST segment elevation this indicates

MI associated with prolonged and complete coronary thrombosis

why must unstable angina be identified and rapidly treated

plaque deterioration may cause complete thrombus of the vessel lumen

The nurse is examining the ECG of a patient who has just been admitted with a suspected MI. Which ECG change is most indicative of prolonged or complete coronary occlusion?

Pathologic Q wave

what is involved in CABG surgery

internal mammary artery will be detached from the chest wall and attached to a coronary artery distal to the stenosis

what causes the pain that occurs with myocardial ischemia

lactic acid accumulation

The nurse would assess a patient with complaints of chest pain for which clinical manifestations associated with a myocardial infarction (MI) (select all that apply)?

Ashen skin Diaphoresis Nausea and vomiting S3 or S4 heart sounds

The nurse prepares a discharge teaching plan for a 44-year-old male patient who has recently been diagnosed with coronary artery disease. Which risk factor should the nurse plan to focus on during the teaching session?

Elevated serum lipids

most common finding in individuals at risk for sudden cardiac death is

left ventricular dysfunction

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

Discussed along with other physical activities

NSTEMI is treated with

acute intensive drug therapy

__ is added for vasodilation and remodeling

captropil

A 52-year-old male patient has received a bolus dose and an infusion of alteplase (Activase) for an ST-segment elevation myocardial infarction (STEMI). To determine the effectiveness of this medication, the nurse should assess the patient for the

presence of chest pain.

when instructing the patient with angina about taking subcut nitro tabs what should the nurse teach the patient

sit and put one tab under the tongue when chest pain occurs

when teaching an older adult with CAD how to manage the treatment program for angina which guideline does the nurse use to teach the patient

sit for 2-5 minutes before standing when getting out of bed

to detect and treat the most common complications from an MI what should the nurse do

use continuous cardiac monitoring

a hospitalized patient with a history of chronic stable angina tells the nurse that she is having chest pain. the nurse bases his actions on the knowledge that ischemia

will be relieved by rest, nitro, or both

In caring for the patient with angina, the patient said, "I walked to the bathroom. While I was having a bowel movement, I started having the worst chest pain ever, like before I was admitted. I called for a nurse, but the pain is gone now." What further assessment data should the nurse obtain from the patient?

"In what areas did you feel this pain?"

A 74-year-old man with a history of prostate cancer and hypertension is admitted to the emergency department with substernal chest pain. Which action will the nurse complete before administering sublingual nitroglycerin?

Obtain a 12-lead electrocardiogram (ECG)

__ is most likely to be in the fibrous stage of development of coronary artery disease

32, thickened coronary arterial walls with narrowed vessel lumen

Which patient is at greatest risk for sudden cardiac death?

52-year-old African American man with left ventricular failure

while obtaining histories which patiet does the nurse identify as having the highest risk for cad

68 white woman BP of 172/100 and is physically unactive

Which individuals would the nurse identify as having the highest risk for CAD?

A 45-year-old depressed male with a high-stress job

a hypertensive patient is just expeianced an MI what drug should be given next

ACE inhibitor

a petient with unstable angina will recieve

ACE inhibitor antiplatelet therapy IV nitro

The patient is being dismissed from the hospital after ACS and will be attending rehabilitation. What information does the patient need to be taught about the early recovery phase of rehabilitation?

Activity level is gradually increased under cardiac rehabilitation team supervision and with ECG monitoring

The patient comes to the ED with severe, prolonged angina that is not immediately reversible. The nurse knows that if the patient once had angina related to a stable atherosclerotic plaque and the plaque ruptures, there may be occlusion of a coronary vessel and this type of pain. How will the nurse document this situation related to pathophysiology, presentation, diagnosis, prognosis, and interventions for this disorder?

Acute coronary syndrome (ACS)

For which problem is percutaneous coronary intervention (PCI) most clearly indicated?

Acute myocardial infarction

Postoperative care of a patient undergoing coronary artery bypass graft (CABG) surgery includes monitoring for what common complication?

Atrial dysrhythmias

__ is the leading cause of death in women with a higher mortality rate after MI than in men

CAD

endothelial alteration may be caused by chemical irritants such as hyperlipidemia or by tobacco use

CAD

__ can differintiate unstable angina from an MI

CK-MBenzyme elevations

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

Oxygen, nitroglycerin, aspirin, and morphine

why is docusate sodium used after an MI

minimizes bradycardia from vagal stimulation

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 food choice?

Canned chicken noodle soup

A patient was admitted to the emergency department (ED) 24 hours earlier with complaints of chest pain that were subsequently attributed to ST-segment-elevation myocardial infarction (STEMI). What complication of MI should the nurse anticipate?

Cardiac dysrhythmias

A female patient who has type 1 diabetes mellitus has chronic stable angina that is controlled with rest. She states that over the past few months she has required increasing amounts of insulin. What goal should the nurse use to plan care that should help prevent cardiovascular disease progression?

Keep Hgb A1C less than 7%

chest pain with no relief from of the pain with rest or position change indicates

MI

Which antilipemic medications should the nurse question for a patient with cirrhosis of the liver (select all that apply)?

Ezetimibe (Zetia) Atorvastatin (Lipitor)

If the MI patients pain was not relieved with nitro what drug is given next

IV morphine

A patient experienced sudden cardiac death (SCD) and survived. What should the nurse expect to be used as preventive treatment for the patient?

Implantable cardioverter-defibrillator (ICD)

The nurse assesses the right femoral artery puncture site as soon as the patient arrives after having a stent inserted into a coronary artery. The insertion site is not bleeding or discolored. What should the nurse do next to ensure the femoral artery is intact?

Inspect the patient's right side and back.

A male patient who has coronary artery disease (CAD) has serum lipid values of LDL cholesterol 98 mg/dL and HDL cholesterol 47 mg/dL. What should the nurse include in the patient teaching?

The lipid levels are normal.

When providing nutritional counseling for patients at risk for CAD, which foods would the nurse encourage patients to include in their diet (select all that apply)?

Tofu Walnuts Tuna fish

The community health nurse is planning health promotion teaching targeted at preventing coronary artery disease (CAD). Which ethnic group would the nurse select as the highest priority for this intervention?

White male

the nurse is caring for a patietn who is 2 days post MI. the patient reports that she is experiancing chest pain. she states it hurts when i take a deep breath which action would be a priority

obtain vital signs and auscultate for a pericardial friction rub

in teaching a patient about CAD the nurse explains the disorder includes

abnormal levels of cholesterol especially lowdensity lipoproteins (LDL) accumulation of lipid and fibrous tissue within th ecoronary arteries development of angina

to which patients should a nurse teach the therapeutic lifestyle changes diet to reduce the risk of CAD

all patients to reduce CAD risk

suspect stable angina over a MI when

pain is relieved by nitro

treatment used first for the patient with a confirmed MI to open the blocked artery within 90 minutes of arrival to the facility

percutaneous coronary intervention (PCI)

After teaching a patient with chronic stable angina about nitroglycerin, the nurse recognizes the need for further teaching when the patient makes which statement?

can take up to five tablets every 3 minutes for relief of my chest pain

__ means thrombolitic therapy to MI was not successful

continued pain

what noninvasive diagnostic test can be used to differentiate angina from other types of chest pain

coronary angiogram

during treatment with reteplase for a patient with a STEMI which finding should most concern the nurse

decrease in responsiveness

a patient is recovering from an uncomplicated MI which rehab guideline is apriority to include in the teaching plan

exercise for 30 minutes 5 times a week

which serum lipid elevation along with elevated LDL is strongly assosiated with CAD

fasting triglycerides

If crackles and S3 heart sound are present which complication should the nurse susect and further investigate

heart failure

tachycardia that is in response to SNS to the pain of ischemia is detrimental because

impairs the perfusion of the coronary arteries