Chapter 53: Management of ST-Elevation Myocardial Infarction (Study Guide)

What is an expected response within minutes of administering IV morphine during a STEMI? (Select all that apply.) A. Decrease in pain. B. Improved hemodynamics. C. Increase in depth of respirations. D. Inversion of T wave on ECG.

A. Decrease in pain. B. Improved hemodynamics.

The nurse knows that nitroglycerin decreases the workload of the heart by: A. dissolving existing clots. B. preventing clot formation. C. slowing the heart rate. D. reducing venous return to the heart.

D. reducing venous return to the heart.

Complete the statement: Risk factors for STEMI include __________1___________, ________2________, ___________3___________, ________4__________, ________5_________, ________6_______, and _________7___________.

1. Advanced age. 2. Family history of MI. 3. Obesity. 4. High serum cholesterol. 5. Hypertension. 6. Smoking. 7. Diabetes.

Complete the statement: Current recommendations for MI include administering oxygen if O2 saturation is less than _______________________.

90%.

When caring for a patient during a STEMI who is prescribed alteplase, the nurse who would question the prescriber if which drug was also prescribed? A. Abciximab (ReoPro). B. Clopidogrel (Plavix). C. Lisinopril (Zestril). D. Low molecular weight (LMW) heparin (Lovenox).

A. Abciximab (ReoPro).

Research suggests which treatment(s) improve(s) outcomes in STEMI? (Select all that apply.) A. Administration of aspirin. B. Administration of a beta-blocker. C. Administration of ibuprofen (NSAID). D. Administration of morphine. E Administration of SL nitroglycerin. F. Administration of oxygen.

A. Administration of aspirin. B. Administration of a beta-blocker. D. Administration of morphine. E Administration of SL nitroglycerin.

The ED triage nurse answers the call of a patient who has a history of angina pectoris and chronic obstructive pulmonary disease (COPD). The patient reports chest pain that has not been relieved by three doses of nitroglycerin. The patient had been told by his physician that he should take chewable aspirin should this occur, but the nurse does not have any aspirin. What should the nurse tell the patient to do? A. Call 911. B. Call his physician for directions. C. Take ibuprofen and seek medical care. D. Turn on his home oxygen and rest.

A. Call 911.

A protocol in the emergency department (ED) is to administer four chewable 81-mg aspirin tablets (total 324-mg) to patients with suspected MI. A student nurse asks the the nurse why four chewable aspirin tablets are administered instead of two regular aspirin tablets (650 mg). What is the most accurate explanation for this protocol for the first dose of aspirin? A. Aspirin is an acid, and acids are more readily absorbed in the acid environment of the stomach. B. Chewable forms of aspirin are readily absorbed through the buccal mucosa. C. Chewing breaks the tablet into smaller particles, which are more readily absorbed in the intestines. D. Exceeding 325-mg doses can offset the vasodilation and antiplatelet effects of lower doses.

B. Chewable forms of aspirin are readily absorbed through the buccal mucosa.

Which laboratory result in the history of a patient who is experiencing STEMI would be most important to report to the prescriber who has just ordered captopril (Capoten)? A. AST 120 international units/L. B. BUN 15 mg/dL. C. eGFR 38 mL/min. D. Troponin T 0.8 ng/mL.

C. eGFR 38 mL/min.

Which drug prescribed for acute STEMI should be withheld and the prescriber consulted immediately if the patient's pulse is 118 beats/min? A. Aspirin. B. Atenolol. C. Morphine. D. Nitroglycerin.

D. Nitroglycerin.

Because of the impairment of blood flow and resulting acidosis with STEMI, the nurse would expect the patient to exhibit. A. Bradycardia. B. Edema. C. Flushing. D. Rapid, deep respirations.

D. Rapid, deep respirations.

A patient who is undergoing an acute STEMI is prescribed metoprolol 50 mg by mouth every 6 hours. It would be a priority to immediately contact the prescriber if which assessment finding was present? A. Altered taste. B. Insomnia. C. Rhinorrhea. D. Wheezing.

D. Wheezing.

Complete the statement: The "ST" in STEMI stands for elevation of the __________________ of the PQRST of the ECG.

ST segment

Complete the statement: Myocardial infarctions where there is partial blockage of the coronary artery are called non-__________ MI.

ST-elevation

Complete the statement: The abbreviation for an MI with complete blockage of the coronary artery is __________________:

STEMI

Complete the statement: Remodeling of the myocardium that occurs with MI is driven in part by local production of ___________________.

angiotensin II.

Complete the statement: Almost all coronary occlusion occur at the site of a ruptured _________________.

atherosclerotic plaque.

Complete the statement: The medical term for a heart attack is ______________:

myocardial infarction

Complete the statement: Intracellular proteins released when cardiac muscle cells are damaged are called ______________ and _____________.

troponins; creatine kinase.