Acute Coronary Syndrome NCLEX

acute coronary syndrome NCLEX

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Terms in this set (63) Central Piedmont Community College NUR 213 Save The client with unstable angina has received education about the acute coronary syndrome. Which of the following indicates that he understood the teaching?

• "This is a big warning, I must modify

my lifestyle or risk having a heart attack in the next year."

• "Angina is just a temporary

interruption of blood flow to my heart."

• "I need to tell my wife I've had a

heart attack."

• "Because this was temporary, I will

not need to take any medications for my heart."

• Among people who have unstable angina, 10% to

30% have a myocardial infarction (MI) within 1 year.Although angina pain is temporary, it reflects underlying coronary artery disease (CAD), which requires attention, including lifestyle modifications.Unstable angina reflects tissue ischemia, but infarction represents tissue necrosis. Clients with underlying CAD may need medications such as aspirin (ASA), lipid-lowering agents, antianginals, or antihypertensives.

The nurse is caring for a group of clients who have sustained myocardial infarction (MI). The nurse observes the client with which type of MI most carefully for the development of left ventricular heart failure?

• Inferior wall
• Anterior wall
• Lateral wall
• Posterior wall
• Owing to the large size of the anterior wall, the

amount of tissue infarction may be large enough to decrease the force of contraction, leading to heart failure. with the inferior wall, the client is more likely to develop right ventricular MI. regarding clients with obstruction of the circumflex artery may experience a lateral wall or posterior wall MI and sinus dysrhythmias.The nurse is providing a cardiac class for a women's group. The nurse emphasizes that which characteristics place women at high risk for myocardial infarction (MI)?Select all that apply.Premenopausal Increasing age Family history Abdominal obesity Breast cancer Increasing age, especially after 70 yo Family history is a risk factor in both men and women

Abdominal obesity: A large waist size/abdominal

obesity is a risk factor for both metabolic syndrome and MI.The nurse is teaching a group of teens about prevention of heart disease. Which point should the nurse emphasize?

1.Reduce abdominal fat.

• Avoid stress.
• Do not smoke or chew tobacco.
• Avoid alcoholic beverages.
• Tobacco exposure, including secondhand

smoke, reduces coronary blood flow, causes vasoconstriction and endothelial dysfunction and thickening of the vessel wall, increases carbon monoxide, and decreases oxygen. Because this is highly addicting, beginning smoking in the teen years may lead to decades of exposure.

The nurse is teaching the client that metabolic syndrome can increase the risk for myocardial infarction (MI).Which signs of metabolic syndrome should the nurse include in the discussion? Select all that apply.Truncal obesity Hypercholesterolemia Elevated homocysteine levels Glucose intolerance Client taking losartan (Cozaar)

Hypercholesterolemia: Decreased high-density

lipoprotein cholesterol (HDL-C) (usually with high low-density lipoprotein cholesterol [LDL-C]), HDL- C less than 40 mg/dL for men or less than 50 mg/dL for women, or taking an anticholesterol drug is a sign of metabolic syndrome.

Glucose intolerance: Increased fasting blood

glucose (caused by diabetes, glucose intolerance, or insulin resistance) is included in the constellation of metabolic syndrome.

Client taking losartan (Cozaar): Blood pressure

greater than 130/85 or taking antihypertensive medication indicates metabolic syndrome.Which of the following atypical symptoms may be present in the female client experiencing myocardial infarction (MI)? Select all that apply.Sharp, inspiratory chest pain Dyspnea Dizziness Extreme fatigue Anorexia Dyspnea, Dizziness, Extreme fatigue

To validate that the client has had a myocardial infarction (MI), the nurse assesses for positive findings on which tests?

• Creatine kinase-MB fraction (CK-

MB) and alkaline phosphatase

• Homocysteine and C-reactive

protein

• Total cholesterol, low-density

lipoprotein (LDL) and high-density lipoprotein (HDL) cholesterols

• Myoglobin and troponin
• Myoglobin, troponin, and CK-MB are the cardiac

markers used to determine whether MI has occurred. Homocysteine and C-reactive protein are markers of inflammation, which may represent risk for MI, but they are not diagnostic for MI.When caring for a client with acute myocardial infarction, the nurse recognizes that prompt pain management is essential for which reason?

1.The discomfort will increase client anxiety and reduce coping.

• Pain relief improves the oxygen

supply and decreases oxygen demand.

• Relief of pain indicates that the

myocardial infarction is resolving.

• Pain medication should not be

used until a definitive diagnosis has been established.

• The focus of pain relief is on reducing myocardial

oxygen demand. Chest discomfort will increase anxiety, but it may not affect coping. The major purpose of pain relief is to reduce myocardial oxygen demand. Relief of pain is secondary to the use of opiates or indicates that the tissue infarction is complete.