PN 4006 ACTUAL 89 QUESTIONS AND

PN 4006 (ACTUAL / ) 89 QUESTIONS AND

VERIFIED ANSWERS.

Myocardial infarction

Infarct: An area of tissue that dies from inadequate

oxygenation Happens when there is prolonged total occlusion of the coronary arterial blood flow Infarction process can take up to 6 hrs Thrombolytic drugs are given during the 6 hour process to try and save cells

S/S: elevated WBC and temp (3-7 days), chest pain, abd

pain, SOB, pale, diaphoretic, tachycardia, weak pulse

Complications

> Arrhythmias/dysrhythmia: Changes in normal

sequence

> Cardiogenic shock: When left ventricle cannot pump

efficiently (high mortality)

> Ventricular rupture: Rupture in soft necrotic area

(poor prognosis: rapid HF)

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> Arterial embolism: Clot formation

> Venous thrombosis: Thrombosis in vein

> Pulmonary embolism: Thrombus that has travelled to

lungs

> Pericarditis: Inflamed pericardium

> Mitral insufficiency: Compromised mitral leaflets

Dx: Serum enzymes, Isoenzymes, myoglobin, troponin,

creatine kinase (CK), lactase dehydrogenase (LDH), asparate aminotransferase (AST), C-reactive protein,

WBC, ECG

Interventions: Thrombolytic agents, streptokinase,

PTCA, CABG, IV therapy, vasodilators, reeduce anxiety, oxygen, stool softener

Cardiac rehabilitation: Combines exercise, education to

speed up recovery and reduce recurrence > Gradual increase in exercise > Establish physical limitations > Recognition and management of depression > Medication regimen > Smoking cessation > When and how to resume sexual activity > Diet > How to monitor vitals 2 / 4

> How to avoid and minimize stressors > Symptoms to report to physician ASAP

PVD is a general term for disorders that affect blood vessels distant from the central blood vessels supplying myocardium

PAD (peripheral arterial disease) Restriction of blood flow through the arteries distal to the aortic arch

Cause: Hyperhomocysteinemia

S/S: Intermittent claudication (pain, cramping in legs),

discomfort during activity, cold limbs, skin lesions, slow wound healing, slow hair growth, slow toenail growth, difficult to palpate pulses, erectile dysfucntion

Dx: Anklebrachial index (comparison of systolic

pressure in brachial artery), doppler ultrasound

Complications: Critical limb ischemia (Open sores and

infection that do not resolve)

Interventions: Weight loss, exercise, smoking cessation,

control BG, washing-drying-moisturizing feet, podiatrist, avoid crossing legs 3 / 4

Raynaud's disease Periodic constriction of the arteries that supply the extremities, that can last about 15 min Most common in young women Usually in the hands and fingers

Cause: idiopathic (unknown), scleroderma, systemic

lupus erythematosus, rheumatoid arthritis, impaired release of prostaglandins

S/S: Cold, blanched, perspiration, numbness, tingling,

cyanosis, achy, ulcers

Dx: NONE

Interventions: Smoking cessation, IV prostaglandins,

sympathectomy (cutting peripheral nerves), amputation, warm hands in water, McIntyre maneuver (Ski motion), warm clothin in cold weather, avoid OTC decongestants, soak nails before trimming, podiatrist

thrombus formed clot in blood vessel

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