NR 341 Exam #2 Review
What is the first line treatment for hypotension and hypertension? - Answer Fluid
management
What is the first line of defense for someone who is at risk for CAD? - Answer Diet
modifications and exercise
What are non-modifiable risk factors for CAD? - Answer -Family hx (age 55 or younger)
-Age
-Gender
-Race
What are modifiable risk factors for CAD? - Answer -Hyperlipidemia
-Smoking, tobacco use
-HTN
-Diabetes
-Obesity
-Physical inactivity
Is alcohol intake a risk factor for CAD? - Answer NO. Alcohol intake is NOT related to
CAD.
If a patient is receiving cardiac catheterization, what must the nurse assess prior to the
procedure? - Answer The nurse must assess renal function, allergies, and medications.
Metformin (used for T2D) interacts with the contrast dye and can cause kidney damage
= call HCP and verify order.
How long should a patient be NPO prior to a cardiac catheterization? - Answer Unless
it's an emergency, a patient should be NPO 8-12 hours prior to the procedure.
If a patient is receiving a right side cardiac catheterization, where will the provider place
the access? - Answer The provider will achieve venous access through the femoral vein
If a patient is receiving a left side cardiac catheterization, where will the provider place
the access? - Answer The provider will achieve arterial access through the femoral
artery or radial artery.
What are important nursing interventions following a cardiac catheterization? - Answer -
Apply pressure to the insertion site.
-Maintain HOB at 30 degrees or less.
-Frequent neurovascular checks on the affected extremity.
-Monitor insertion site for infection/bleeding.
-Maintain bedrest for 4-6 hours following procedure.
-Keep affected extremity straight.
-Frequent vital signs per doctor's order.
, NR 341 Exam #2 Review
What is the gold standard to rule out an MI in a patient experiencing chest pain? -
Answer Gold standard is to obtain a 12-lead EKG within 10 minutes of arrival.
What is the priority intervention for a patient experiencing chest pain? - Answer Obtain
an EKG FIRST, then obtain vitals.
STEMI vs. NSTEMI - Answer STEMI: ST elevation
NSTEMI: no ST elevation or EKG changes but has an increase in cardiac biomarkers or
T wave depression/inversion (could be an old MI)
How should you obtain a patient's blood sample for cardiac biomarkers? - Answer Draw
patient's blood in a serial fashion (I.e., q 6 hours x 3).
What labs do you look at to determine if a patient is experiencing an MI? - Answer
Troponin, CK-MB, and myoglobin. NOT BNP (this is indicative of chronic HF, not an
acute problem).
What specific labs are included in cardiac biomarkers? - Answer -Troponin: I & T most
specific for cardiac muscle; detects recent myocardial damage.
-CK: not necessarily specific to cardiac muscle; can increase when there is muscle
damage anywhere in the body.
-CK-MB: cardiac specific.
What is the MONA protocol for chest pain? - Answer 1. Oxygen FIRST
2. Nitroglycerin
3. Aspirin
4. Morphine
Why is morphine given in the MONA protocol for chest pain? - Answer Although
morphine can help manage pain, it is given to decrease the myocardial oxygen
consumption need (RR, pain, and anxiety should decrease after administration)
What is the management of acute coronary syndrome and MI? - Answer In addition to
EKG, vitals, etc...
-Give thrombolytic (to dissolve existing clots).
-Start diuretics to pull off extra fluid (dec. CO and work of the heart).
-Limit fluids (to dec. risk of circulatory overload0.
What type of diet should a patient who is post-op from a CABG follow? - Answer Patient
must maintain a low-cholesterol diet. Cholesterol comes from animal-derived foods
(only animal-derived food without cholesterol is egg whites). Patient can have beans,
fruits, veggies, etc.
Describe left-sided heart failure - Answer Pulmonary congestion occurs when left
ventricle cannot effectively pump blood out of the ventricle into aorta and systemic
What is the first line treatment for hypotension and hypertension? - Answer Fluid
management
What is the first line of defense for someone who is at risk for CAD? - Answer Diet
modifications and exercise
What are non-modifiable risk factors for CAD? - Answer -Family hx (age 55 or younger)
-Age
-Gender
-Race
What are modifiable risk factors for CAD? - Answer -Hyperlipidemia
-Smoking, tobacco use
-HTN
-Diabetes
-Obesity
-Physical inactivity
Is alcohol intake a risk factor for CAD? - Answer NO. Alcohol intake is NOT related to
CAD.
If a patient is receiving cardiac catheterization, what must the nurse assess prior to the
procedure? - Answer The nurse must assess renal function, allergies, and medications.
Metformin (used for T2D) interacts with the contrast dye and can cause kidney damage
= call HCP and verify order.
How long should a patient be NPO prior to a cardiac catheterization? - Answer Unless
it's an emergency, a patient should be NPO 8-12 hours prior to the procedure.
If a patient is receiving a right side cardiac catheterization, where will the provider place
the access? - Answer The provider will achieve venous access through the femoral vein
If a patient is receiving a left side cardiac catheterization, where will the provider place
the access? - Answer The provider will achieve arterial access through the femoral
artery or radial artery.
What are important nursing interventions following a cardiac catheterization? - Answer -
Apply pressure to the insertion site.
-Maintain HOB at 30 degrees or less.
-Frequent neurovascular checks on the affected extremity.
-Monitor insertion site for infection/bleeding.
-Maintain bedrest for 4-6 hours following procedure.
-Keep affected extremity straight.
-Frequent vital signs per doctor's order.
, NR 341 Exam #2 Review
What is the gold standard to rule out an MI in a patient experiencing chest pain? -
Answer Gold standard is to obtain a 12-lead EKG within 10 minutes of arrival.
What is the priority intervention for a patient experiencing chest pain? - Answer Obtain
an EKG FIRST, then obtain vitals.
STEMI vs. NSTEMI - Answer STEMI: ST elevation
NSTEMI: no ST elevation or EKG changes but has an increase in cardiac biomarkers or
T wave depression/inversion (could be an old MI)
How should you obtain a patient's blood sample for cardiac biomarkers? - Answer Draw
patient's blood in a serial fashion (I.e., q 6 hours x 3).
What labs do you look at to determine if a patient is experiencing an MI? - Answer
Troponin, CK-MB, and myoglobin. NOT BNP (this is indicative of chronic HF, not an
acute problem).
What specific labs are included in cardiac biomarkers? - Answer -Troponin: I & T most
specific for cardiac muscle; detects recent myocardial damage.
-CK: not necessarily specific to cardiac muscle; can increase when there is muscle
damage anywhere in the body.
-CK-MB: cardiac specific.
What is the MONA protocol for chest pain? - Answer 1. Oxygen FIRST
2. Nitroglycerin
3. Aspirin
4. Morphine
Why is morphine given in the MONA protocol for chest pain? - Answer Although
morphine can help manage pain, it is given to decrease the myocardial oxygen
consumption need (RR, pain, and anxiety should decrease after administration)
What is the management of acute coronary syndrome and MI? - Answer In addition to
EKG, vitals, etc...
-Give thrombolytic (to dissolve existing clots).
-Start diuretics to pull off extra fluid (dec. CO and work of the heart).
-Limit fluids (to dec. risk of circulatory overload0.
What type of diet should a patient who is post-op from a CABG follow? - Answer Patient
must maintain a low-cholesterol diet. Cholesterol comes from animal-derived foods
(only animal-derived food without cholesterol is egg whites). Patient can have beans,
fruits, veggies, etc.
Describe left-sided heart failure - Answer Pulmonary congestion occurs when left
ventricle cannot effectively pump blood out of the ventricle into aorta and systemic
