Nu 372 Final Exam With Correct Answers
m m m m m m m
Anginam-mANSWERm-chestmpainmbroughtmaboutmbym*myocardial mischemia*
*Manifestations:*
-*ChestmPain*:msubsternal,mprecordial,mmaym*radiatemtomneck/arms/shoulders mormjaw*
-Usuallymlasts m*2-5mminutes*
-Quality:mtight,msqueezing,mconstricting,mheavymsensation,mburning,mdull,maching,mconstant
-
Dyspnea,mpallor,mtachycardia,manxietymandmfear,mindigestion,mnausea,mvomiting,muppermback
mpain
-ECGmchanges:m*T-waveminversionmandmdepressedmSTmsegments*m(*invertedmT-
wavem=mmyocardial mischemia*)
*Treatment*:
-
*Nitroglycerin*:mgoal mismtomreducemoxygenmdemandmandmincreasedmoxygenmsupplymtomthemmyoc
ardium
-*Organicmnitrates*:mshortmandmlong-
termmforms,musedmtomtreatmacutemanginamattacks mandmpreventmangina
*Nursingminterventions*:
-knowmwhenmthemanginamis mhappening
-decreasemdemands mofmO2mneededmonmthemheart
-increasemeffectiveness mofmmedication
-reducemanxiety
-patientmshouldm*stopmall mactivitymandmsitmandmrest*minmbedm(*semi-fowlermposition*)
-*administermoxygen*m2mL/minmthroughmnasal mcannula
,-assess mpatients m*pain,mvital msigns,mRR*
-*Tell mpatient mtomcarrymnitroglycerinmatmall mtimes*
Stablemanginam-mANSWERm-Mostmcommonmtype
-Chestmpainmthatmoccurs mwhenmampersonmis m*activemormundermseveremstress*m(cold,metc.)
-Usuallym*subsides mwithmrest*
-*Treatment*:mnitrates,mreducingmstress/activity
*Clinical mManifestations*:manginamthatmusuallymoccurs mwhenmwork mofmthemheartmincreasedmbymp
hysical mexertion:mphysical mactivity,memotion,mstress,meatingmamheavymmeal,mexposuremtomcold
Unstable manginam-mANSWERm-Anginamthatmis m*notmrelievedmwithmrest*
-Requires m*medical mintervention*
-Occurs mwithm*increasedmfrequency,mseverity,mandmduration*
-Painmoccurs mwithmdecreasingmlevel mofmactivitymormstress
-Maymoccurmwhenmthempatientmis mjustmresting
-Patient mis m*atmrisk mformmyocardial minfarction*m(MI)
*Clinical mmanifestations*:
-*chestmpains*mduringmperiods mofmrestmormverymlittlemactivity
Nitroglycerinm-mANSWERm*Shortmactingmsublingual mNitroglycerin*:
-Drugmofmchoicemformtreatingmacutemangina
-Takes meffectminm*1-2mminutes*
-Decreases mmyocardial mworkloadmandmoxygenmdemand
,-Makemsuremnomlesions/abrasions mundermthemtonguemthatmcouldmeffectmabsorption
-*Domnotmswallow*:mcouldmcausemmedicinemtomlosemits meffectiveness mifmitmenters mthemstomach
-
*1msublingual mtablet*mdissolvedmundermthemtonguemorminmthembuccal mpouchmas msoonmas manginamb
egins.m*Repeat meverym5mminutes*,mifmneeded,mtomam*maximummofmthreemdoses*mwithinma
15-
minutemperiod.mClientmmustm*callmformmedical massistance*mifmanginamismnotmrelievedmaftermth
irdmdose
*LongermactingmNitroglycerinmprep*:
-comes minmanmoral mtablet,mointment,mormtransdermal mpatches
-usedmtom*prevent*manginamattacks—*NOTmtomtreatmacute*mattacks
-mainmproblemmis m*development mofmtolerance*
-*nitratemfreemperiods*mcanmlimitmtolerancembymschedulingmwithmamperiodmofm*8-10mhrs*mpermday
-scheduledmtomgivem*atmnight*mwhenmpatientmis mless mlikelymtomexperience mangina
*Transbuccal madministration*:
-
Check mtheminsidemofmthempatientsmcheek mtommakemsuremtheremarem*nomulcerationsmormabrasio
ns*mthatmcouldminterfere mwithmthemabsorptionmofmthemdrug
-Havemthempatientm*placembetweenmgums mandmcheek*muntil mfull mabsorbed
-Domnotmswallow
-*Rotate mfrommsidemtomsidemwithmeachmdose*
*Transdermal madministration*:
-discuss mthemadministrationmwithmthempatient
-
makemsuremthempatient mknows mtom*takemoffmoldmtransdermal mpatches mandmwashmthemareambef
oremreplacingmamnewmone*mtomprevent mseveremhypotension
-
, informmpatients mthatmtheymshouldm*labelminmbigmwritingmtheirmtubes*mtomprevent msomeonem(ormt
hemselves)mfrommusingmitmas mhandmlotionmwhichmwouldmcausemdrugmtoxicity
m m m m m m m
Anginam-mANSWERm-chestmpainmbroughtmaboutmbym*myocardial mischemia*
*Manifestations:*
-*ChestmPain*:msubsternal,mprecordial,mmaym*radiatemtomneck/arms/shoulders mormjaw*
-Usuallymlasts m*2-5mminutes*
-Quality:mtight,msqueezing,mconstricting,mheavymsensation,mburning,mdull,maching,mconstant
-
Dyspnea,mpallor,mtachycardia,manxietymandmfear,mindigestion,mnausea,mvomiting,muppermback
mpain
-ECGmchanges:m*T-waveminversionmandmdepressedmSTmsegments*m(*invertedmT-
wavem=mmyocardial mischemia*)
*Treatment*:
-
*Nitroglycerin*:mgoal mismtomreducemoxygenmdemandmandmincreasedmoxygenmsupplymtomthemmyoc
ardium
-*Organicmnitrates*:mshortmandmlong-
termmforms,musedmtomtreatmacutemanginamattacks mandmpreventmangina
*Nursingminterventions*:
-knowmwhenmthemanginamis mhappening
-decreasemdemands mofmO2mneededmonmthemheart
-increasemeffectiveness mofmmedication
-reducemanxiety
-patientmshouldm*stopmall mactivitymandmsitmandmrest*minmbedm(*semi-fowlermposition*)
-*administermoxygen*m2mL/minmthroughmnasal mcannula
,-assess mpatients m*pain,mvital msigns,mRR*
-*Tell mpatient mtomcarrymnitroglycerinmatmall mtimes*
Stablemanginam-mANSWERm-Mostmcommonmtype
-Chestmpainmthatmoccurs mwhenmampersonmis m*activemormundermseveremstress*m(cold,metc.)
-Usuallym*subsides mwithmrest*
-*Treatment*:mnitrates,mreducingmstress/activity
*Clinical mManifestations*:manginamthatmusuallymoccurs mwhenmwork mofmthemheartmincreasedmbymp
hysical mexertion:mphysical mactivity,memotion,mstress,meatingmamheavymmeal,mexposuremtomcold
Unstable manginam-mANSWERm-Anginamthatmis m*notmrelievedmwithmrest*
-Requires m*medical mintervention*
-Occurs mwithm*increasedmfrequency,mseverity,mandmduration*
-Painmoccurs mwithmdecreasingmlevel mofmactivitymormstress
-Maymoccurmwhenmthempatientmis mjustmresting
-Patient mis m*atmrisk mformmyocardial minfarction*m(MI)
*Clinical mmanifestations*:
-*chestmpains*mduringmperiods mofmrestmormverymlittlemactivity
Nitroglycerinm-mANSWERm*Shortmactingmsublingual mNitroglycerin*:
-Drugmofmchoicemformtreatingmacutemangina
-Takes meffectminm*1-2mminutes*
-Decreases mmyocardial mworkloadmandmoxygenmdemand
,-Makemsuremnomlesions/abrasions mundermthemtonguemthatmcouldmeffectmabsorption
-*Domnotmswallow*:mcouldmcausemmedicinemtomlosemits meffectiveness mifmitmenters mthemstomach
-
*1msublingual mtablet*mdissolvedmundermthemtonguemorminmthembuccal mpouchmas msoonmas manginamb
egins.m*Repeat meverym5mminutes*,mifmneeded,mtomam*maximummofmthreemdoses*mwithinma
15-
minutemperiod.mClientmmustm*callmformmedical massistance*mifmanginamismnotmrelievedmaftermth
irdmdose
*LongermactingmNitroglycerinmprep*:
-comes minmanmoral mtablet,mointment,mormtransdermal mpatches
-usedmtom*prevent*manginamattacks—*NOTmtomtreatmacute*mattacks
-mainmproblemmis m*development mofmtolerance*
-*nitratemfreemperiods*mcanmlimitmtolerancembymschedulingmwithmamperiodmofm*8-10mhrs*mpermday
-scheduledmtomgivem*atmnight*mwhenmpatientmis mless mlikelymtomexperience mangina
*Transbuccal madministration*:
-
Check mtheminsidemofmthempatientsmcheek mtommakemsuremtheremarem*nomulcerationsmormabrasio
ns*mthatmcouldminterfere mwithmthemabsorptionmofmthemdrug
-Havemthempatientm*placembetweenmgums mandmcheek*muntil mfull mabsorbed
-Domnotmswallow
-*Rotate mfrommsidemtomsidemwithmeachmdose*
*Transdermal madministration*:
-discuss mthemadministrationmwithmthempatient
-
makemsuremthempatient mknows mtom*takemoffmoldmtransdermal mpatches mandmwashmthemareambef
oremreplacingmamnewmone*mtomprevent mseveremhypotension
-
, informmpatients mthatmtheymshouldm*labelminmbigmwritingmtheirmtubes*mtomprevent msomeonem(ormt
hemselves)mfrommusingmitmas mhandmlotionmwhichmwouldmcausemdrugmtoxicity
