NUR 508 Exam 1 With 54 questions and answers Newest edition

NUR 508 Exam 1 With 54 questions and
answers Newest edition

oxygen (sats >93%), 12-lead EKG (within 10 min), chewable aspirin (162-325 mg), sublingual nitro,
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morphine (as needed if unresponsive to NTG, nitro drip after sublingual NTG has been used
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(titrate drip to pain and BP, keep systolic BP >90, dosed mcg/min) - Correct Answers
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Interventions performed when a patient presents to the ER with angina
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II! an imbalance between the supply and demand of the myocardium (reduced perfusion to the
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II! heart) - due to accumulation of lactic acid - Correct Answers What does chest pain result from?
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II! ST elevation in >2 associated or contingent, later development of pathologic Q wave - sometimes
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II! might see inverted T wave or T wave changes - Correct Answers ECG changes diagnostic of a
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II! STEMI



II! Troponin most specific and sensitive (specifically troponin-I, troponin-T), CK-MB also sensitive,
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II! but more useful when patient has reinfarction - Correct Answers Cardiac biomarker that is
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II! specific and sensitive to myocardial cell death
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II! ventricular dysfunction from tissue infarction with subsequent necrosis (scar tissue does not
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II! contract well), systolic dysfunction is usually what we see - Correct Answers Complication that
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II! can occur if death of myocardial cells is significant after MI
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II! (manifestations of systolic heart failure) pulmonary edema, pink frothy cough, crackles to II! II! II! II! II! II! II! II! II! II! II!




II! auscultation, S3, pallor, cool extremities, low urine output - if we suspect cardiogenic shock we
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II! see hypotension, mental status changes, depressed level of consciousness - Correct Answers
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II! physical findings of left ventricular dysfunction after MI
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, II! dysrhythmias (ventricular, atrial and sinus node dysfunction) - Correct Answers common II! II! II! II! II! II! II! II! II! II! II! II! II! II!




II! complication of MI II! II!




II! unable to get to cardiac cath lab within 90 min, outlying rural hospital, STEMI - Correct Answers
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II! indications for TPA administration with MI II! II! II! II! II!




II! monitor for significant signs and symptoms of bleeding, ensure adequate IV access and avoid
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II! invasive procedures during infusion - Correct Answers nursing interventions associated with
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II! TPA administration
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II! bleeding, hemorrhage, more serious complications such as retroperitoneal or intracranial -
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II! Correct Answers Complications of TPA administration
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II! altered LOC (lethargy, hypotension, significant bruising throughout abdomen) - Correct Answers
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What would be seen with serious complications of TPA administration?
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II! monitor for excessive chest tube output or bleeding and possible chest tube occlusion - concerns
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II! are related to accumulation of blood in the chest cavity and surrounding pericardium which can
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II! lead to cardiac tamponade - no specific numbers or values for chest tube output - if pt has
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II! adequate output one hour then none the next hour, you have a problem - monitor color and
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II! consistency of drainage - Correct Answers Nursing interventions for the post-operative patient
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II! after CABG with chest tube drainage
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II! pH < 7.35, CO2 > 45, - Correct Answers lab values of respiratory acidosis
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II! COPD, drug overdose, advancing neuromuscular condition (ALS, myasthenia gravis with
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II! exacerbations) - Correct Answers patient scenarios where we see respiratory acidosis II! II! II! II! II! II! II! II! II! II! II! II! II! II!