NUR 411 exam 1 2025
What does a weak pulse indicate? - answer Contractility problem and problem with
strength of the heart
what does a thready pulse indicate? - answer usually r/t to issue with volume and poor
fluid
CK-MB - answer most specific enzyme r/t myocardial problem. Cardiac specific
May not rise up to 4 hours after onset
Troponin - answerin cardiac and skeletal muscle
Indirect indicator
can be seen as early as within 1 hour of sx.
If negative, not heart issue
If positive, keep looking for heart issue because may be + r/t skeletal muscle breakdown
(athlete)
CRP (c-reactive protein) - answercan determine RISK for heart disease and
inflammatory processes such as atherosclerosis.
Doesn't necessarily mean problem now
BNP (b-type natriuretic peptide) - answertends to rise in inflammatory situations
Preload causes stretching on heart and releases BNP
Can't indicate HF alone
Also elevates with things like SEPSIS
Lipid profile - answerhigh levels of lipids in blood correlate with high RISK for coronary
artery disease
Nurse responsibilities during TEE - answerGoes through heart, don't have to be asleep
Nurses do conscious sedation, monitor airway, and gagging and vomiting after
Can't tell you anything about vessels
Electrophysiology Study (EPS) - answerlook for cardiac arrythmias
May help determine whether the patient needs ablation or pacemaker based on results
HF: Class one - answerSymptoms with exertion that most people would have SOA from
but takes them longer to recover and may take meds before
Ex. hiking hill may take healthy person 5 min to recover, but HF patient 1 hour to
recover
HF: Class 2 - answerSymptoms with oridinary activity like going to the grocery
, ex. going to grocery store; they can do it but when they get to car they are SOA and
chest pain. Plan whole day around this
HF: Class 3 - answerSymptoms less than ordinary acttivity
Ex. making dinner or feeding dog. Taking a lot of breaks
Only going up and down stairs once or twice a day
HF: Class 4 - answerSymptoms pretty much all the time
No stairs at all, bedroom downstairs, just bed then bathroom then chair
Low quality of life, lots of psychosocial support
Trifecta therapy for HF - answerACE inhibitor-catopril
Bblockers-carvedilol
Diuretic- Lasix
What is unstable angina caused by? - answerThrombi that PARTIALLY occlude arteries
What EKG changes will a pt. with unstable angina have? - answerT-wave inversion and
ST depression are 2 hallmark indicators of ischemia
What meds would someone be started on if they have an MI? - answerBblocker
therapy: metoprolol
Anticoag therapy: Heparin
Contraindications for thrmbolytic therapy - answerPregnancy
Recent surgery (within past 6 mos)
Active internal bleeding (don't want to make them bleed more)
Previous hemorrhagic stroke (too high risk for brain bleed)
How do you monitor for reperfusion complication associated with thrombolytic therapy?
- answerCan tell based on dysrhythmias
heart is getting used to having more blood and oxygen
How do you monitor for reocclusion when providing thrombolytic therapy? -
answerChest pain
What medication must be on MAR for post-op stent placement? - answerPlavix. Causes
clots to be slippery, making them hard to latch on to stent
Indications for CABG - answerSevere Left Main Coronary Artery (LMCA) compromise
(feeds L ventricle)
Triple Vessel disease (do cath and see several vessels totally or partially occluded)
Acute re-stenosis (re-occluded)
Coronary artery rupture
Pulsus Paradoxus - answerA DECREASE of > 10mmHg in SBP on inspiration
What does a weak pulse indicate? - answer Contractility problem and problem with
strength of the heart
what does a thready pulse indicate? - answer usually r/t to issue with volume and poor
fluid
CK-MB - answer most specific enzyme r/t myocardial problem. Cardiac specific
May not rise up to 4 hours after onset
Troponin - answerin cardiac and skeletal muscle
Indirect indicator
can be seen as early as within 1 hour of sx.
If negative, not heart issue
If positive, keep looking for heart issue because may be + r/t skeletal muscle breakdown
(athlete)
CRP (c-reactive protein) - answercan determine RISK for heart disease and
inflammatory processes such as atherosclerosis.
Doesn't necessarily mean problem now
BNP (b-type natriuretic peptide) - answertends to rise in inflammatory situations
Preload causes stretching on heart and releases BNP
Can't indicate HF alone
Also elevates with things like SEPSIS
Lipid profile - answerhigh levels of lipids in blood correlate with high RISK for coronary
artery disease
Nurse responsibilities during TEE - answerGoes through heart, don't have to be asleep
Nurses do conscious sedation, monitor airway, and gagging and vomiting after
Can't tell you anything about vessels
Electrophysiology Study (EPS) - answerlook for cardiac arrythmias
May help determine whether the patient needs ablation or pacemaker based on results
HF: Class one - answerSymptoms with exertion that most people would have SOA from
but takes them longer to recover and may take meds before
Ex. hiking hill may take healthy person 5 min to recover, but HF patient 1 hour to
recover
HF: Class 2 - answerSymptoms with oridinary activity like going to the grocery
, ex. going to grocery store; they can do it but when they get to car they are SOA and
chest pain. Plan whole day around this
HF: Class 3 - answerSymptoms less than ordinary acttivity
Ex. making dinner or feeding dog. Taking a lot of breaks
Only going up and down stairs once or twice a day
HF: Class 4 - answerSymptoms pretty much all the time
No stairs at all, bedroom downstairs, just bed then bathroom then chair
Low quality of life, lots of psychosocial support
Trifecta therapy for HF - answerACE inhibitor-catopril
Bblockers-carvedilol
Diuretic- Lasix
What is unstable angina caused by? - answerThrombi that PARTIALLY occlude arteries
What EKG changes will a pt. with unstable angina have? - answerT-wave inversion and
ST depression are 2 hallmark indicators of ischemia
What meds would someone be started on if they have an MI? - answerBblocker
therapy: metoprolol
Anticoag therapy: Heparin
Contraindications for thrmbolytic therapy - answerPregnancy
Recent surgery (within past 6 mos)
Active internal bleeding (don't want to make them bleed more)
Previous hemorrhagic stroke (too high risk for brain bleed)
How do you monitor for reperfusion complication associated with thrombolytic therapy?
- answerCan tell based on dysrhythmias
heart is getting used to having more blood and oxygen
How do you monitor for reocclusion when providing thrombolytic therapy? -
answerChest pain
What medication must be on MAR for post-op stent placement? - answerPlavix. Causes
clots to be slippery, making them hard to latch on to stent
Indications for CABG - answerSevere Left Main Coronary Artery (LMCA) compromise
(feeds L ventricle)
Triple Vessel disease (do cath and see several vessels totally or partially occluded)
Acute re-stenosis (re-occluded)
Coronary artery rupture
Pulsus Paradoxus - answerA DECREASE of > 10mmHg in SBP on inspiration
