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N4161- Week 2 cardiac challenges exam with correct answers

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N4161- Week 2 cardiac challenges exam with correct answers

Instelling
ENGR 161
Vak
ENGR 161

Voorbeeld van de inhoud

N4161- Week 2 cardiac challenges exam ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\




with correct answers ||\\||\\ ||\\||\\




What should you as the nurse do if you hear an S4 in an adult? - correct answer✔✔Report it to HCP/ doc
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Mr. J is a 58 year old under your care. In the morning you are auscultating his heart. You hear a
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dysrhythmia. What is your next step as the nurse? - correct answer✔✔Compare apical and radial pulse to ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\




determine if there is a pulse deficit. If doing alone, do apical first and then immediately do radial. ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\




Rationale: pulse deficit occurs because irregular rhythms affect that ability of blood to flow to the periphery
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which fails to send pulse waves to the periphery. ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\




After finding a pulse deficit for Mr.J what should you as the nurse do? - correct answer✔✔Report pulse
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deficit to HCP ||\\||\\ ||\\||\\




What are murmurs? - correct answer✔✔Sustained swishing or blowing heart sounds that occur due to
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increased blood flow thru normal valve, forward flow through step if valve, backward through a valve,
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What is a Thrill? - correct answer✔✔A tremor or vibration felt on palpation of auscultation site where
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murmur is heard. ||\\||\\ ||\\||\\




What is atherosclerosis? - correct answer✔✔The build-up of fats, cholesterol, and other substances in and
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on the artery walls.
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How does atherosclerosis develop? - correct answer✔✔Endothelial injury occurs due to factors like
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hypertension, which allows lipids and irritants in the blood to accumulate in the injured endothelium. They ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\




start oxidizing which signals monocytes to the area > become macrophages and start to eat the debris. They
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engorge themselves and become foam cells which die and signal more monocytes and the cycle continues
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and plaque continues to buildup. Smooth muscle under the endothelium then starts to proliferate into the
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fatty plaque, and secretes a fibrous cap which prevents the plaque from coming into further contact with
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blood.


What is CAD? - correct answer✔✔CAD is a condition in which the coronary arteries become occluded due
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to plaque which restricts blood flow to the heart muscle.
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, What are the two categories of CAD? - correct answer✔✔Chronic coronary syndrome or stable angina and
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Acute coronary syndrome which includes: unstable angina, STEMI-MI AND NSTEMI- MI.
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What is stable angina? - correct answer✔✔Chest pain that occurs in a person who has coronary vessel
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blockage that is partial in nature. ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\




At rest this person's blood flow is enough to meet the oxygen demands of the heart. But when they put
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themselves through stress like exercise or emotional stress the demands of oxygen on the heart increase ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\




which isn't met by the reduced blood flow. So it leads to chest pain. It is predictable and is relieved by rest
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and nitroglycerin which dilates the vessel and allows for more blood flow.
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What is acute coronary syndrome? - correct answer✔✔Develops when blood flow is reduced or completely
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blocked for a prolonged period of time. Encompases a spectrum of unstable angina, non-st-segment-elevation
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myocardial infaction (NSTEMI), and ST-segment elevation myocardial infarction (STEMI).
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types of acute coronary syndrome - correct answer✔✔unstable angina, NSTEMI, STEMI
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What is unstable angina? - correct answer✔✔Occurs when the fibrous cap of the plaque ruptured which
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allows platelets passing by in the blood to aggregate on the plaque. A clot with fibrin starts forming in an
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effort to contain the plaque but makes things worse. It continues to grow and partially obstructs blood flow
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to the heart muscle. But it isn't prolonged enough to lead to necrosis. The unstable nature of the plaque
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makes symptoms appear randomly which is why it is acute in nature.
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What is MI and how does it occur? - correct answer✔✔MI is myocardial infarction in which ischemia to the
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heart muscle due to plaque rupture and subsequent clot formation leads to either partial or complete
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obstruction. ||\\||\\




Myocytes are what allow the heart to beat. In a MI, the decreased blood flow leads to myocytes becoming
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deprived of oxygen. As this oxygen depletes and blood flow reduces in the myocytes they send a signal to
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the brain, which allows adrenaline to be released. Adrenaline causes the heart to pump faster and the
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coronary arteries to constrict which increases demand on the heart. Eventually the myocytes in response to
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reduced blood flow and oxygen are unable to keep up with ATP production, so they slow down their rate of
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contraction which also helps to decrease workload on the heart.
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Eventually the myocytes begin to die because of toxin buildup since the blood supply isn't there to take a
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away the toxins. As they die and the membranes rupture, they release their protyeins: troponin and CK-MB
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into the bloodstream which tells there has been a heart attack.
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What are the two types of MI? - correct answer✔✔STEMI and non-STEMI
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ENGR 161

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