Chapter 27 CAD and ACS

Which items would the nurse anticipate administering during emergent care for a patient with a suspected myocardial infarction (MI)?

Nitroglycerin, aspirin, and fentanyl

Which foods would the nurse encourage patients at risk for coronary artery disease (CAD) to include in their diets? (Select all that apply.)

Tofu

Walnuts

Tuna fish

A male patient with coronary artery disease (CAD) has a low-density lipoprotein (LDL) cholesterol of 98 mg/dL and high-density lipoprotein (HDL) cholesterol of 47 mg/dL. What information would the nurse include in patient teaching?

Maintain the normal lipid levels.

A nurse is providing discharge teaching to a patient with chronic stable angina. Which patient statement indicates the need for further teaching?

"I can shovel snow in the morning if I take my medication first."

The nurse would assess a patient with reports of chest pain for which manifestations associated with a myocardial infarction (MI)? (Select all that apply.)

Ashen skin

Diaphoresis

Nausea and vomiting

S₃ or S₄ heart sounds

The nurse teaches a patient with chronic stable angina about nitroglycerin. Which patient statement would alert the nurse to a need for further teaching?

"I can take up to 5 tablets every 3 minutes for relief of my chest pain."

Which prescribed antilipemic medications would the nurse question for a patient who has cirrhosis of the liver? (Select all that apply.)

Niacin

Ezetimibe

Gemfibrozil

Atorvastatin

Which complication of a ST-segment-elevation myocardial infarction (STEMI) would the nurse anticipate in a patient 24 hours after the initial event?

Dysrhythmias

A patient arrives in the emergency department with crushing substernal chest pain, shortness of breath, and diaphoresis. The nurse suspects an acute myocardial infarction (MI). Which actions would the nurse take first?

Obtain a 12-lead ECG

The patient has been discharged from the hospital after acute coronary syndrome (ACS) and is beginning a cardiac rehabilitation program. Which focus of care would the nurse plan for the early recovery phase of rehabilitation?

Activity level is gradually increased under supervision and monitoring.

A patient has received a bolus dose and an infusion of alteplase for an ST-segment elevation myocardial infarction (STEMI). Which finding would be used to evaluate the effectiveness of the medication?

Presence of chest pain

The nurse teaches a patient with high cholesterol about natural lipid-lowering therapies. The nurse determines further teaching is necessary when the patient makes which statement?

"I will take garlic instead of my prescription medication to reduce my cholesterol."

A patient with a history of prostate cancer and hypertension is in the emergency department with substernal chest pain. Which priority action will the nurse complete before administering sublingual nitroglycerin?

Obtain a 12-lead electrocardiogram (ECG).

The nurse is examining the electrocardiogram (ECG) of a patient just admitted with a suspected myocardial infarction (MI). Which ECG change is most indicative of prolonged or complete coronary occlusion?

Pathologic Q wave

Which information would the nurse consider when caring for a female patient with suspected coronary artery disease?

Fatigue may be the first symptom.

The nurse prepares a discharge teaching plan for a patient who has recently been diagnosed with coronary artery disease (CAD). Which priority risk factor would the nurse plan to focus on during the teaching session?

Elevated serum lipids

A nurse is reviewing discharge medications with a patient who has chronic stable angina. Which medications would be expected to be part of the treatment plan? (Select all that apply.)

Nitroglycerin

Beta-blockers

Long-acting nitrates

Calcium channel blockers

The nurse is teaching a patient recovering from a myocardial infarction (MI). How would the nurse present the topic of resuming sexual activity?

Explained along with other physical activities

The patient with angina tells the nurse, "While I was having a bowel movement, I started having the worst chest pain ever, like before I was admitted. After I called for a nurse, the pain went away." Which question would be a priority for the nurse to ask the patient?

"In what areas did you feel the pain?"

Which patient is at greatest risk for sudden cardiac death (SCD)?

A 52-yr-old black male with left ventricular failure

A patient experienced sudden cardiac death (SCD) and survived. Which treatment would the nurse expect to be implemented to prevent an SCD recurrence at home?

Implantable cardioverter-defibrillator (ICD)

The nurse recognizes additional teaching is needed when the patient prescribed a low-sodium, low-fat cardiac diet selects which food?

Canned chicken noodle soup

A female patient with type 1 diabetes has chronic stable angina controlled with rest. She states that over the past few months, she has required increasing amounts of insulin. Which goal would the nurse implement when planning care to prevent cardiovascular disease progression?

Keep Hgb A1C less than 7%.

Which person would the nurse identify as having the highest risk for coronary artery disease (CAD)?

A 45-yr-old male with a high-stress job who is depressed

For which condition would the nurse expect that the patient would undergo percutaneous coronary intervention (PCI)?

Acute myocardial infarction

A patient returns to the unit after a cardiac catheterization. Which nursing care would the registered nurse (RN) delegate to the assistant personnel (AP)?

Take vital signs and report abnormal values.

The nurse in the recovery room assesses the right femoral artery puncture site after the patient had a stent inserted into a coronary artery. The insertion site is not bleeding or discolored. Which action would the nurse take next to ensure the femoral artery is intact?

Inspect the patient's right hip and back.

The nurse providing postoperative care for a patient after coronary artery bypass graft (CABG) surgery would monitor for which common complication?

Atrial dysrhythmias