care Of Patients With Acute Coronary Syndrome

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Vbabiy5465
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  • 1/7 Questions

    After receiving the change-of-shift report, which client should the nurse assess first? The client with:

    • Stable angina who had chest pain relieved with two nitroglycerin tablets 1 hour ago
    • Unstable angina having substernal chest pain, nausea, sweating, and anxiety.
    • Stable vital signs who returned from the percutaneous coronary intervention lab 30 minutes ago.
    • N acute MI transferred from the coronary care unit earlier today reporting a headache
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About This Quiz

Acute Coronary Syndrome is a potentially life threatening condition as is a name given to three types of coronary artery disease that are associated with sudden rupture of plaque inside the coronary artery. Take the quiz and see how you should care for patients with coronary syndrome. All the best!

care Of Patients With Acute Coronary Syndrome - Quiz

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  • 2. 

    A client had a coronary artery bypass graft 2 days ago and has a new onset of atrial fibrillation. What diagnostic test will the nurse check that could explain this dysrhythmia?

    • Arterial oxygen level

    • Serum potassium

    • Serum sodium

    • Blood urea nitrogen

    Correct Answer
    A. Serum potassium
    Explanation
    p. 849, Physiological Integrity
    Hypokalemia after a coronary artery bypass graft procedure is a common cause of atrial fibrillation. Other complications may also include hypotension, hypothermia, hypertension, bleeding, cardiac tamponade, decreased level of consciousness, and anginal pain. Studies remain inconclusive on the role sodium plays in the development of atrial fibrillation. Elevated blood urea nitrogen levels may occur related to dehydration or decreased cardiac perfusion but have no connection to the development of atrial fibrillation.

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  • 3. 

    Your patient is a 47-year-old woman who presents to the emergency department with complaints of sudden onset of mid-sternal chest pain radiating to her right arm, nausea, and profuse sweating for the past hour. Her past medical history is unremarkable for cardiac disease. She had abdominal surgery 1 month ago to remove her spleen. She is given a total of three sublingual nitroglycerin tablets without relief and is receiving an IV infusion of nitroglycerin. The team is now considering administering tissue plasminogen activator (t-PA). Her laboratory work and electrocardiogram (ECG) confirm the diagnosis of myocardial infarction. Which parameter will be most affected when administering nitroglycerin?

    • Heart Rate

    • Blood Pressure

    • Heart Rhythm

    • Respiratory Rate

    Correct Answer
    A. Blood Pressure
    Explanation
    p. 861 The blood pressure is continuously monitored. Refer also to Chart 40-5. Nitrates cause general vasodilation, and a decrease in blood pressure occurs with vasodilation.

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  • 4. 

    A client who had thrombolytic therapy is receiving a continuous infusion of sodium heparin. In the past hour, the client’s blood pressure changed from 122/74 to 98/46 mm Hg. His pulse is rapid and weak. What is the nurse’s first action at this time?

    • Assess for signs of bleeding

    • Slow the heparin infusion rate

    • Document the blood pressure change

    • Stop the heparin infusion immediately

    Correct Answer
    A. Stop the heparin infusion immediately
    Explanation
    p. 840, Physiological Integrity
    Based on the assessment data, the nurse’s first action should be to stop the heparin infusion, because the change in vital signs is consistent with bleeding. Heparin is an anticoagulant and increases the client’s risk for bleeding. The client may be bleeding internally, so symptoms of bleeding on assessment may not be overt. Simply decreasing the infusion rate will still lead to anticoagulation of the blood and increase the client’s risk for further bleeding. Documentation is always an important nursing action but, in this case of suspected bleeding, documentation can wait until after the heparin infusion is stopped.

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  • 5. 

    A client with chronic stable angina receives discharge teaching from the nurse. Which statement by the client indicates a need for further teaching?

    • “I need to take my nitroglycerin tablets to prevent any serious problems.”

    • “At the first sign of chest discomfort, I will stop any activity and sit down.”

    • “I will call 911 if my chest discomfort continues after taking 3 nitroglycerin tablets.”

    • “I understand I must follow up with my health care provider regularly.”

    Correct Answer
    A. “I need to take my nitroglycerin tablets to prevent any serious problems.”
    Explanation
    Nitroglycerin should be taken at the first sign of chest discomfort. Nitroglycerin increases collateral blood flow, dilates the coronary arteries, and redistributes the blood flow toward the subendocardium. It also decreases both preload and afterload by decreasing myocardial oxygen demand through peripheral vasodilation.
    B is incorrect. If rest does not provide relief for the chest pain, the client may need to take nitroglycerin.
    C is incorrect. If the nitroglycerin does not relieve the chest discomfort after 3 tablets, the client needs to be immediately transported to a hospital where further evaluation and monitoring to rule out an MI are possible.
    D is incorrect. Continued supervision by a health care provider is necessary to monitor progress of coronary heart disease to prevent complications and provide support.

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  • 6. 

    An older client has a history of stable angina. Which modifiable risk factors will the nurse assess to guide the client’s teaching plan? Select all that apply.

    • Older Age

    • Tobacco use

    • Activity level

    • Serum lipid levels

    • Family history

    • Weight

    Correct Answer(s)
    A. Tobacco use
    A. Activity level
    A. Serum lipid levels
    A. Weight
    Explanation
    p. 834, Health Promotion and Maintenance. \

    Modifiable risk factors are lifestyle choices that can be controlled by the client, such as smoking, activity level, control of serum lipid levels, and control of obesity through dietary management. Nonmodifiable risk factors are personal characteristics that cannot be altered or controlled. These risk factors, which interact with each other, include age, gender, family history, and ethnic background.

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  • 7. 

    The nurse is assessing the client with chest pain to evaluate whether the client is suffering from angina or myocardial infarction (MI). Which symptom is indicative of an MI?

    • Chest pain brought on by exertion or stress

    • Substernal chest discomfort not relieved by rest

    • Substernal chest discomfort relieved by nitroglycerin or rest

    • Substernal chest pressure relived only by opioids

    Correct Answer
    A. Substernal chest pressure relived only by opioids

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  • Current Version
  • Mar 21, 2023
    Quiz Edited by
    ProProfs Editorial Team
  • Aug 25, 2012
    Quiz Created by
    Vbabiy5465
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