Coronary Artery Disease – Flashcards

58F postmenopausal, seen at Women's Health Clinic for routine checkup. Reports no health problems other than fatigue, vaginal bleeding, and occasional "heartburn." Nurse's assessment ID's pt is at high risk for CAD and HCP schedules for labwork. Which info from Hx increases risk for CAD?

Since pt has numerous risk factors for CAD, she attends the clinic's online learning class on reducing the risk for heart disease. At the conclusion of the class, pt tells nurse, "I don't need any more of these classes because I know God will take care of my heart." Which nursing diagnosis is most appropriate for pt?

What is the best response to nurse to pt's statement?

Pt's lab: serum cholesterol 280mg/dL LDL 180mg/dL HDL 32mg/dL Pt asks if these results are bad. What info should the nurse include in the teaching plan?

After discussing the tests with HCP and nurse, pt expresses interest in learning how to lower her cholesterol and lose weight. HCP prescribes antihyperlipidemic agent lovastatin 20mg PO daily Which instructions should the nurse include in pt's teaching plan r/t use of an antihyperlipidemic

Which ongoing lab test should pt anticipate during Tx w/antihyperlipidemics?

Pt visits clinic for routine lab work. After walking into the clinic on a hot day, she reports chest pain. Following assessment and ECG eval, Dx stable angina and receives 2 Rx: - Nitro 0.2mg/hr transdermal path. QAM and remove at bedtime -Nitro 0.3mg SL prn chest pain Which instruction should the nurse include when teaching pt about the use of SL nitro?

The nurse should prepare pt for which AE that can occur when daily dose of transdermal Nitro is started?

Pt is scheduled for echocardiogram. Which instruction should the nurse provide to pt prior to the test?

Pt's angina remains stable, she undergoes hysterectomy for dysmenorrhea r/t uterine fibroids. the day after being d/c from hospital, pt comes to ED w/crushing substernal chest pain radiating down her left arm. She is dyspneic, pale and diaphoretic. Which nursing intervention should be implemented first?

ECG findings indicate that pt has had a MI. Which intervention should the nurse implement first?

IV nitroglycerin (Tridil) is prescribed for pt. What is a primary goal of this medication?

Dx tests orders serial cardiac enzymes. The Dx of MI is confirmed by ECG changes and elevation of cardiac enzymes and isoenzymes. Which ECG change is indicative of MI?

Which cardiac isoenzyme is the most sensitive indicator for myocardial damage?

The nurse assessed pt's symptoms during the MI. Which question should the nurse include in the assessment of pt's chest pain?

The nurse also assesses pt for changes in VS and for dysrhythmias. Other assessment findings r/t MI: -dyspnea -pallor -diaphoresis -weakness -fatigue -nausea -vomiting -fever Pt is transferred to the CCU for tx and monitoring. She is still receiving O2 at 2L/min and IV nitro infusion. VS are stable. O2 sat 94%, breath sounds are clear, she denies any pain at the present time. Pt's nurse develops a plan of care based on the following Dx - pain r/t imbalance between myocardial O2 supply and demand -ineffective tissue perfusion (cardiac) r/t blood flow interruption -activity intolerance r/t imbalance between O2 supply and demand -anxiety r/t pain & fear Which nursing intervention should be included in plan of care?

on pt's 2nd day post-MI, the nurse notes a change in pt's cardiac monitor. Pt's rhythm strip changed from normal sinus rhythm to sinus rhythm w/short runs of ventricular tachycardia. The nurse assesses pt, whose BP is now 100/54. Pt is lethargic, but is arousable. Which intervention should the nurse initiate first?

HCP Rx continuous IV infusion of amiodarone 1mg/minute for pt. The available drug is amiodarone 900mg in 500mL of D5W. The nurse should set IV pump at how many mL/hour?

Pt is started on continuous IV infusion of lidocaine at 2mg/minute. Ventricular tachycardia is controlled, and her cardiac monitor shows a sinus rhythm w/occasional PVCs. The nurse monitors pt for AE of infusion, including hypotension, drowsiness, seizures, bradycardia, and confusion. Pt's scheduled for percutaneous transluminal coronary angioplasty (PTCA) via femoral insertion. PTCA involves the insertion of a balloon-tipped catheter into the diseased coronary artery. When the balloon is inflated, compresses the plaque against the vessel wall, resulting in an increase in the inner diameter of the BV so blood flows. Which nursing intervention should be implemented when pt returns to her room?

The next day, pt is transferred to the Progressive Cardiac Unit. During report, the nurse is assigned four clients. Which client should the nurse assess first?

While the nurse is assessing pt, a group of people dressed in street clothes and lab coats enters pt's room. They are carrying clipboards and pens, and they begin to ask pt questions r/t her hospitalization. Pt seems unsure how to respond. The nurse should immediately intervene to prevent violation of which client right?

Which expected outcome(s) indicate that the nurse's discharge teaching was effective?