Quiz 6 Myocardial Infarction

Question 1

Difference between stable and unstable angina:

Answer 1

Stable Angina: Predictable and relieved by nitroglycerin

UNstable Angina: NOT relieved by rest or nitroglycerin, not predictable, and related to MI

Question 2

What Dx findings would you find for someone who has a confirmed MI?

Answer 2

+ ECG

+ Elevated S -T wave in the ECG

Question 3

What labs will they run (for someone who has a confirmed MI)?

Answer 3

+ Troponin (cardiac enzyme)
+ 3 sets of troponin labs 6 hours apart, if they all come back positive, this is another means of confirming an MI [they also run CK and CKMB - but the most accurate is troponin labs]

Question 4

Pathophysiology of an MI:

Answer 4

Impaired blood flow

Question 5

What is the main cause of impaired blood flow in the arteries of the heart?

Answer 5

Atherosclerosis // built up plaques in the arteries of the heart can cause MI

Question 6

S/S of an MI:

Answer 6

*Elevated BP*
Nausea 
Vomiting
Chest pain relieved with rest 
SOB (shortness of breath) 
Referred pain to the let arm
Tachycardia 
Substernal chest pain

Question 7

What is the primary intervention for a client with chest pain suspected for an MI?

Answer 7

Immediately apply O2 (oxygen)

EKG

Question 8

What is oxygen or oxygenation expected to do? How would we expect the heart to respond?

Answer 8

Decrease cardiac workload and increase oxygenation to the heart

Question 9

Evidence that ischemia {lack of oxygen} has improved: What will we see on the ECG/ EKG?

Answer 9

S - T elevation would return to baseline

Question 10

Pathophysiology of interior wall MI, where is the damage located?

Answer 10

Right Coronary Artery

Question 11

Discharge teaching for pt who is receiving tx for an MI?

Answer 11

Rest / bed rest

Question 12

Complication of an MI: What happens as a result of an MI?

Answer 12

Decreased cardiac output

+ Increased cardiac workload because of tissue damage (muscle, artery), it will not perform as normal

Question 13

What is a PTCA {Percutaneous Transluminal Coronary Angioplasty}? (-plasty = molding, grafting, or forming)

Answer 13

Scrapes the plaque out of the artery and a stent is applied to keep the artery open

Question 14

What is the goal of a PTCA?

Answer 14

Improve the blood flow and open the artery

Question 15

What is the nursing dx for a client with MI?

Answer 15

• Impaired or decreased oxygenation* as a result of this you will have myocardial tissue perfusion
• Impaired perfusion is why oxygenation is impaired

Question 16

What is the priority assessment for a pt receiving thrombolytics (tPA / clot buster)? What are you watching for in these patients?

Answer 16

Bleeding risk

Question 17

Pathophysiology of a STEMI

Answer 17

Tissue damage / atherosclerosis

Question 18

Where is the STEMI does the damage occur? What part of the heart will you see damage?

Answer 18

Endocardium and Epicardium

Question 19

What type of MI involves the complete heart? (All 3 layers)

Answer 19

Transmural MI

Question 20

What post acute care is usually ordered now for a pt who is discharged after an MI? What type of care is ordered?

Answer 20

Cardiac Rehabilitation (includes different aerobic activities)

Question 21

S/S of an MI?

Answer 21

*Elevated BP*
Tachycardia 
N/ V
SOB
Pain in the: 
Chest pain that is NOT relieved with rest
Neck
Jaw
Left arm 
Substernal chest