Nokea
The nurse is caring for a patient with a non-ST-segment-elevation myocardial infarction (NSTEMI) who is receiving heparin. Which of the following information explains the purpose of the heparin?
- A. Platelet aggregation is enhanced by IV heparin infusion.
- B. Heparin will dissolve the clot that is blocking blood flow to the heart.
- C. Coronary artery plaque size and adherence are decreased with heparin.
- D. Heparin will prevent the development of new clots in the coronary arteries.
Correct Answer: D
Rationale: Heparin helps prevent the conversion of fibrinogen to fibrin and decreases coronary artery thrombosis. It does not change coronary artery plaque, dissolve already formed clots, or enhance platelet aggregation.
You may also like to solve these questions
The nurse is caring for a patient with newly diagnosed Prinzmetal's (variant) angina and has a prescription for amlodipine. Which of the following information is accurate about amlodipine?
- A. Reduce the 'fight or flight' response
- B. Decrease spasm of the coronary arteries
- C. Increase the force of myocardial contraction
- D. Help prevent clotting in the coronary arteries
Correct Answer: B
Rationale: Prinzmetal's angina is caused by coronary artery spasm. Calcium channel blockers (e.g., amlodipine, nifedipine) are a first-line therapy for this type of angina. Platelet inhibitors, such as Aspirin, help prevent coronary artery thrombosis, and β-blockers decrease sympathetic stimulation of the heart. Medications or activities that increase myocardial contractility will increase the incidence of angina by improving oxygen demand.
The nurse is caring for a patient who has recently started taking crestor who reports all of these symptoms to the nurse. Which of the following finding is most important to communicate to the health care provider?
- A. Generalized muscle aches and weakness
- B. Skin flushing after taking the medications
- C. Dizziness when changing positions quickly
- D. Nausea when taking the drugs before eating
Correct Answer: A
Rationale: Muscle aches and weakness may indicate myopathy and rhabdomyolysis, which have caused acute renal failure and death in some patients who have taken the statin medications. These symptoms indicate that the rosuvastatin may need to be discontinued. The other symptoms are common adverse effects when taking niacin, and although the nurse should follow up with the patient, they do not indicate that a change in medication is needed.
Which of the following electrocardiogram (ECG) changes is most important for the nurse to communicate to the health care provider when caring for a patient with chest pain?
- A. Frequent premature atrial contractions (PACs)
- B. Inverted P wave
- C. Sinus tachycardia
- D. ST segment elevation
Correct Answer: D
Rationale: The patient is likely to be experiencing an ST-segment-elevation myocardial infarction (STEMI) and immediate therapy with percutaneous coronary intervention (PCI) or fibrinolytic medications is indicated to minimize the amount of myocardial damage. The other ECG changes also may suggest a need for therapy, but not as rapidly.
The nurse is evaluating the outcomes of pre-operative teaching with a patient scheduled for a coronary artery bypass graft (CABG) using the internal mammary artery. Which of the following patient statements indicates that additional teaching is needed?
- A. I will have incisions in my leg where they will remove the vein.
- B. They will circulate my blood with a machine during the surgery.
- C. I will need to take an Aspirin a day after the surgery to keep the graft open.
- D. They will use an artery near my heart to bypass the area that is obstructed.
Correct Answer: A
Rationale: When the internal mammary artery is used there is no need to have a saphenous vein removed from the leg. The other statements by the patient are accurate and indicate that the teaching has been effective.
The nurse is caring for a patient with angina who has been prescribed propranolol. Which of the following parameters should the nurse assess to determine whether the drug is effective?
- A. Decreased blood pressure and apical pulse rate
- B. Fewer complaints of having cold hands and feet
- C. Improvement in the quality of the peripheral pulses
- D. The ability to do daily activities without chest discomfort
Correct Answer: D
Rationale: Because the medication is ordered to improve the patient's angina, effectiveness is indicated if the patient is able to accomplish daily activities without chest pain. Blood pressure (BP) and apical pulse rate may decrease, but these data do not indicate that the goal of decreased angina has been met. The non-cardioselective β-blockers can cause peripheral vasoconstriction, so the nurse would not expect an improvement in peripheral pulse quality or skin temperature.