Nokea
Which drug class has been found to decrease mortality if given within 8 hours of an MI due to a decrease in cardiac workload?
- A. Antiplatelets
- B. Beta-adrenergic blockers
- C. ACE inhibitors
- D. Calcium channel blockers
Correct Answer: B
Rationale: Beta-adrenergic blockers have been shown to decrease mortality when administered within 8 hours of a myocardial infarction (MI). They do so by reducing cardiac workload, which helps improve outcomes post-MI. These drugs work by blocking the effects of adrenaline on the heart, leading to decreased heart rate, blood pressure, and myocardial oxygen demand, thereby protecting the heart muscle from further damage. This makes them a crucial part of the treatment regimen for acute coronary syndromes like MI.
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The nurse is caring for a client who has chronic angina. Treatment for the condition has been unsuccessful. Which medication does the nurse anticipate will be prescribed?
- A. Atenolol (Tenormin)
- B. Nitroglycerin (Nitrostat)
- C. Sildenafil (Viagra)
- D. Ranolazine (Ranexa)
Correct Answer: D
Rationale: In cases of chronic angina where initial treatment has not been successful, Ranolazine (Ranexa) is often prescribed. This medication helps by reducing the frequency of angina episodes. Atenolol, Nitroglycerin, and Sildenafil are also used in angina management but Ranolazine is more specifically indicated in cases of refractory angina where other treatments have failed.
Why should the nitrate patch be off for 8 hours per day?
- A. "There is no reason to take the patch off each day."
- B. "The patch can be addictive; leaving it off reduces the addiction."
- C. "You should only leave the patch off for 15 minutes."
- D. "Leaving the patch off for 8 hours per day helps to delay the development of tolerance."
Correct Answer: D
Rationale: Removing the nitrate patch for 8 hours each day is essential to prevent the body from developing tolerance to the medication. By allowing the body to have a drug-free period, the effectiveness of the medication is maintained over time. This practice helps in ensuring that the nitrate patch continues to provide its intended therapeutic effects without diminishing its efficacy. Therefore, it is important for the client to adhere to the prescribed schedule of removing the patch for 8 hours daily to optimize the treatment outcomes.
Reteplase (Retavase) has been ordered for a client diagnosed with an MI. The nurse understands that this drug needs to be administered within which time frame following the onset of symptoms?
- A. 45 minutes to 18 hours
- B. 30 minutes to 12 hours
- C. 90 minutes to 36 hours
- D. 60 minutes to 24 hours
Correct Answer: B
Rationale: Reteplase (Retavase) is a thrombolytic medication used in the treatment of myocardial infarction (MI). It is crucial to administer this drug within 30 minutes to 12 hours following the onset of symptoms to achieve optimal therapeutic effects and improve patient outcomes. Administering Reteplase within this time frame helps in restoring blood flow to the affected areas of the heart by dissolving blood clots, reducing myocardial damage, and potentially preventing further complications associated with MI.
How can the nurse best explain the difference between angina and a myocardial infarction to a client presenting with severe chest pain?
- A. "Angina usually resolves with rest, and is rarely fatal, while a myocardial infarction necessitates immediate treatment and can be life-threatening."
- B. "There is a clear distinction between the two. You will receive treatment based on the diagnosis of a myocardial infarction."
- C. "Both conditions result from a clot obstructing the coronary arteries. Angina occurs with the blockage of a small vessel, whereas a myocardial infarction occurs with a blockage of a large vessel."
- D. "Angina may not cause as intense chest pain, whereas a myocardial infarction always presents with severe chest pain."
Correct Answer: A
Rationale: When educating a client about the differences between angina and a myocardial infarction, it is crucial to emphasize key distinguishing factors. Angina typically improves with rest and is not usually life-threatening, whereas a myocardial infarction requires urgent intervention as it can be life-threatening. This explanation helps the client understand the urgency and severity associated with a myocardial infarction compared to angina.
The healthcare professional is preparing to administer atenolol (Tenormin) to a client with angina. Which vital sign would cause the healthcare professional to question administering this drug?
- A. Respirations 12 breaths per minute
- B. Pulse 52 beats per minute
- C. Blood pressure 134/72
- D. Oxygen saturation 95%
Correct Answer: B
Rationale: Atenolol is a beta-blocker medication that can lower heart rate. A pulse of 52 beats per minute is relatively low and administering atenolol could further decrease the heart rate, potentially leading to bradycardia. Monitoring the pulse rate and holding the medication if the pulse is below the prescribed parameters is crucial to prevent adverse effects such as bradycardia and hypotension.