Questions and Answers
Which of the following is NOT a key benefit of early intervention in acute myocardial infarction (MI)?
What is the recommended timeframe for initiating percutaneous coronary intervention (PCI) after medical contact in a patient with suspected acute coronary syndrome (ACS)?
Which of the following laboratory markers is MOST specific for myocardial damage and is typically elevated within 2-4 hours of an acute myocardial infarction (MI)?
Which of the following medications is NOT typically used in the initial management of acute coronary syndrome (ACS)?
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Which of the following BEST describes the underlying pathophysiology of heart failure (HF)?
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Which of the following nursing interventions is MOST appropriate for a patient with heart failure (HF) who is experiencing shortness of breath and fatigue?
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Which type of myocardial infarction is characterized by ST-segment elevation on an EKG?
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What is a common symptom of a myocardial infarction in women that differs from the typical presentation in men?
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Which of the following is NOT a manifestation of myocardial infarction?
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What immediate treatment goal is essential for a patient diagnosed with myocardial infarction?
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Which risk factor is commonly associated with the development of acute coronary syndrome?
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Which of the following heart failure types is characterized by a reduced ejection fraction?
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Which of the following is NOT a common cause of heart failure?
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What is the significance of an ejection fraction (EF) of 50% in left-sided heart failure?
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Which diagnostic test is primarily used to assess the severity of heart failure?
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Which pharmacological agent is classified as a positive inotropic agent?
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In right-sided heart failure, which manifestation is typically observed?
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What does an increase in jugular venous pressure (JVP) indicate in heart failure?
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Which type of heart failure is characterized by increased pressure in the pulmonary circulation?
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What nursing intervention is most appropriate for a patient exhibiting signs of heart failure?
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Which of the following is a common symptom of acute coronary syndrome (ACS) that may present differently in women compared to men?
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Which of the following is a characteristic of a non-ST-segment elevation myocardial infarction (NSTEMI)?
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Which type of heart failure is characterized by a reduced ejection fraction (EF)?
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Which of the following is a modifiable risk factor for acute coronary syndrome (ACS)?
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What nursing intervention is most appropriate for a patient with heart failure experiencing shortness of breath?
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Which of the following is a common cause of right-sided heart failure?
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What is a primary goal of administering fibrinolytics in patients with myocardial infarction?
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Which laboratory marker is significant for indicating myocardial damage and typically lasts up to 10-14 days after elevation?
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Which statement best describes the definition of heart failure?
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What is the recommended approach for patients with acute myocardial infarction to maintain cardiovascular stability?
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Which of the following is a common risk factor associated with acute coronary syndrome?
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Which nursing intervention is most appropriate for a patient with heart failure who presents with dyspnea?
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What is a common risk factor for developing heart failure?
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Which manifestation is typically associated with left-sided heart failure?
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In terms of diagnostic testing for heart failure, what does a BNP level over 900 indicate?
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Which of the following best describes two common types of heart failure?
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Which nursing intervention is most effective for a patient with right-sided heart failure exhibiting peripheral edema?
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What is the main purpose of using angiotensin-converting enzyme (ACE) inhibitors in heart failure treatment?
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Which of the following is NOT a common complication contributing to heart failure?
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Which type of heart failure is characterized by a preserved ejection fraction?
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Study Notes
Heart Function and Cardiac Output
- Cardiac output (CO) formula: CO = Heart Rate (HR) x Stroke Volume (SV)
- Normal CO ranges from 4-8 L/min, with some sources citing 5-6 L/min.
Causes of Heart Failure
- Myocardial Infarction (MI) and coronary artery disease (CAD) leading causes.
- Hypertension, including pulmonary hypertension, contributes to heart strain.
- Conditions causing fluid overload, abnormal heart rhythms (A-fib), and valvular insufficiencies are significant.
- Infection, substance use disorders, congenital issues, and hypermetabolic states also play roles in heart failure.
Heart Failure Types and Symptoms
Right-Sided Heart Failure
- Causes systemic symptoms, including peripheral edema and jugular venous pressure (JVP) increase.
- Patients may experience weight gain (2 lbs/day or 5 lbs/week), hepatomegaly, lethargy, and nocturia.
Left-Sided Heart Failure
- Leads to pulmonary edema and diminished ejection fraction (EF<50%).
- Symptoms include crackles, orthopnea, paroxysmal nocturnal dyspnea (PND), dyspnea on exertion, and weight gain.
Heart Failure Diagnostic Testing
- B-type natriuretic peptide (BNP) levels: >300 (mild), >600 (moderate), >900 (severe).
- Imaging and cardiac tests: Chest X-ray (CXR), ECG, echocardiogram.
- Assessments of serum electrolytes, liver function tests (LFTs), urinalysis, blood urea nitrogen (BUN), serum creatinine, and arterial blood gas (ABG).
Pharmacological Treatments
- Angiotensin-Converting Enzyme (ACE) inhibitors like Perindopril.
- Angiotensin II-Receptor Blockers (ARBs) such as Atacand (Candesartan).
- Beta-blockers, diuretics, vasodilators, antiarrhythmics, and positive inotropic agents like digoxin.
Myocardial Infarction (MI)
- Occurs due to prolonged ischemia, resulting in irreversible myocardial cell death.
- Classic symptoms include chest pain (radiating to neck, jaw, and arms), tachycardia, dyspnea, nausea, anxiety, diaphoresis, and potential altered mental status.
EKG Findings in MI
- STEMI indicates ST-segment elevation, while Non-STEMI does not show this elevation.
Immediate Treatment Goals for MI
- Obtain EKG within 10 minutes of patient presentation.
- Alleviate chest pain and ensure cardiovascular stability.
- Minimize myocardial damage and prevent complications; “time is muscle” emphasizes rapid intervention.
Essential Labs and Monitoring in MI
- Troponin I: elevated 2-4 hours post-event, peaks at 24-36 hours, persists for 7-10 days.
- Troponin T: similar timelines as Troponin I but lasts longer (10-14 days).
- Creatine Kinase-MB (CK-MB): elevated at 4-8 hours, peaks in 18-24 hours, lasts 72 hours.
- Monitor inflammatory markers like C-reactive protein, complete blood count (CBC), and vital signs.
Angina and Additional Treatment Considerations
- Fibrinolytics (TNK, Streptokinase) are critical; ensure to rule out contraindications.
- Morphine may be utilized alongside oxygen and nitroglycerin for symptom relief.
- Antiplatelet and anticoagulant medications, such as ASA and heparin, are commonly prescribed.
Heart Function and Cardiac Output
- Cardiac output (CO) formula: CO = Heart Rate (HR) x Stroke Volume (SV)
- Normal CO ranges from 4-8 L/min, with some sources citing 5-6 L/min.
Causes of Heart Failure
- Myocardial Infarction (MI) and coronary artery disease (CAD) leading causes.
- Hypertension, including pulmonary hypertension, contributes to heart strain.
- Conditions causing fluid overload, abnormal heart rhythms (A-fib), and valvular insufficiencies are significant.
- Infection, substance use disorders, congenital issues, and hypermetabolic states also play roles in heart failure.
Heart Failure Types and Symptoms
Right-Sided Heart Failure
- Causes systemic symptoms, including peripheral edema and jugular venous pressure (JVP) increase.
- Patients may experience weight gain (2 lbs/day or 5 lbs/week), hepatomegaly, lethargy, and nocturia.
Left-Sided Heart Failure
- Leads to pulmonary edema and diminished ejection fraction (EF<50%).
- Symptoms include crackles, orthopnea, paroxysmal nocturnal dyspnea (PND), dyspnea on exertion, and weight gain.
Heart Failure Diagnostic Testing
- B-type natriuretic peptide (BNP) levels: >300 (mild), >600 (moderate), >900 (severe).
- Imaging and cardiac tests: Chest X-ray (CXR), ECG, echocardiogram.
- Assessments of serum electrolytes, liver function tests (LFTs), urinalysis, blood urea nitrogen (BUN), serum creatinine, and arterial blood gas (ABG).
Pharmacological Treatments
- Angiotensin-Converting Enzyme (ACE) inhibitors like Perindopril.
- Angiotensin II-Receptor Blockers (ARBs) such as Atacand (Candesartan).
- Beta-blockers, diuretics, vasodilators, antiarrhythmics, and positive inotropic agents like digoxin.
Myocardial Infarction (MI)
- Occurs due to prolonged ischemia, resulting in irreversible myocardial cell death.
- Classic symptoms include chest pain (radiating to neck, jaw, and arms), tachycardia, dyspnea, nausea, anxiety, diaphoresis, and potential altered mental status.
EKG Findings in MI
- STEMI indicates ST-segment elevation, while Non-STEMI does not show this elevation.
Immediate Treatment Goals for MI
- Obtain EKG within 10 minutes of patient presentation.
- Alleviate chest pain and ensure cardiovascular stability.
- Minimize myocardial damage and prevent complications; “time is muscle” emphasizes rapid intervention.
Essential Labs and Monitoring in MI
- Troponin I: elevated 2-4 hours post-event, peaks at 24-36 hours, persists for 7-10 days.
- Troponin T: similar timelines as Troponin I but lasts longer (10-14 days).
- Creatine Kinase-MB (CK-MB): elevated at 4-8 hours, peaks in 18-24 hours, lasts 72 hours.
- Monitor inflammatory markers like C-reactive protein, complete blood count (CBC), and vital signs.
Angina and Additional Treatment Considerations
- Fibrinolytics (TNK, Streptokinase) are critical; ensure to rule out contraindications.
- Morphine may be utilized alongside oxygen and nitroglycerin for symptom relief.
- Antiplatelet and anticoagulant medications, such as ASA and heparin, are commonly prescribed.
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Description
Learn about cardiac output formula, normal ranges, and causes of heart failure including myocardial infarction, hypertension, and more.
