NCM 112 - MODULE 3B
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Questions and Answers

What is the primary purpose of performing laboratory tests in patients suspected of having unstable angina, NSTEMI, or STEMI?

  • To clarify the type of cardiac event occurring (correct)
  • To assess overall heart function
  • To determine the exact location of the blockage
  • To diagnose related respiratory conditions
  • What does an elevated troponin level indicate in a patient suspected of having a cardiac event?

  • Increased blood flow to the heart
  • Death of cardiac muscle tissue (correct)
  • Improvement in heart muscle condition
  • Presence of a respiratory condition
  • Which is NOT a characteristic of NSTEMI when compared to STEMI?

  • Partial blockage of a coronary artery
  • Total blockage of a coronary artery (correct)
  • Presence of chest pain
  • Elevated cardiac biomarkers
  • Which troponin is specifically used to assess cardiac injury?

    <p>Troponin I</p> Signup and view all the answers

    Which of the following symptoms is least likely to indicate a serious cardiac event?

    <p>Persistent headache</p> Signup and view all the answers

    What does a 12-lead ECG primarily assess in patients with suspected cardiac events?

    <p>Heart rate and rhythm</p> Signup and view all the answers

    What type of cardiac event is indicated by near total blockage of a coronary artery?

    <p>STEMI</p> Signup and view all the answers

    Which of the following is a common nursing intervention during the assessment of a patient with suspected cardiac events?

    <p>Monitoring vital signs frequently</p> Signup and view all the answers

    What results when a fibrous cap over a plaque becomes thin and inflammation is present?

    <p>Vulnerable plaque development</p> Signup and view all the answers

    How does a ruptured plaque affect blood flow in the coronary arteries?

    <p>It causes obstructive thrombus formation.</p> Signup and view all the answers

    Which condition is a potential result of blood flow obstruction due to thrombus formation in coronary artery disease?

    <p>Acute myocardial infarction (MI)</p> Signup and view all the answers

    What symptom is most likely to arise from deficient blood supply to the myocardium in coronary artery disease?

    <p>Chest pain or angina</p> Signup and view all the answers

    What is the most common manifestation of ischemia related to atherosclerosis?

    <p>Chest pain</p> Signup and view all the answers

    In managing a patient with acute coronary syndrome, which assessment is most critical?

    <p>Heart rhythm and rate</p> Signup and view all the answers

    Which of the following symptoms may be considered atypical in women experiencing ischemia?

    <p>Indigestion</p> Signup and view all the answers

    What is a possible outcome of a large lipid core within a plaque?

    <p>Rupture of the fibrous plaque</p> Signup and view all the answers

    What pro-inflammatory marker is associated with chronic atherosclerosis?

    <p>C-reactive protein</p> Signup and view all the answers

    Which of the following is NOT a factor affecting the clinical manifestations of coronary artery disease?

    <p>Degree of blood vessel movement</p> Signup and view all the answers

    Which condition is NOT usually associated with atherosclerosis?

    <p>Severe dehydration</p> Signup and view all the answers

    When does myocardial tissue become necrotic in the context of acute coronary syndrome?

    <p>After prolonged ischemia</p> Signup and view all the answers

    What clinical measurement indicates a prothrombotic state in patients potentially experiencing ischemia?

    <p>High fibrinogen level</p> Signup and view all the answers

    In the context of ischemia, which of the following blood pressure readings would indicate a potential risk factor?

    <p>130/85 mmHg</p> Signup and view all the answers

    Which symptom may appear as a prodromal signal before an acute cardiac event?

    <p>Angina</p> Signup and view all the answers

    What is a common radiating symptom of chest pain associated with ischemia?

    <p>Pain that radiates to the left arm</p> Signup and view all the answers

    Study Notes

    Inflammatory Response and Atherosclerosis

    • Atherosclerosis begins with injury to the vascular endothelium, followed by an inflammatory response.
    • Ischemia, defined as low blood supply and oxygen, is linked to the development of atherosclerosis.

    Clinical Manifestations

    • Angina pectoris is the most common symptom, characterized by chest pain.
    • Symptoms may also include epigastric distress, pain radiating to the jaw or left arm, and shortness of breath.
    • Atypical symptoms in women may manifest as indigestion, nausea, palpitations, and numbness.
    • Prodromal symptoms like angina may occur hours to days before a severe cardiac event.

    Coronary Artery Disease (CAD) Progression

    • The fibrous cap over the plaque can be thick and stable, resisting stress from blood flow.
    • A thin fibrous cap and ongoing inflammation result in "vulnerable plaque."
    • Growth of the lipid core may lead to plaque rupture, attracting platelets and causing thrombus formation.
    • Obstruction of blood flow can lead to acute coronary syndrome or acute myocardial infarction (MI), resulting in necrosis of heart tissue.

    Diagnosis and Assessment

    • Symptoms and complications of CAD depend on the degree of arterial narrowing, thrombus formation, and blood flow obstruction to the myocardium.
    • Diagnostic tools include 12-lead ECG, echocardiogram, and laboratory tests for cardiac biomarkers.
    • Biomarkers help distinguish between unstable angina, NSTEMI (Non-ST segment elevation myocardial infarction), and STEMI (ST segment elevation myocardial infarction).

    Cardiac Biomarkers

    • NSTEMI is associated with partial blockage of the coronary artery, indicating that some cardiac muscle may have died.
    • STEMI involves total or near-total blockage, resulting in the death of significant portions of cardiac muscle.
    • Troponin isoenzymes (C, I, T) are critical indicators; elevated levels of Troponins I and T confirm cardiac muscle damage.

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    Description

    This quiz covers the inflammatory response associated with the development of atherosclerosis, focusing on the injury to the vascular endothelium and its progression to ischemia, characterized by low blood supply and oxygenation. It will help nursing students understand the key concepts and mechanisms involved in these conditions.

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