Questions and Answers
What is the primary purpose of performing laboratory tests in patients suspected of having unstable angina, NSTEMI, or STEMI?
What does an elevated troponin level indicate in a patient suspected of having a cardiac event?
Which is NOT a characteristic of NSTEMI when compared to STEMI?
Which troponin is specifically used to assess cardiac injury?
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Which of the following symptoms is least likely to indicate a serious cardiac event?
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What does a 12-lead ECG primarily assess in patients with suspected cardiac events?
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What type of cardiac event is indicated by near total blockage of a coronary artery?
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Which of the following is a common nursing intervention during the assessment of a patient with suspected cardiac events?
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What results when a fibrous cap over a plaque becomes thin and inflammation is present?
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How does a ruptured plaque affect blood flow in the coronary arteries?
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Which condition is a potential result of blood flow obstruction due to thrombus formation in coronary artery disease?
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What symptom is most likely to arise from deficient blood supply to the myocardium in coronary artery disease?
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What is the most common manifestation of ischemia related to atherosclerosis?
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In managing a patient with acute coronary syndrome, which assessment is most critical?
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Which of the following symptoms may be considered atypical in women experiencing ischemia?
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What is a possible outcome of a large lipid core within a plaque?
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What pro-inflammatory marker is associated with chronic atherosclerosis?
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Which of the following is NOT a factor affecting the clinical manifestations of coronary artery disease?
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Which condition is NOT usually associated with atherosclerosis?
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When does myocardial tissue become necrotic in the context of acute coronary syndrome?
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What clinical measurement indicates a prothrombotic state in patients potentially experiencing ischemia?
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In the context of ischemia, which of the following blood pressure readings would indicate a potential risk factor?
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Which symptom may appear as a prodromal signal before an acute cardiac event?
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What is a common radiating symptom of chest pain associated with ischemia?
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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.
