QUESTION 1 Case Study Patient M is 75 years of age, who presented to her local emergency room with sudden complaints of

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Question 1 Case Study Patient M Is 75 Years Of Age Who Presented To Her Local Emergency Room With Sudden Complaints Of 1 (225.98 KiB) Viewed 38 times

Question 1 Case Study Patient M Is 75 Years Of Age Who Presented To Her Local Emergency Room With Sudden Complaints Of 2 (111.63 KiB) Viewed 38 times

Question 1 Case Study Patient M Is 75 Years Of Age Who Presented To Her Local Emergency Room With Sudden Complaints Of 3 (127.68 KiB) Viewed 38 times

Question 1 Case Study Patient M Is 75 Years Of Age Who Presented To Her Local Emergency Room With Sudden Complaints Of 4 (177.14 KiB) Viewed 38 times

Question 1 Case Study Patient M Is 75 Years Of Age Who Presented To Her Local Emergency Room With Sudden Complaints Of 5 (135.95 KiB) Viewed 38 times

Question 1 Case Study Patient M Is 75 Years Of Age Who Presented To Her Local Emergency Room With Sudden Complaints Of 6 (121.5 KiB) Viewed 38 times

QUESTION 1 Case Study Patient M is 75 years of age, who presented to her local emergency room with sudden complaints of chest pain. She described the pain as a severe substernal burning sensation that radiated across the chest to her shoulders bilaterally and then to the neck and jaw region. Although not brought on by exertion, the chest pain was associated with dyspnea, pallor, diaphoresis, nausea, and epigastric discomfort. Patient M had taken one nitroglycerin tablet with partial relief. When the chest pain recurred 10 to 15 minutes later, her family dialed 911 and the local emergency medical service responded. Once transported to the emergency room, her pain persisted. She received two additional doses of nitroglycerin and was placed on 2 L of oxygen per nasal cannula. Following stabilization, she was admitted to a telemetry floor for further observation and medical management. Nursing assessment revealed a 50-pack-year history of cigarette smoking, hypertension, and mild-to-moderate obesity. As part of the medical workup, Patient M was scheduled for a cardiac catheterization the following day. The cardiac catheterization revealed an 80% blockage of the right coronary artery and the cardiologist recommended Patient M consider a PCI to open the coronary artery blockage. The following day, Patient M underwent a PCI to the right coronary artery. The procedure was progressing uneventfully until she had an episode of bradycardia; her heart rate dropped to 38 beats per minute. The patient received a 0.5 mg dose of IV atropine, which was repeated in 10 minutes. Other than this episode, Patient M did not experience any other postprocedure complications, such as hypotension, or other technical-related problems. Why was nitroglycerin given to patient M? O Relaxes and dilates the coronary vessels Relaxes and dilates the ventricles Relaxes and dilates only the major cardiac vessels such as the aorta O Relaxes and dilates the cardiac atrium to decrease overall workload

QUESTION 2 Why was patient M given atropine to treat her bradycardia? O It decreases cardiac conduction through the SA and AV node to increase heart rate while blocking acetylcholine receptors It increases cardiac conduction through the SA and AV node to decrease heart rate while blocking acetylcholine receptors O It increases cardiac conduction through the SA and AV node to increase heart rate while blocking acetylcholine receptors O It decreases cardiac conduction through the SA and AV node to increase heart rate while blocking acetylcholine receptors QUESTION 3 Which cardiovascular risk factors does Mrs M have? Select all that apply o Obesity Smoking Post menopausal Ethnicity Age Diet

QUESTION 4 Which of the following symptoms are normal for women when experiencing chest pain syndrome? Check all that apply Pain radiating to the shoulder Epigastric pain "Feels like there is an elephant sitting on my chest" Nausea Dyspnea Pallor QUESTION 5 Patient M is doing well post PCI and is getting ready to go home. While getting her bag packed she suddenly became short of breath. Vital signs are as follows: BP 125/80 P-103 RR-20 SPO2-96% What do you think is happening to patient M? O Pulmonary embolism O Post surgical pneumonia Respiratory concern due to smoking history and over exertion O Allergic reaction

QUESTION 6 Patient M knows that she needs to make some drastic lifestyle changes and has expressed interest in exercising. What teaching should be provided to her post PCI to prevent injury and complications? O You can return to your normal level of exercise within 24 hours. Just ensure that you are not lifting anything heavy. It is recommended that you increase your daily exercise as this is excellent prevention. You must wait two weeks until you can slowly start increasing your daily activity, speak with your family physician on day 7 to come up with an exercise plan. O It is recommended that you take it easy with limited lifting for the first 5 days after surgery. You can walk, but don't start increasing your exercise time frame until after your follow appointment with your physician on day 7. It is recommended that you take it easy with limited lifting for the first 7-10 days post surgery. Follow up with your physician on day 7 and together develop an exercise plan. QUESTION 7 Patient M recognizes that she needs to quit smoking, but doesn't feel that she has the will power to do it. How are you going to support her to be successful? Refer her to the smoking cessation out patient clinic Refer her to her family physician for medication assistance Provide her with pamphlets about nicotine replacement, and explain she can do this on her own and get everything she needs from her local pharmacy Tell her not to worry about that right now. She needs to focus on getting stronger over the next 7-10 days, then she can come up with a smoking cessation plan.

QUESTION 8 Why is smoking so dangerous post PCI? O It causes dilation of the brain arteries and major constriction of the cardiac arteries. It will also increase her risk for DVT formation. o It causes narrowing of the brain arteries and major constriction of the cardiac arteries. Studies have shown that it increases the risk of clot formation. o It causes narrowing of the heart and brain arteries and puts an individual at increased risk for developing clotting within the new stent O It decreases clotting time, and puts her at risk for bleeding issues post op. QUESTION 9 What dietary recommendations will you providing patient M with? Choose all that apply. o Reduce all added fat foods Eat more whole grain products Limit high fat snacks and desserts Eat more fruits and vegetables Processed meats are ok so long as you buy the low fat products Don't worry as much about salt intake, but pay close attention to cholesterol and total fat

QUESTION 10 Patient Masks you when she can resume sexual activity. What is some important information that you will provide her with? So long as you can climb a flight of stairs you can resume sexual activity in 48 hours Advise patient M that she should abstain from sexual activity for at least a month, and to follow up with her doctor Follow up with your cardiologist, if you can climb 2 flights of stairs at a brisk pace without pain or SOB it is fine There are no set guidelines regarding when it is appropriate to resume sexual activity, it is dependent on when you feel you are ready QUESTION 11 The following symptoms are common following PCI, select all that apply. Feeling fatigued and tired Leg pain and cramps Bleeding from the insertion site Bruising at the insertion site Angina may return Difficulty breathing on exertion