Caring with a Patient with Chest Pain : Nursing Course


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The most immediate diagnostic tool to diagnose a myocardial infarction is:

EKG

Rationale: A definitive diagnosis of a myocardial infarction is often made by changes on an electrocardiogram(ECG), and is supported by abnormal serum cardiac enzyme levels. ECG is the single most valuable immediate diagnostic tool for the nurse. An ECG records different views of the electrical activity of the heart and provides information by viewing the heart from different angles. About 80% of patients that are having an MI have changes on an EKG, including ST segment elevation of 1mm or more in two leads. These changes generally occur within 20 minutes to two hours of the onset of cardiac symptoms.


Prior to administering nitroglycerin to a patient for chest pain, be sure to check their:

blood pressure

Rationale: Nitroglycerin is the most common nitrate, and is available in many different forms. Nitroglycerin helps decrease chest pain by dilating coronary arteries and dilating venous blood vessels which reduces resistance to blood flow in the body. Patients with cardiac related chest pain should receive up to 3 doses of nitroglycerin given either by sublingual tablets or spray. It should be administered every 5 minutes X 3, or until the chest pain is relieved. Since nitroglycerin works by dilating coronary arteries, special consideration needs to be given to the blood pressure. Blood pressure of a patient receiving nitroglycerin should be checked before and after each tablet is administered. The medication should be held if the systolic pressure drops 30 mmHg from baseline. Nitroglycerin is also contraindicated in patients with significant bradycardia, right ventricular infarction, or those who have recently taken a medication for erectile dysfunction, such as Viagra, Cialis or Levitra


Chest pain that occurs if an area of heart muscle is not getting enough oxygen, but without permanent muscle damage is:

angina

Rationale:

When caring for a patient with chest pain, remember the basic steps of care through the mnemonic:

MONA

Rationale:

To help prevent blockages in the coronary arteries after an angioplasty, the doctor may insert a:

stent

Rationale:

The most common sign of a heart attack is:

chest pain

Rationale:

A medication that reduces mortality rates for patients that are suffering from chest pain by inhibiting the action of platelets is:

aspirin

Rationale:

When blockage is present during a cardiac catheterization, the doctor may open the narrow pathways by performing a:

coronary angioplasty

Rationale:

A medical procedure in which a catheter is inserted into a vessel so the doctor can diagnose and treat heart conditions is:

cardiac catheterization

Rationale:

Muscle damage to the heart because of a lack of blood flow is a:

myocardial infarction

Rationale:

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