Nursing 412 Blueprint Exam 2.docx - Nursing 412 Exam 2...

Nursing 412
Exam 2 Med-Surg Content Blueprint
Chp 33-4 questions
Important lab values for ACS/MI patients
 BNP-b-type natriuretic peptide, indicator of how much fluid
 ANP-atrial natriuretic peptide
 Troponin (1
st
one to rise, most sensitive), myoglobin (general muscle damage), CK-MB
(muscular damage cardiac specific)
Prioritization of care for a patient status post PCI, purpose of PCI
 Percutaneous coronary intervention- is a non-surgical procedure that uses a catheter
(a thin flexible tube) to place a small structure called a stent to open up blood
vessels in the heart that have been narrowed by plaque buildup, a condition
known as atherosclerosis.
 Priority Nursing intervention: Pulses, distal to the puncture site, should be
monitored at regular intervals to ensure adequate blood flow.
 For patients with MI/ACS
 Vitals, look for arrhythmias, poor blood perfusion, bleeding risk, lay flat for at least 8
hours
MI
 STEMI/NONSTEMI
 Result of an abrupt stoppage of blood
 Worried about infarction/narcosis
 Severe chest pain-not relieved by nitroglycerin or position change, nausea, vomiting
 Often occurs in morning
 1
st
interventions: 02 high flow, EKG 12 lead, upright position, nitro vasodilator, statins,
morphine, IV access, aspirin (anti-platelet)
 Leukocytes fill the area, takes a while to heal
 Scar tissue forms and heart failure symptoms begin
Complications of MI
 Dysrhythmias-vtacc (give antidysrhythmias), vfib
 Cardiogenic shock-open heart surgery
 Acute pericarditis
 Pericardial friction rub
Chp 34-7 questions
Left sided heart failure vs right sided heart failure signs and symptoms
 Left:
 most common

