Acute Coronary Syndrome and Basic EKG Review

Front

Your patient presents to the ED with c/o chest pain that started 2 hours ago, described as a heaviness in their chest, of the following what is the priority intervention? Options: place the patient on 2 Liters of 02 via NC, Get a 12-lead EKG, draw cardiac enzymes, start a large bore IV

Back

Get a 12-lead EKG

Front

Which of the following results would confirm an NSTEMI? elevated cardiac troponin, decreased cardiac troponin, ST elevation on an EKG, elevated brain natrietic peptide (BNP)

Back

elevated cardiac troponin

Front

Which of the following is a contraindication for administering nitroglycerin? Blood pressure of 84/49, recent administration of a beta-blocker, use of sidenafil (Viagra) 1 month ago, pt report of headache in the past with nitroglycerin

Back

Blood pressure of 84/49

Front

Your patient returns from the OR following bypass surgery using the right saphenous vein for graft. Which of the following assessment findings would require immediate intervention? incisional chest pain, fine crackles at right lung base, O2 sat of 95 on 2L O2, cold, right foot with non-palpable pulse

Back

cold, right foot with non-palpable pulse

Front

Your patient on the unit complains of sudden onset chest pain 8/10, you attain an EKG and you find ST elevation in 3 leads on the EKG what is your priority?

Back

Call a code STEMI and prep the patient for the cath lab

Front

Your patient that complained of chest pain when he first arrived on the unit makes the following statements, which one requires further education and clarification from the nurse?
Options:
If the chest pain returns or worsens I will be sure to let the nurse know
Since my first troponin lab test came back negative that means I am in the clear and I can go home right?
I understand that you may do frequent lab draws and that I will be on the continuous cardiac monitor while I am in the hospital
I understand that I may get a headache after I take nitroglycerin

Back

Since my first troponin lab test came back negative that means I am in the clear and I can go home right?

Front

A patient presents to an ED with c/o of chest pain, the EKG shows ST elevation and the patient is diagnosed with a STEMI, unfortunately they do not have a cath lab on site? Which of the following is appropriate? transfer the patient to facility that can perform a cardiac cath and get them there within 90 minutes, Avoid fibrolytic therapy due to risk of bleeding even if the cath lab is hours away, Give the patient nitroglycerin for the pain and request transfer in the AM, Tell the patient the plan will depend on the results of the cardiac enzymes

Back

transfer the patient to facility that can perform a cardiac cath and get them there within 90 minutes

Front

The nurse is reviewing a patient’s electrocardiogram. Which wave should the nurse recognize as being the first positive wave in a normal cardiac cycle?

Back

P wave

Front

What does the P wave on the ECG tracing represent?

Back

Depolarization of the atria

Front

The nurse is analyzing a client’s electrocardiogram tracing. Which of the following complexes is not normally seen on an electrocardiogram tracing? P wave, QRS complex, T wave, U wave

Back

U wave