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CAD and ACSMedical Surgical Nursing

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Which type of dysrhythmias are common for up to three days post CABG?
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Atrial dysrhythmias (usually fibrillation)
What type of medications are required for a patient that has had a CABG using the radial artery?
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Calcium channel blockers (for at least three months) to prevent spasms
Which patients typically experience higher levels of pain, those who have had a thoracotomy incision for a MIDCAB or OPCAB, or those that have had a sternotomy for CABG?
Show Answer
The patients who have had a thoracotomy. Pain management is very important to speed healing
What are the 6 levels/categories of emotional and behavioral responses to ACS?
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Denial, Anger, Anxiety/Fear, Dependency, Depression, Realistic Acceptance
What is MET related to heart function?
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The amount of oxygen required by the body at rest (3.5 mL per kilogram per minute OR 1.4 kcal/kg per minute)
What is the goal for a patient's MET (related to heart function) by discharge?
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3-6 METs (essentially, be able to walk down the hall, up a few stairs, etc. without experiencing cardiac ischemia)
What is an important teaching point related to a patient's activity after hospital discharge?
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How to monitor their pulse and to listen to what their body is saying to avoid overexertion and recognize when to rest
Which is more important when assessing activity tolerance, a patient's heart rate or development of stable angina/dyspnea? Why?
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The development of symptoms like angina, dyspnea are more important because a patient may be on beta blockers that would impact the heart rate
Which type of exercise is most optimal for a cardiac patient, static/isometric, or dynamic/isotonic?
Show Answer
Dynamic/Isotonic
You have a patient with a history of MI. Which of the exercise plans below would be the best for him? Option one: Weight lifting, carrying heavy objects, pushing/pulling weight bearing exercises Option two: Walking, jogging, biking, swimming
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Option two: they are isotonic activities that put a safe and steady load on the heart
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At what point should a patient post-MI be referred to a specialist for treatment of depression?
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If is lasts more than 4 months
You have a patient post-MI that wants to resume sexual activity. What teaching should you provide?
Show Answer
Physical exercise is recommended because it improves the physiological response during sex, no food or alcohol 3-4 hours prior, masturbation may be beneficial to identify sex is still possible, no hot or cold showers immediately before or after, no ED meds, foreplay is encouraged, it gradually raises the HR, oral is fine, anal isn't.
How soon after an uncomplicated MI can a patient resume sexual activity?
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7-10 days
What is the most common complication of sudden cardiac death encountered by those who survive?
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Neurological impairment
What is the most common cause of sudden cardiac death?
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CAD
Death from sudden cardiac disease typically occurs within _______ of the onset of symptoms.
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One hour
Who is most likely to suffer from sudden cardiac death, a person with a history of acute MI, or one who has never had angina?
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A person who has never had a sign/symptom of CAD like angina
What are the strongest risk factors for Sudden Cardiac Death (SCD)?
Show Answer
Ejection fraction less than 30%, history of ventricular dysrhythmias, male, African American, family history of atherosclerosis, tobacco use, diabetes mellitus, hypercholesterolemia, hypertension, and cardiomyopathy
What is the most common treatment used to prevent recurrence of SCD (Sudden Cardiac Death)?
Show Answer
Implantation of a cardioverter-defibrillator (ICD) with amiodarone medication to prevent dysrhythmias
What is the most common condition associated with an increased risk of sudden cardiac death?
Show Answer
Atherosclerotic heart disease/CAD
  
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