Question

Prep Questions for Cardiogenic Shock Secondary to AMI Scenario 1. Describe the nursing care of the post angioplasty patient. 2. Identify the possible complications and their causes following coronary stent placement and the nursing care that is designed to prevent these complications. 3. Describe the administration and desired effect of nitroglycerin 4. What should be included in a complete neurovascular assessment to the lower extremities following a cardiac catheterization? 5. What are the signs and symptoms of a myocardial infarction? What laboratory values and trends reflect a positive myocardial infarction? What is the relationship of PVCs to a myocardial infarction? 6. Describe drug eluting stents and the rationale for their use. Compare cardioversion and defibrillation. 7. 8. What effect does albumin have on the circulatory system What are the pharmacokinetics of heparin and morphine? 9.

Answer 1

1. ANS: Nursing care of the post angioplasty patient:

At first assess the vitals, SpO2, I / O, assess for bruits, assess patient for bleeding, keep extremity with catheter immobile, HOB no higher than 30 degrees, push fluids to flush out contrast dye, SOB, monitor neuro status for changes in LOC, asses for chest pain and back pain.

2. ANS: Coronary stent placement possible complications and nursing care:

Restenosis (re-narrowing of artery): It can happen without stent placement, drug-eluding stents reduce the risk of restenosis.

Blood clots: can form even after surgery and can lead to a heart attack; important to take aspirin, Plavix, or other medication that can reduce risk of blood clots forming stent and it is important to educate the patient on never stopping medications without speaking with their doctor first.

Bleeding: It can occur in arm/leg where catheter was inserted, may result in a bruise or serious bleeding that could require a blood transfusion

3. ANS: Nitroglycerin side effects: Nitroglycerin can cause serious cerebral pains. These migraines may bit by bit turn out to be less extreme as you keep on using nitroglycerin. Try not to quit taking this solution. Ask your specialist before utilizing any cerebral pain torment solution.

Common side effects may include:

Headache

Dizziness, turning sensation

Nausea, heaving

Flushing (warmth, redness, or tingly feeling)

4. ANS: Cardiac catheterization neurovascular assessment: Monitor the peripheral pulses, color, and sensation of extremity distal to insertion site (every 15 minutes x 4, every 30 minutes x 4, and every 1 hour x 2). Monitor opposite extremity pulse to asses for presence of equal pulses, color and sensation bilaterally.

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