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1) You are in the Emergency Department when a 54 year old male arrives rubbing the center of his chest. He states “it feel like someone is sitting on my chest.” He appears pale and his skin is diaphoretic. His radial pulse is strong, but fast. Blood pressure is 130/80 with a pulse ox of 90% on room air. He has no past medical history and takes no medications except for Tylenol for an occasional headache. He has no allergies. You take him back to a room, place on the monitor and gain IV access. His monitor strip is as follows.    This rhythm is?   Atrial Flutter   Third Degree Heart Block   Normal Sinus Rhythm   Atrial Fibrilation   2) Although the patient is not short of breath, he should receive oxygen because   He is hypoxic   Third Degree Heart Block   Normal Sinus Rhythm   Atrial Fibrillation   3) Early signs and symptoms of Acute Coronary Syndrome (ACS) – MI or Heart Attack include:   Pressure – fullness, squeezing, or pain in the center of the chest lasting several minutes (usually more than 15 minutes)   Pain – spreading to the shoulders, neck, arms, or jaw, or pain in the back or between the shoulder blades   Other symptoms: weakness, dizziness, sweating, N/V, uneasiness, dyspnea; distress, anxiety, or sense of impending doom   ALL of these are signs and symptoms of Acute Coronary Syndrome/MI or Heart Attack   4) Women may NOT exhibit typical signs and symptoms of ACS. Which of the following heart attack  symptoms is LESS common in women?   Shortness of breath   Profound sense of fatigue/flu-like discomfort   Indigestion or heartburn   Sudden onset of crushing chest pressure   5) The next priority in his assessment (within 10 minutes of arrival) is   Obtain a 12 lead ECG and have it interpreted by a physician.   Exercise stress test   Portable chest X-ray   CT scan   6) You complete a 12 Lead ECG which reveals:    Unstable angina   Normal ECG   Bundle branch block   STEMI   7) This patient most likely has experienced an   Occlusion of a carotid artery   Occlusion of a coronary vein   Occlusion of a coronary artery   Occlusion of a peripheral artery   8) What should you do next?   Wait and see if the patient improves.   Place the ECG in the chart.   Activate a Code STEMI by dialing X22222 and saying “911 STAT Cardiology Consult.”   Look for a Resident or Attending   9) Which medication(s) should be given immediately upon diagnosis of myocardial infarction?   Dual antiplatelet therapy such as Aspirin and Ticagrelor   Epinephrine   Lidocaine   Amiodarone   10) Nitroglycerin is administered to this patient without pain relief. He continues to complain of chest pain that he rates as an 8/10. He is obviously uncomfortable. Which type of medication should be given to relieve the pain of myocardial infarction?   Narcotics such as Morphine, Fentanyl   Calcium Channel Blockers such as Diltiazem   Beta blockers such as Lopressor   Statins such as Lipitor   11) Which of the following Lab tests are important to the diagnosis of Acute MI?   Complete blood count   Lactic Acid level   Troponin Level   Chem-14   12) This patient should be prepared to be emergently transported to?   Radiology for a CT scan   The cardiac catheterization lab   The cardiac telemetry unit   The ICU/coronary care unit   13) What is the goal from patient symptom onset to restoring blood flow to the coronary artery?   There are no goals   The amount of time the vessel remains blocked does not affect patient outcomes   10 minutes   90 minutes   14) The size of this patient’s infarction (amount of myocardium that dies) is what will determine  how well he does into the future (mortality). The size of his infarction is dependent upon   LDL levels at discharge.   Amount of time it takes to get a beta blocker.   Genetics.   Length of time until the vessel is opened and flow is restored.   15) As you are preparing the patient for transport, he suddenly becomes dizzy and feels as if he is going to pass out. You follow protocol and the patient is currently on a transport cardiac monitor which reveals Sinus Bradycardia at a rate of 32. His blood pressure is now 70/50 and his pulse oximetry is 96%. IV access was obtained earlier. You should   Administer Epinephrine 1mg IVP.   Administer Amiodarone 150mg IVP.   Administer an additional 181mg of aspirin.   Administer Atropine 0.5mg IV.   16) There is no response to the administration of Atropine. Another option in the acute management of this patient is   Transcutaneous pacing   Defibrillation   Amiodarone 150mg   Cardioversion   17) After a successful percutaneous coronary intervention in which the patient received a coronary stent, he returns to the floor. Two hours later, your patient complains of chest pressure and shortness of breath. Assessment of his telemetry rhythm reveals Sinus Rhythm with frequent PVCs and ST segment elevation. Identify which the strip below exhibits ST segment elevation:           A   B   C   D   18) What do you do next?   Document the strip and place it in the chart.   Activate a Code Stroke   Call Pastoral Care   Immediately obtain a 12 lead ECG and activate Code STEMI process by dialing X22222 and saying “911 STAT Cardiology Consult.”   19) If you suspect your patient is having a MI, but are not sure, which course of action could be harmful?   Activating the Code STEMI process.   Notifying the physician.   Notifying your team leader or charge nurse.   Waiting one hour and see if things improve.   20) You would expect this patient to be discharged on   Cardizem, Digoxin, Beta Blocker and Verapamil   Beta Blocker, Ace Inhibitor, Aspirin and High intensity Statin   There are no guidelines or recommendations for patients with an acute MI.   Amiodarone, Lidocaine and Epinephrine   21) Modifiable risk factors for Heart Disease include ALL of the following, EXCEPT:   Physical inactivity   Obesity   Old age   High cholesterol   22) All Acute MI patient receive Cardiac Rehabilitation inpatient education because:   Cardiac rehab is most effective when introduced while in a hospital setting.   Cardiac rehab cuts the risk of repeat heart attacks by 15-20% by educating patients on modifiable risk factors.   Cardiac rehab participants have a 35% lower death rate than non-participants.   All of the above.   23) SSM SLUH STEMI Program information and resources can be found:   On the SSM SLUH Intranet site under Departments/STEMI Program   Twitter   Snapchat   In the bathroom   Back To Course Information   S ubmit Results ORDER A SIMILAR ESSAY WRITTEN FROM SCRATCH at : https://www.nursingessayhub.com/