University:
West Coast University
Course:
NURS 110 | Introduction to Professional Nursing
Academic year:

2021
Views:

238

Pages:

3
Author:

Hallie Randolph

Topic 1 CAD - Activity 4: Mini Case Study Mr J, a non-smoking 63 year old male suffers several bouts of severe chest pain during the night and faints on trying to get out of bed. His wife calls an ambulance and paramedics record the ECG below (chart speed = 25 mm (5 large boxes)/sec). He takes little physical activity. He has no significant family history. He has been prescribed blood pressure medication but nothing else. The paramedics treat this as a STEMI. Q1. What are the medical terms for Mr J’s signs and symptoms of (a) chest pain and (b) fainting? A. B. C. D. E. (a) (a) (a) (a) (a) Stable Angina (b) Syncope Stable Angina (b) Ataxia Unstable Angina (b) Ataxia Unstable Angina (b) Syncope Variant Angina (b) Diaphoresis Q2. How many risk factors for Coronary Artery Disease does Mr J have? A. B. C. D. E. 5 7 6 4 3 Q3. STEMI stands for: A. B. C. D. E. Status Triage Emergency Myocardial Infection Sinus Tachycardia Evidence of Myocardial Ischaemia Severe Troponin Elevation Myocardial Injury ST segment Elevation Myocardial Infarction Symptoms Typical of Emergency Myocardial Incident Q4. The lead(s) which have their positive pole on Mr J’s right arm electrode are: A. B. C. D. Only II Only aVR I and aVR II and aVR E. Only I Q5. Which region of the ventricles appears to be affected? A. B. C. D. E. The The The The The right lateral wall posterior wall inferior wall left lateral wall anterior wall Q6. Which coronary artery is most likely involved (keep scratching for correct answer to Q6)? A. B. C. D. E. Left anterior descending artery (LAD) Right main coronary artery (RCA) Left circumflex artery (LCX) Posterior branch of the right coronary artery Impossible to assess from ECG alone Mr J undergoes coronary angiography and a stent is inserted in a blocked coronary artery Q7. To conduct this procedure the catheter is inserted into the coronary circulation: A. B. C. D. E. Via a peripheral artery Surgically via the coronary sinus Surgically via the aorta Surgically via the pulmonary vein Via a peripheral vein Q8. Mr J’s average heart rate is: A. B. C. D. E. 75 beats/min 115 beats/min 103 beats/min 86 beats/min 94 beats/min Q9 Stent placement is coupled with which of the following procedures? A. B. C. D. E. Thrombectomy CABG Thrombolysis Key-hole surgery Angioplasty On arrival at hospital a blood test is ordered and reveals the follow results Blood screen Mr J Normal Range Haemoglobin (g/L) White Cell Count (109/L) Troponin T (g/L) Albumin (g/L) 115 15.2 2.65 62 132-170 4.0 -11.0 0.00 – 0.03 35-50 Blood screen (mmol/L) Total cholesterol LDL cholesterol Fasting blood glucose Urea Q10. What blood result(s) confirm that an MI has occurred? A. Troponin coupled with Urea B. Troponin coupled with White Cell Count Mr J 6.8 4.8 5.5 9.2 Normal Range 3.0 – 5.5 2.0 -3.4 3.5-5.5 2.5-7 C. Troponin Coupled with LDL cholesterol D. Troponin alone E. None of these