Acute Coronary Syndrome
The first-line medication for chest pain that also reduces preload
What is Morphine?
— provides pain relief and venodilation, decreasing preload and myocardial O₂ demand.
What does the acronym “BE FAST” stand for in stroke recognition?
Balance, Eyes, Face, Arms, Speech, Time.
What are the two most common causes of acute pancreatitis?
Gallstones and alcohol use.
Name the classic “4 Fs” risk factors for cholelithiasis.
Female, Forty, Fertile, Fat.
Case:
A 64-year-old male recovering from an inferior STEMI suddenly develops slurred speech and right-sided weakness.
He’s on heparin and has a BP of 180/100.
What is the most likely complication, and what are your immediate nursing priorities?
Hemorrhagic stroke due to anticoagulation.
Actions: Stop anticoagulant, maintain airway, elevate HOB 30°, prepare for CT scan, and notify provider immediately.
This cardiac biomarker is the most specific indicator of myocardial injury.
What is Troponin I/T?
— rises 4–6 hours after injury, peaks 10–24 hours, returns to baseline in 10–14 days.
This type of stroke results from a ruptured blood vessel.
Hemorrhagic stroke.
Why is the patient with acute pancreatitis kept NPO?
To prevent pancreatic stimulation and autodigestion by enzymes.
What stool and urine color changes occur with bile duct obstruction?
Clay-colored stool and dark amber urine.
What is the goal “door-to-balloon” time for PCI in a STEMI?
What is 90 minutes of hospital arrival.
tPA (alteplase) must be administered within how many hours of symptom onset for ischemic stroke?
Within 4.5 hours (after ruling out hemorrhage).
What are Cullen’s and Grey-Turner’s signs?
Cullen’s = Bluish discoloration around the umbilicus Grey-Turner’s = flank bruising
— signs of retroperitoneal bleeding.
What symptom is most common after eating a fatty meal in cholelithiasis?
Right upper quadrant pain radiating to the shoulder or scapula.
Name two immediate nursing actions for a patient presenting with chest pain and ST-segment elevation.
Obtain a 12-lead ECG, apply O₂, give chewable aspirin, and start an IV for rapid treatment.
A patient has right-sided weakness and facial droop. Which side of the brain is affected?
Left hemisphere.
Describe the hallmark pain pattern of acute pancreatitis.
Severe epigastric or LUQ pain radiating to the back, unrelieved by vomiting.
What is the diagnostic test of choice for gallbladder disease?
Ultrasound
— most accurate and noninvasive.
What are two potential post-MI complications related to the pericardium?
Pericarditis and Dressler’s syndrome
— inflammation causing chest pain relieved by leaning forward.
Differentiate between thrombotic and embolic stroke.
Thrombotic = local clot formation;
Embolic = clot traveled from another site.
What life-threatening complication can result from severe pancreatitis?
Pancreatic necrosis or acute respiratory distress syndrome (ARDS).
What surgical intervention is commonly performed for gallstones, and what is a key post-op instruction?
Laparoscopic cholecystectomy
— encourage early ambulation and monitor for shoulder pain from CO₂ gas.