mi

Question 1

What is a myocardial infarction (MI)?

Answer 1

Total occlusion of one or more coronary arteries → ischemia & death of myocardial tissue.

Question 2

What is the most common cause of MI?

Answer 2

Atherosclerosis.

Question 3

How does atherosclerosis lead to MI?

Answer 3

Accumulations obstruct artery or break off → platelets aggregate → thrombus formation.

Question 4

Why is aspirin given in MI?

Answer 4

To prevent platelet aggregation and allow blood to flow (“platelets slide by”).

Question 5

Besides a thrombus, what else can cause an MI?

Answer 5

Clot breaking off or embolus.

Question 6

Major risk factors for MI?

Answer 6

Family history of CAD, hypertension, smoking, hypercholesteremia/hyperlipidemia, obesity, diabetes, concurrent diabetes with comorbidity, high CRP, hyperhomocysteinemia.

Question 7

What inflammatory marker is linked with MI risk?

Answer 7

High-sensitivity C-reactive protein (CRP).

Question 8

What unusual blood finding may be associated with MI?

Answer 8

Elevated RBC count.

Question 9

What is the classic symptom of MI in men?

Answer 9

Chest pain or crushing pressure radiating to left arm, shoulder, or jaw (“elephant on chest”).

Question 10

What MI symptoms are more common in women?

Answer 10

Fatigue, weakness, syncope, anxiety, upper back pain, indigestion, epigastric pain, nausea, vomiting.

Question 11

Other common MI symptoms (both genders)?

Answer 11

Dizziness, shortness of breath, sweating, pallor.

Question 12

What diagnostic tools are used for MI?

Answer 12

History & physical exam, labs (troponin I, CK-MB), ECG, angiography, echocardiography, chest radiograph.

Question 13

What key questions should be asked in history for MI?

Answer 13

How long? When did it start? What were you doing when it started?

Question 14

What cardiac enzyme is most specific for MI?

Answer 14

Troponin I (elevated in MI, peaks 24–48 hrs).

Question 15

What ECG finding indicates STEMI?

Answer 15

ST elevation in ≥2 leads.

Question 16

How is STEMI different from NSTEMI?

Answer 16

STEMI: ST elevation, rapid heart muscle death, absolute emergency. NSTEMI: No ST elevation, elevated troponin, ECG may be normal.

Question 17

How quickly should a STEMI patient be in the cath lab?

Answer 17

Within 90 minutes.

Question 18

Why do NSTEMI patients stay in the hospital 3 days?

Answer 18

To monitor troponin trend (peaks then returns to baseline).

Question 19

Initial emergency treatment for suspected MI?

Answer 19

ABCs (Airway, Breathing, Circulation).

Question 20

What surgical procedures may be used for MI?

Answer 20

PCI (percutaneous coronary intervention), PTCA (percutaneous transluminal coronary angioplasty).

Question 21

How is PCI/PTCA performed?

Answer 21

Catheter inserted via groin/arm → balloon inflated → plaque pushed aside → stent placed → balloon removed.

Question 22

What are nursing implications post-stent placement?

Answer 22

Assess VS (perfusion, cardiogenic shock, HF), puncture site (bleeding/hematoma), pulses on puncture side (perfusion).

Question 23

What medications are used for MI (acute and long-term)?

Answer 23

Aspirin, statins, beta blockers, clopidogrel (Plavix), ACE inhibitors, nitroglycerin.

Question 24

What dose of aspirin is given in MI (STEMI or NSTEMI)?

Answer 24

324 mg.

Question 25

Why is clopidogrel (Plavix) prescribed after stent placement?

Answer 25

Prevent platelet aggregation and complications (works with aspirin).

Question 26

Example of statin used after MI?

Answer 26

Atorvastatin (Lipitor).

Question 27

Example of beta blocker used after MI?

Answer 27

Carvedilol (Coreg).

Question 28

Example of ACE inhibitor used after MI?

Answer 28

Lisinopril (Zestril).

Question 29

Routes nitroglycerin can be given?

Answer 29

IV, sublingual, topical.

Question 30

Nursing precautions with topical nitroglycerin?

Answer 30

Wear gloves, risk of hypotension, fainting, change every 6 hrs, apply ~1 inch strip.

Question 31

Long-term management of MI includes what?

Answer 31

Medications (aspirin, beta blockers, ACE inhibitors), lifestyle modifications (healthy diet, exercise, smoking cessation, control chronic conditions).

Question 32

What complications must be monitored for in MI (esp. STEMI)?

Answer 32

Cardiogenic shock, pulmonary edema, heart failure.