A patient is experiencing classic signs and symptoms of acute coronary artery disease.
What should be the nurse’s priority intervention?

Choice B rationale:

LDL (low-density lipoprotein) cholesterol is often referred to as "bad" cholesterol. It contributes to the buildup of plaque in the arteries, which narrows the arteries and can lead to coronary artery disease (CAD). CAD is a major risk factor for heart attack and stroke.

HDL (high-density lipoprotein) cholesterol is often referred to as "good" cholesterol. It helps to remove LDL cholesterol from the arteries and transport it back to the liver, where it can be broken down and removed from the body. Therefore, a high HDL level is protective against heart disease.

An elevated LDL level and a lowered HDL level are both associated with an increased risk of CAD. This is because the elevated LDL level contributes to plaque buildup, while the lowered HDL level means that there is less "good" cholesterol available to remove the "bad" cholesterol from the arteries.

Therefore, the statement "Increased LDL and decreased HDL increase my risk of coronary artery disease" indicates an understanding of the significance of these cholesterol levels.

Choice A rationale:

This statement is incorrect. An increased LDL level will actually increase the amount of cholesterol deposited on the artery walls.

Choice C rationale:

This statement is also incorrect. A decreased HDL level will decrease the amount of cholesterol moved away from the artery walls.

Choice D rationale:

This statement is incorrect. Increased LDL has the potential to increase, not decrease, the risk of heart disease.

Cardiac tamponade is a life-threatening condition that occurs when fluid accumulates in the pericardial sac, the thin, doublelayered membrane that surrounds the heart. This fluid buildup compresses the heart, preventing it from filling properly and pumping blood effectively.

The classic triad of symptoms of cardiac tamponade is muffled heart sounds, jugular vein distention (JVD), and hypotension.

Muffled heart sounds occur because the fluid in the pericardial sac dampens the sound of the heart's valves closing. JVD occurs because the fluid in the pericardial sac compresses the superior vena cava, which is a large vein that carries blood from the upper body back to the heart. Hypotension occurs because the compressed heart is unable to pump blood effectively.

Other signs and symptoms of cardiac tamponade may include:

Tachycardia (rapid heart rate)

Dyspnea (shortness of breath)

Chest pain

Pulsus paradoxus (a drop in blood pressure during inspiration)

Anxiety or restlessness

Altered mental status

Cardiac tamponade is a medical emergency that requires immediate treatment. The goal of treatment is to relieve the pressure on the heart by removing the fluid from the pericardial sac. This is typically done through a procedure called pericardiocentesis, which involves inserting a needle into the pericardial sac and draining the fluid.

Choice B rationale:

Artery dissection is a condition that occurs when the inner layer of an artery tears, allowing blood to flow between the layers of the artery wall. This can lead to a number of complications, including aneurysm formation, rupture, and ischemia (lack of blood flow) to the organs and tissues supplied by the affected artery.

The signs and symptoms of artery dissection vary depending on the location of the dissection. Common symptoms include sudden, severe pain; weakness or numbness; and a difference in blood pressure between the arms or legs.

Artery dissection is a serious condition that requires prompt medical attention. Treatment options may include medication, surgery, or a combination of both.

Choice C rationale:

It is not normal to have muffled heart sounds, JVD, and hypotension following stent placement. These are signs of a serious complication, such as cardiac tamponade or artery dissection.

Choice D rationale:

Myocardial infarction (MI), also known as a heart attack, occurs when blood flow to a portion of the heart is blocked, causing damage to the heart muscle. The classic symptom of an MI is chest pain, but other symptoms may include shortness of breath, nausea, vomiting, sweating, and lightheadedness.

The signs and symptoms of cardiac tamponade and MI can overlap, but there are some key differences. For example, chest pain is more common in MI, while JVD is more common in cardiac tamponade.