Acute Coronary syndromes

Question 1

What is coronary artery disease?

Answer 1

an umbrella term that includes angina and acute coronary syndrome

Question 2

Ischemia

Answer 2

insufficient oxygen is supplied to meet requirements

Question 3

Infarction

Answer 3

necrosis when ischemia is prolonged causing decreased perfusion and irreversible damage

Question 4

what is the difference between stable and unstable angina?

Answer 4

stable is predictable and occurs with exertion
unstable is new onset, poorly relieved by NTG

Question 5

What is angina pectoris?

Answer 5

chest pain caused by temporary imbalance of oxygen supply and the demand for oxygen

Question 6

What is Chronic stable angina?

Answer 6

chest discomfort that occurs with moderate to prolonged exertion due to FIXED atherosclerotic plaque

Question 7

Typical 3 features of chronic stable angina

Answer 7

substernal chest pain or heaviness
precipitated by stress
relieved by rest or NTG

Question 8

What is a diagnostic indicator for stable angina?

Answer 8

cardiac biomarkers like troponin are not elevated

Question 9

what is the usual dosage for plavix?

Answer 9

75 mg/day

Question 10

What is acute coronary syndrome?

Answer 10

used to describe patients with unstable angina or acute MI

Question 11

Vasospastic angina

Answer 11

chest pain from coronary artery spasm and occurs at rest

Question 12

Myocardial infarction

Answer 12

myocardial tissue is deprived of oxygen

Question 13

what are the 2 types of MIs?

Answer 13

Non ST segment elevation (NSTEMI)
ST elevation (STEMI)

Question 14

How does an NSTEMI present on an EKG?

Answer 14

ST segment depression and T inversion

Question 15

How does a STEMI present on a EKG?

Answer 15

ST segment elevation

Question 16

What are the cardiac biomarkers?

Answer 16

Troponin T
Troponin I
CK-MB
Myoglobin

Question 17

Characteristics of Unstable angina

Answer 17

pressure lasting longer than 15 min
poorly relieved by NTG
severe activity limitation
increase in number of attacks

Question 18

What does the T-wave inversion represent for NSTEMI?

Answer 18

some ischemia

Question 19

What does the ST elevation represent for STEMI?

Answer 19

zone of injury

Question 20

What happens over a 2-3 month period after an infarction?

Answer 20

ventricular remodeling

Question 21

What is the problem with ventricular remodeling?

Answer 21

scar tissue decreases left ventricular function
causes HF
does not contract or conduct electrically

Question 22

What is the immediate tx for a patient presenting with MI symptoms?

Answer 22

Morphine
Oxygen (NC)
Nitroglycerin
Aspirin 324-650mg

Question 23

Dosage for sublingual NTG

Answer 23

0.4 mg 5 min up to 3 doses for stable angina
multiple doses titrated for NSTEMI

Question 24

Nursing management for ACS

Answer 24

Managing acute pain
increase perfusion
identify and manage dysrhythmias
monitor and manage heart failure

Question 25

what are some diagnostic procedures to rule out cardiac etiology?

Answer 25

stress test imaging angiogram

Question 26

What is a coronoary angiogram?

Answer 26

catheter is snaked through femoral artery and contrast is injected to visualize blockages

Question 27

What is an angioplasty?

Answer 27

a balloon is used to stretch the vessels of the wall and put in a stent

Question 28

what are some things to take into consideration for an angiogram?

Answer 28

allergies bleedings pulses creatinine

Question 29

What is a CABG?

Answer 29

coronary artery bypass graph disease in multiple areas harvest veins from body and create bypass graphs

Question 30

what are examples of percutaneous therapies?

Answer 30

angiogram and angioplasty

Question 31

what are some complications of CABG?

Answer 31

bleeding cardiac tamponade change in LOC hypo or hypertension

Question 32

What do you assess after a CABG?

Answer 32

distal pulses

Question 33

what medication can interact with nitroglycerin?

Answer 33

Viagra

Question 34

Why would we do a transesophageal echo? (TEE)

Answer 34

to get a clearer view to look for clots or vegetation

Question 35

what is the pre procedure for cath lab?

Answer 35

vital signs auscultate lungs assess pulses allergy hx make sure signed consent is done analyze labs withhold anticoagulants or diuretics

Question 36

potential complications for cath lab

Answer 36

tamponade hematoma retroperitoneal bleeding

Question 37

post cath nursing interventions

Answer 37

assess VS every 15 min keep leg straight for 2-6 hrs assess site

Question 38

what is cardiogenic shock?

Answer 38

heart can't pump enough to meet demands

Question 39

s/s of cardiogenic shock

Answer 39

tachycardia hypotension cold clammy skin tachypnea