Angina

Question 1

What is atherosclerosis?

Answer 1

Endothelial lining of arteries reacts to HTN and high cholesterol by inflammation. Platelets are activated and macrophage infiltration causes uptake of lipids. This causes blockages

Question 2

Is arterial blood flow under high or low pressure?

Answer 2

Higher than the venous system

Question 3

What does the aorta do in relation to blood flow?

Answer 3

Regulates coronary artery blood flow and supply

Question 4

Modifiable risk factors for CAD?

Answer 4

Elevated lipids, HTN, cig smoking, diabetes type 2, stress, physical inactivity, and obesity.

Question 5

Non modifiable risk factors CAD?

Answer 5

Gender (men>women until 65 yrs), Diabetes types 1, increasing age, genetic predisposition, family redisposition, and ethnicity.

Question 6

Psychological risk factors for CAD?

Answer 6

Depression, anger, stress, and hostility.

Question 7

Symptoms of angina?

Answer 7

Usually chest pain (described as burning, crushing chest pain, pressure can go down into shoulder and left arm). Can also be described as indigestion or tooth ache

Question 8

What is angina?

Answer 8

Pain causes by imbalance between O2 supply and the cardiac muscle demand for it. There’s not enough O2 getting to the cells and it causes ischemia.

Question 9

Stable and unstable angina?

Answer 9

Stable- chest pain after exertion that resolves with rest/nitro within 5 min, it’s familiar/unchanged
Unstable- episode of chest pain that doesn’t resolve within 5 minutes, poorly relieved by nitro/rest and pressure may last longer than 15 min, occurs at rest/with exertion, its a new onset,

Question 10

What can angina be a precursor to?

Answer 10

MI

Question 11

What are the focused nursing assessments for angina?

Answer 11

CVS and PVS. Auscultate heart, skin colour (ashy or blue colour), edema, peripheral pulses, signs of HF.

Question 12

What is cardiac blood work?

Answer 12

Let’s you know serum cardiac markers (proteins release into blood when there’s necrosis and damage to the myocardium). CKs indicate cardiac muscle damage.

Question 13

Dx and labs for angina?

Answer 13

Cardiac blood work, ECG, ASA, O2 therapy, nitroglycerin

Question 14

ECG for angina?

Answer 14

Obtain a 12 lead ECG within 10 minutes of pt reporting chest pain. This will identify QRS or ST abnormalities and is the easiest way to rule out an MI.

Question 15

Pharmacological management for angina?

Answer 15

Give aspirin initially to reduce thrombus formation (162-325 mg). Nitroglycerin is a coronary vasodilator and works fast to relieve chest pain. Give morphine if nitro doesn’t work/pain persists because it reduces pain and has some coronary vasodilation properties. Also can give platelet inhibitors.

Question 16

What do beta blockers and ace inhibitors do?

Answer 16

BB- slow HR and increase CO
AI- vasodilator, decrease amount of effort the heart needs to use

Question 17

Exercise stress test?

Answer 17

Common dx test that combines exercise (treadmill) and ECG monitoring to evaluate myocardial tissue perfusion. Positive stress test means there’s a positive result (mismatch between O2 demand and perfusion rates).

Question 18

What does thrombotic therapy do?

Answer 18

Medication will break up clots and open blood vessels. Need to monitor for bleeding.

Question 19

What is a coronary artery stent?

Answer 19

Put a stent where the blockages are, expand the balloon and it keeps the artery open.

Question 20

Pt education for angina?

Answer 20

Have a good diet (low fat intake), increase omega 3 fatty acids, smoking cessation, decrease nicotine use

Question 21

What is CAD?

Answer 21

Broad term that includes chronic stable angina and ACS. It affects arteries that provides blood and O2 to myocardium. Ischemia and infarction can occur

Question 22

What is ischemia and infarction?

Answer 22

1. There’s insufficient O2 supplied to meet requirements of myocardium
2. Also known as cell death, occurs when severe ischemia is prolonged and decreased perfusion causes irreversible damage to tissue

Question 23

What is acute coronary syndrome (ACS)?

Answer 23

Patients who have unstable angina or acute MI. The atherosclerosis plaque in coronary artery ruptures which causes clot formation and blood flow is impaired

Question 24

What is vasospatic angina?

Answer 24

Chest pain resulting from coronary artery spasms and usually occurs after rest

Question 25

What is an MI?

Answer 25

Most serious ACS and myocardial tissue is abruptly deprived of O2 and blood flow is reduced/ischemia develops. There’s 2 types

Question 26

Troponin lab test?

Answer 26

These lab values rise quickly if there’s MI and necrosis.

Question 27

Nurses priority assessment for ACS?

Answer 27

Pain. Chest pain can be from muscle damage from ischemia. Need to improve cardiac perfusion (ABC-C)

Question 28

What does chest pain longer than 30 min indicate?

Answer 28

Obstruction in the coronary artery

Question 29

What is the priority nursing intervention for pt receiving thrombolytic therapy?

Answer 29

Monitor LOC. Changes in it indicate bleeding in brain

Question 30

Gold star diagnostic tool for ACS?

Answer 30

ECG. Always do it first

Question 31

What is the purpose of heparin?

Answer 31

It prevents clots from forming.

Question 32

What question should nurse ask so client can be a candidate from fibrinolytic therapy?

Answer 32

What time did your chest pain begin? This type of therapy has a time limit and knowing when chest pain started allows team to determine therapy