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Cardiac > CAD > Flashcards

CAD Flashcards

1
Q

Is CAD the most common type of heart disease?

A

Yes

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2
Q

What does CAD include?

A
  • Chronic stable angina

- Acute coronary syndrome

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3
Q

What is Chronic stable angina?

A

Intermittent decreased blood Flow to the myocardium which leads to ischemia causing temporary pain/pressure in chest

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4
Q

What brings the pain on in chronic stable angina?

A

Low oxygen usually d/t exertion

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5
Q

What relieves the pain in chronic stable angina?

A

Rest and/or Nitro SL

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6
Q

What meds are used for treatment of chronic stable angina?

A

Nitroglycerin SL

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7
Q

What does nitro cause the body to do?

A
  • Venous and arterial dilation

- Dilation of coronary arteries

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8
Q

What does venous and arterial dilation cause?

A

Decreased preload and afterload

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9
Q

What does dilation of the coronary arteries do?

A

Increase blood flow to the actual heart muscle (myocardium)

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10
Q

How often can you take Nitro SL?

A

-1 every 5 min x 3

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11
Q

Is nitro ok to swallow?

A

No

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12
Q

Where should nitro be kept?

A

Dark, glass bottle in a dry and cool place

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13
Q

May nitro burn or fizz?

A

Yes, if not check expiration date

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14
Q

What will the clients get after taking nitro?

A

HA

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15
Q

How often should you renew nitro?

A

Every 6 months

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16
Q

How often should nitro spray be renewed?

A

Every 2 years

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17
Q

After nitro what do you expect bp to do?

A

drop

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18
Q

Should you ever leave an unstable client?

A

No

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19
Q

Take on Nitro SL, after five minutes if chest pain/discomfort is unimproved or worsened, activate what?

A

Emergency response

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20
Q

Can BB be used for prevention of angina?

A

Yes

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21
Q

What do BB do to BP, P and myocardial contractility?

A

decrease it

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22
Q

What do BB do to the world of the heart?

A

decrease it

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23
Q

BB block the beta cells which are the receptor sites for what?

A

Catecholamines (epi/norepi)

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24
Q

With BB contractility is decreased doing what to CO?

A

decreasing it

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25
Q

Do BB decrease the workload of the heart?

A

YEs

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26
Q

Can CO be decreased too much with BB?

A

Yes

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27
Q

BB decrease the work of the heart and the need for oxygen which decreases what?

A

angina

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28
Q

What do CC blockers do to BP?

A

Decrease it

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29
Q

Do CC blocker cause vasodilation of arterial system?

A

Yes

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30
Q

Do CC blockers dilate the coronary arteries?

A

Yes

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31
Q

What are two benefits of CC blockers?

A
  • Decrease afterload

- increase oxygen to heart muscle

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32
Q

Is Acetylsalicylic acid (aspirin) used for chronic stable angina?

A

Yes, dose determined by HCP

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33
Q

Should clients with Chronic stable angina rest frequently?

A

Yes

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34
Q

Should people with chronic stable angina avoid overheating and excess caffeine or any drugs that increase HR?

A

Yes

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35
Q

Should people with chronic label angina wait 2 hours after eating to exercise?

A

Yes

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36
Q

Could any temperature extremes precipitate an attack with chronic stable angina?

A

Yes

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37
Q

Should people with Chronic stable angina smoke? lose weight? avoid isometric exercise? reduce stress?

A
  • No smoking
  • Yes, lose weight
  • Yes, avoid isometric exercise
  • Yes, reduce stress
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38
Q

In chronic stable angina should you do everything you can to decrease the workload of the heart?

A

Yes

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39
Q

Can cardiac Cath be used for chronic stable angina?

A

Yes

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40
Q

With Cardiac Cath should we assess if client I s allergic to iodine or shell fish?

A

yes

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41
Q

When using dye what labs should you check?

A

Kidney function tests

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42
Q

What is commonly prescribed before a cardiac Cath procedure to help protect the kidneys?

A

Acetylcysteine

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43
Q

Can dye feel like a hot shot?

A

Yes

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44
Q

Are palpitations after cardiac cath normal?

A

Yes?

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45
Q

Post Cath procedure what should you watch the puncture site for?

A

Bleeding and hematoma formation

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46
Q

Post Cath procedure what should you assess when assessing the distal extremity to the puncture site?

A

5 p’s:

  • pulselessness
  • pallor
  • pain
  • paresthesia
  • paralysis
47
Q

After cardiac cath the client have to lay flat on bedrest with extremity straight for how long?

A

4-6 hours

48
Q

What is a major complication post cardiac Cath?

A

Hemorrhage

49
Q

Should pain post cardiac Cath be reported asap?

A

Yes, may be developing a hematoma

50
Q

If a client takes metformin how long after a cardiac cath should it be held?

A

48 hours, worried about kidneys

51
Q

Unstable chronic angina= ?

A

Impending MI

52
Q

What can acute coronary syndrome encompass?

A

MI or unstable angina?

53
Q

Decreased blood flow to the myocardium results in?

A

Ischemia and necrosis

54
Q

Does the client have to be doing anything to have pain from acute coronary syndrome?

A

No

55
Q

In acute coronary syndrome will nitro relieve the pain?

A

No

56
Q

What are s/s of acute coronary syndrome?

A
  • Pain (chest discomfort)
  • Cold/clammy/bp drops
  • CO is going down
  • ECG changes
  • Vomiting
57
Q

What may chest discomfort in acute coronary syndrome be described as?

A
  • crushing
  • elephant on chest
  • pressure radiating to neck, jaw, one or both arms, shoulder/shoulder blades
58
Q

With acute coronary syndrome, a client may report tightness or pressure in the chest as well as what?

A
  • Dizziness
  • Sweating
  • N/V
59
Q

Women usually present with GI signs and symptoms in acute coronary syndrome such as what?

A
  • Epigastric discomfort
  • Pain between shoulders
  • An aching jaw or a choking sensation
60
Q

In acute coronary syndrome the elderly often report what?

A

SOB

61
Q

Elderly women, and diabetics likely deny symptoms and delay care because why?

A

symptoms are vague and less typical

62
Q

Is a NSTEMI or STEMI worse?

A

STEMI

63
Q

with a STEMI what time is the goal to get patient to Cath lab?

A

90 minutes

64
Q

Why are NSTEMI clients usually less worrisome?

A

Partial coronary vessel blockage by a thrombus

65
Q

What labs can determine acute coronary syndrome?

A
  • CPK-MB
  • Troponin
  • Myoglobin
66
Q

What is CPK-MB?

A

A cardiac specific isoenzyme

67
Q

Is CPK-MB increased or decreased with damage to cardiac cells?

A

Increased

68
Q

When does the CPK-MB elevate, peak, and return to normal?

A
  • Elevate: 6 hours
  • Peaks: 12-24 hours
  • Normal: within 24-36 hours
69
Q

What is troponin?

A

a cardiac biomarker with high specific to myocardial damage

70
Q

When does troponin elevate? peak? Remain elevated?

A
  • Elevate: 3-4 hours
  • Peak: 10-24 hours
  • Elevated: for up to 3 weeks
71
Q

When does myoglobin increase with a acute coronary syndrome? peak?

A

2 hours and peaks 3-15 hours

-negative results= a good thing

72
Q

Which cardiac biomarker is the most sensitive indicator for an MI?

A

-Troponin

73
Q

Which enzymes or biomarkers are most helpful when the client delays seeking care?

A

Troponin (stays elevated longest)

74
Q

What untreated arrhythmias will put the client at risk for sudden death?

A
  • Pulseless tach
  • vfib
  • asystole
75
Q

What is the priority treatment for vfib?

A

Defib the vfib

76
Q

If defibrillation doesn’t work for fib what is the first med or vasopressor we give?

A

Epi

77
Q

Amiodarone and lidocaine are anti-arrhythmic drugs commonly used when?

A

When fib and pulseless VT are resistant to vasopressor (epi) and shock (defibrillation) therapy

78
Q

What indicates lidocaine toxicity?

A

Any neuro changes

79
Q

What are important side effects of amiodarone? and why?

A

Hypotension (can affect heart and lead to arrhythmias)

80
Q

In acute coronary syndrome what meds are used for chest pain when they get to the ED?

A
  • Oxygen (if <90%)
  • Aspirin
  • Nitro
  • Morphine (vasodilator and pain)
81
Q

Why should a client with acute coronary syndrome have head up position?

A

Decreases workload on the heart and increases CO

82
Q

Can fibrinolytic therapy be used for acute coronary syndrome?

A

Yes

83
Q

What is the goal of fibrinolytic therapy?

A

Dissolve the clot that is blocking blood flow to the heart muscle which decreased size of infarction

84
Q

What meds are fibrinolytic therapy?

A
  • alteplase
  • tenecteplase
  • reteplase
  • streptokinase
85
Q

How soon after onset of myocardial pain should tfibrinolytic therapy be administered?

A

within 12 hours, the sooner the better

86
Q

Stroke: Time is ?

A

Brain

87
Q

What are amor complications of fibrinolytic therapy?

A

Bleeding

88
Q

Is a good bleeding history needed before fibrinolytic therapy?

A

Yes

89
Q

What are absolute contraindications o fibrinolytic therapy?

A
  • Intracranial neoplasm
  • intracranial bleed
  • suspected aortic dissection
  • Internal bleeding
90
Q

During and after fibrinolytic therapy take what precautions?

A

Bleeding

91
Q

What are encompasses bleeding precautions?

A
  • Watch for bleeding gums
  • hematuria
  • black stools
  • use electric razor
  • soft toothbrush
  • no IMs
92
Q

With fibrinolytic therapy should you draw blood when starting IVs?

A

Yes, decrease number of puncture sites

93
Q

Can you do ABGs if you have done fibrinolytic therapy?

A

No, too deep of puncture

94
Q

What are medical interventions for acute coronary syndrome?

A
  • PCI

- CABG

95
Q

What is PCI?

A

Includes all interventions such as PTCA (percutaneous transluminal coronary angioplasty) and stents

96
Q

What is a major complication of a angioplasty?

A

MI

97
Q

After a angioplasty could a client bleed from heart Cath site or could they reocclude?

A

Yes

98
Q

In any problems occur after a angioplasty, what happens?

A

go back to surgery

99
Q

If there is chest pain after a angioplasty what should you do?

A

Call HCP asap, may be reoccluding

100
Q

Are there meds given after a angioplasty to help with successfulness and other precautions?

A

yes

101
Q

Can a CABG be scheduled or emergent?

A

Yes

102
Q

When is a CABG used?

A

multiple vessel disease or L main coronary artery occlusion

103
Q

The left main coronary artery supplies the entire what part of the heart?

A

left ventricle

104
Q

When you think of left main coronary artery occlusion think what?

A

sudden death or widow maker

105
Q

Does cardiac rehab teach guidelines and lifestyle changes to help with heart disease?

A

Yes

106
Q

Should you quit smoking in cardiac rehab?

A

Yes

107
Q

Is cardiac rehab a stepped- care -plan which increases activity gradually?

A

Yes

108
Q

What diet changes are made in cardiac rehab?

A
  • Low fat
  • Low salt
  • Low cholesterol
109
Q

In cardiac rehab is it recommended to do isometric exercises?

A

No, because it increases workload of heart

110
Q

Does cardiac rehab say it is ok to valsalva or strain?

A

No

111
Q

What time of day is sex recommended in cardiac rehab?

A

morning b/c they are well rested (8-9am)

112
Q

What is the best exercise for a MI client?

A

walking

113
Q

What are s/s to teach for HF?

A
  • Weight gain
  • ankle edema
  • SOB
  • Confusion

Cardiac (8 decks)

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