cad Flashcards
Which characteristic is typical of the pain related to chronic stable angina?
1
Relieved by rest, nitroglycerin, or both
2
Indicates irreversible myocardial damage
3
Generally lasts longer than 15 to 20 minutes
4
Frequently associated with vomiting and fatigue
1
Relieved by rest, nitroglycerin, or both
Chronic stable angina is characterized by intermittent chest pain, often described as pressure or tightness that occurs over a period of time in the same pattern, onset, and intensity. It commonly subsides when precipitating factors have stopped and the patient is at rest or with the use of nitroglycerin. The pain does not always indicate irreversible myocardial damage and usually lasts just 5 to 15 minutes. Vomiting and extreme fatigue are symptoms of myocardial infarction and are not commonly seen in chronic stable angina.
The nurse provides information to a patient about preventing coronary artery disease (CAD) by maintaining healthy serum low-density lipoprotein (LDL) and high-density lipoprotein (HDL) levels. Which goals would the nurse emphasize? 1 Decreased LDLs; decreased HDLs 2 Decreased LDLs; increased HDLs 3 Increased LDLs; increased HDLs 4 Increased LDLs; decreased HDLs
2
Decreased LDLs; increased HDLs
LDLs contain more cholesterol than any other lipoprotein and have an attraction to arterial walls, whereas HDLs carry lipids away from the arteries to the liver for metabolism and prevent lipid accumulation within the arterial walls. Therefore increasing HDL levels and decreasing LDL levels are most helpful in lowering the patient’s risk for coronary artery disease. The nurse should not advise the patient to decrease HDLs or increase LDLs because these actions would be counterproductive.
Which factor leads to total occlusion of a coronary artery?
1
Thrombus formation in the arterial wall
2
Transport of cholesterol into the arterial intima
3
Smooth muscle proliferation of the arterial wall
4
Lipid-filled smooth muscle cells in the coronary artery
1
Thrombus formation in the arterial wall
A thrombus may form and adhere to the wall of the coronary artery, leading to total occlusion. The transport of cholesterol into the arterial intima may lead to the formation of plaques on one portion of the artery, or in a circular fashion involving the entire lumen. Smooth muscle proliferation may lead to the thickening of the arterial wall. The earliest lesions are fatty streaks characterized by lipid-filled smooth muscle cells.
Which laboratory result increases a patient’s risk for coronary artery disease (CAD)?
1
Decreased triglycerides
2
Elevated low-density lipoproteins (LDLs)
3
Elevated high-density lipoproteins (HDLs)
4
Decreased very-low-density lipoproteins (VLDLs)
2
Elevated low-density lipoproteins (LDLs)
Elevated LDLs contain more cholesterol than any of the other lipoproteins and have an affinity for arterial walls. Elevated LDL levels correlate most closely with an increased incidence of atherosclerosis and CAD. Elevated HDLs, decreased triglycerides, and decreased VLDLs are all negative risk factors for CAD.
Which assessment data is a nonmodifiable risk factor for coronary artery disease? 1 Diabetes 2 White male 3 Hyperlipidemia 4 Cigarette smoking
2
White male
White race and male sex are nonmodifiable risk factors for coronary artery disease that the patient cannot change. Diabetes is modifiable through diet, medication, and exercise for tight blood sugar control. Hyperlipidemia is modifiable through medication, diet, and exercise to control cholesterol and triglyceride levels. Cigarette smoking is modifiable through the cessation of tobacco use.
Which risk factor for coronary artery disease is considered nonmodifiable? 1 Obesity 2 Diabetes 3 Tobacco use 4 Family history of heart disease
4
Family history of heart disease
Family history of heart disease is a nonmodifiable risk factor for coronary artery disease. Diabetes, obesity, and tobacco use are all considered modifiable risk factors for coronary artery disease.
Place the effects of cigarette smoking on the cardiovascular system in order. 1. Catecholamines are released. 2. Workload on the heart increases. 3. Heart rate and BP increase. 4. Nicotine enters through tobacco smoke.
1. Nicotine enters through tobacco smoke. 2. Catecholamines are released. 3. Heart rate and BP increase. 4. Workload on the heart increases.
Nicotine enters the body through the inhalation of tobacco smoke. Nicotine causes the release of the catecholamines epinephrine and norepinephrine. The release of epinephrine and norepinephrine increase the heart rate and the BP. Increased heart rate and BP increase the workload of the heart.
The community health nurse is planning health promotion teaching to prevent coronary artery disease (CAD). Which population has the highest incidence of CAD? 1 White male 2 Hispanic male 3 Black male 4 Native American female
1
White male
The incidence of CAD and myocardial infarction (MI) is highest among white, middle-aged men. Hispanic individuals have lower rates of CAD than non-Hispanic whites or blacks. Blacks have an earlier age of onset and more severe CAD than whites and more than twice the mortality rate of whites of the same age. Native Americans have increased mortality in 35-year-old-and-under people and have major modifiable risk factors, such as diabetes.
Which is a correct term for the development of arterial anastomoses? 1 Atheromas 2 Angioedema 3 Angiogenesis 4 Atherosclerosis
3
Angiogenesis
Angiogenesis (development of new blood vessels) best describes the development of arterial anastomoses, which are new arterial connections forming between two vessels that are not usually connected. Atheromas (atheromatous plaques) are fatty deposits that form within and on the layers of the coronary artery walls during atherosclerosis. Atherosclerosis is an arterial disease characterized by gradual arterial narrowing due to atheroma formation within and on the coronary artery walls. If arterial blockage from atherosclerosis forms very gradually, the process of angiogenesis has been known to create collateral circulation around the arterial blockage. Angioedema is the rapid and severe swelling of the soft tissues (e.g., skin or mucosa) caused by medications, allergies, or an inherited condition.
A male patient who has coronary artery disease (CAD) has serum values of low-density lipoprotein (LDL) cholesterol 98 mg/dL, and high-density lipoprotein (HDL) cholesterol 47 mg/dL. Which information would the nurse include in patient teaching? 1 Consume a diet low in fats. 2 Reduce total caloric intake. 3 Increase intake of olive oil. 4 The lipid levels are normal.
4
The lipid levels are normal.
For men, the recommended LDL is less than 100 mg/dL, and the recommended level for HDL is greater than 40 mg/dL. The patient’s normal lipid levels should be included in the patient teaching, and the patient should be encouraged to continue taking care of himself. It is not necessary to begin a low-fat, low-calorie diet or to use olive oil based on this information, but the patient’s diet should be assessed for health promotion needs.
Which characteristic describes a complicated coronary artery lesion? 1 Formation of a fibrous plaque 2 Lipid-filled smooth muscle cells 3 Platelet aggregation and adhesion 4 Transport of lipids into arterial intima
3
Platelet aggregation and adhesion
A complicated lesion is characterized by accumulation of platelets leading to thrombus formation. Formation of a fibrous plaque is the beginning of progressive changes in the endothelium of the arterial wall. It is called the fibrous plaque stage. Fatty streaks are the earliest lesions of atherosclerosis and are characterized by lipid-filled smooth muscle cells. Transport of lipids into the arterial intima occurs in the fibrous plaque stage.
In which stage of arterial disease does the plaque rupture in the artery? 1 Fatty streak 2 Fibrous plaque 3 Complicated lesion 4 Chronic endothelial injury
3
Complicated lesion
The rupture of plaque in the artery occurs when the lesion is complicated. The plaque ruptures, and thrombus formation occurs, as does further narrowing or total occlusion of the vessel. Fibrous plaque occurs when collagen covers the fatty streak, narrowing the artery and thus reducing the blood flow. When the fatty streak forms, lipids accumulate and migrate into the smooth muscle cells. Chronic endothelial injury occurs secondary to exposure of toxins, infections, and certain disease processes.
