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XIO > CAD > Flashcards

CAD Flashcards

1
Q

atherosclerosis starts with (NOT inflammation for this one)

A

a fatty streak sticks

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2
Q

total cholesterol (cholesterol has your fav numbers)

A

< 200 low risk
200-239 borderline
>239 high risk

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3
Q

HDL (H High at 35)

A

> 35 low
< 35 high

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4
Q

LDL (29, 30, and 59 are liddle old)

A

<129 low
130-159 medium
>159 high

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5
Q

triglycerides (try 201 units to get high)

A

<200 low
201-399 high
400-1000 very high
>1000

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6
Q

how atherosclerosis forms

A

inflammation, formation of fibrous cap, if thrombus, it’s just a ruptured plaque.

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7
Q

blood sugar with athleroscoloris should be

A

right at 100

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8
Q

signs of CAD (Caddy is 4th) - AND BP and heart rhythm? (CAddy can be high or low)

A

4th heart sound, tachycardia, hypotension, HTN, angina

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9
Q

signs of CV disease (my CV has some pulses and headaches)

A

Diminished carotid pulses, carotid artery bruits, focal neurological deficits, headaches

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10
Q

signs of PVD

A

Decreased peripheral pulses, peripheral artery bruits, pallor, peripheral cyanosis, gangrene, ulceration, difficulty ambulating, pain with ambulation

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11
Q

signs of AAA

A

Pulsatile abnormal mass, peripheral embolism, circulatory collapse, pre/syncope, weakness

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12
Q

Atheroembolism (if Athens is blocked, it will fall off the map)

A

Gangrene, cyanosis, ulceration

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13
Q

athero risk factors (DH LAGGS in athens)

A

Risk factor assessment (diabetes, HLPD, gender, LV function, provocation of angina, genetics, stress)

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14
Q

athero - Echocardiography (The echo in athens is my liver EF)

A

to assess LV function, EF, predicts survival

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15
Q

athero diagonostics (the 2 Es and a C in Athens)

A

ECG, CXR, Echo, labs

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16
Q

CAD

A

RCA, L main, LAD (left anterior descending), circumflex

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17
Q

cause of supply demand imbalance

A

thromus or embolus, spasm, hypovolemia, anemia, HR up or down, BP up or down

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18
Q

prevention of CAD

A

Control cholesterol, diet, physical activity, medications, quit smoking, manage HTN, control diabetes

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19
Q

angiography risk assessment (Angie is high, med, low - that’s it)

A

just know that there is risk assessment for high, medium, and low

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20
Q

angina pectoris - cause?

A

A syndrome characterized by episodes or paroxysmal pain or pressure in the anterior chest caused by insufficient coronary blood flow

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21
Q

angina pectoris - Physical exertion or emotional stress

A

increases myocardial oxygen demand, and the coronary vessels are unable to supply sufficient blood flow to meet the oxygen demand

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22
Q

Chronic Stable Angina (stable will disappear with rest)

A

Decreased blood flow to myocardium usually caused by CAD
Temporary pain/pressure
Predictable, long term, familiar pattern
Resolves with nitroglycerin, oxygen or rest. This ALWAYS goes away with rest, etc.

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23
Q

exertion angina (thanksgiving ppl) - how long does it last? (exert for less than 15 min)

A

Resolves with rest or NTG (nitrogycerin)
Lasts < 15 minutes
May radiate to arm, shoulder, back, jaw, neck, wrists

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24
Q

Variant or atypical or Prinzmetal angina

A

Not caused by exertion
Often caused by coronary artery spasm

Often there is no coronary artery blockage or atherosclerosis

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25
Q

angina described as

A

May be described as tightness, choking, or a heavy sensation

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26
Q

symptoms of angina - and what time of day usually?

A

dyspnea, SOB, dizziness, nausea, vomiting. will often wake up feeling this way.

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27
Q

angina pain is where? (Not chest)

A

retrosternal and may radiate to neck, jaw, shoulders, back or arms (usually left)

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28
Q

does angina pain subside with rest?

A

yes, or NTG

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29
Q

anxiety and angina?

A

usually happen together

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30
Q

unstable angina requires

A

medical intervention!

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31
Q

if ppl have to take 2 TNG,

A

call EMS.

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32
Q

assessment of chest pain

A

Scale of 1-10
Quality
Severity
Frequency
Location and radiation
Duration
Precipitating factors
Relieving factors

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33
Q

most common areas of pain for angina (just 4 places - most obvious)

A

left arm, left chest, around neck, middle of back

34
Q

angina in males (men have chest pain, stomach pain and they sweat)

A

typical spots, chest pain, stomach pain, sweating,

35
Q

angina in females

A

anxiety, N/V, back of shoulder, dizziness, feels like a pulled muscle

36
Q

angina - Gerontologic Considerations

A

Diminished pain transition that occurs with aging may affect presentation of symptoms
“Silent” CAD
Teach older adults to recognize their “chest pain–like” symptoms (i.e., weakness)
Pharmacologic stress testing; cardiac catheterization
Medications should be used cautiously!
could have target organ damage

37
Q

angina management - 3 Goals (gyna gets aspirin)

A

Identify and respond ASAP - rest the patient, call for help and give them an aspirin
Establish prophylactic drug regimen
Widen or circumvent narrowed arteries

38
Q

angina treatment - HOB

A

decrease myocaridal O2 demand and increase 02 supply, reduce and control risk factors, medications, reperfusion therapy, HOB 30 degrees

39
Q

meds for angina

A

NTG, beta-adrenargic blockers, calcium channel blockers, antiplatelet and anticoagulants

40
Q

aspirin

A

Acetylsalicylic Acid
Antiplatelet effect
81-325 mg
Chewable. chew it, they need it fast!

41
Q

NGT (Nitro dilates everything)

A

Causes venous and arterial dilation and dilation of coronary arteries, resulting in decreased preload, afterload and increased blood flow to the myocardium

42
Q

NGT dosing

A

Take 1 every 5 minutes X 3 doses sublingually
Don’t swallow
Take out cotton ball in container as it absorbs the drug
Keep in a dark, glass bottle, dry, cool & renew every 6 months
Usually burns/fizzes under tongue
HA

43
Q

NGT before administration

A

Check BP before and after administration

44
Q

NGT - after meds have been given

A

AHA recommends contacting EMS (911) after the client takes the first dose of NTG. Don’t wait more than 5 minutes to call 911

45
Q

NGT almost always causes a

A

headache from the vasodilation

46
Q

morphine

A

decreases cardiac workload
Analgesic effects decreases the sympathetic response thereby decreased diaphoresis lightheadedness, & Decreases HR, BP and venous return
Stimulates local histamine mediated responses
Might inhibit or delay of antiplatelet absorption

47
Q

beta blockers - what about the liver?

A

(beta1 selective
Decrease BP, P and myocardial contractility
Improve LV function

48
Q

Calcium Channel Blockers (Calcium dilates)

A

Decrease BP and dilate coronary arteries

49
Q

angina patient education - exercise?

A

Avoid isometric exercise
Rest frequently

50
Q

unstable angina - when does it occur? How long does it last?

A

Change in pattern = ⇧ severity or > time
Not relieved by NTG or rest
Occurs at rest or awakens patient at night
> 15 minutes

51
Q

acute coronary symptoms - WBC and temp? (Aces raises my WBCs)

A

Pain
Cold and clammy
Increased WBC and increased temp
ECG changes
N & V

52
Q

serial cardiac enzymes

A

CPK (creatinine), LDH, troponin

53
Q

acute coronary syndrome - Common Precipitating Factors - what triggers it? (A cute coronary in my sleep)

A

Exercise 13%
Unusual exertion 18%
Surgery 6%
Rest 51%
Sleep 8%

54
Q

signs and symptoms of acute coronary syndrome (ACS) - how long? (Play aces for less than 30 min)

A

coronary pain < 30 min severe. Not relieved by NTG and/or rest.
N/V
anxiety, apprehension, denial.
dyspnea, diaphroesis, palpitations, dysthrmias, orthopnea, weakness/fatigue, dizziness

55
Q

ACS diagnosis (Aces is inverted)

A

Patient history
Signs & Symptoms
Type of pain
ECG changes
Inverted T waves
ST elevation
Q waves
Other tests
Cardiac enzymes
Cardiac markers

56
Q

ACS treatment (Aces gets hobs, then fiber)

A

meds first, HOB, Fibrinolytics

57
Q

ACS - Fibrinolytics

A

not first choice. Goal is to dissolve the clot that is blocking the blood flow to the heart and thereby decreasing the size of the infarction

58
Q

Fibrinolytics - nursing considerations (fiber bleeds)

A

Detailed H & P are critical (bleeding and time of onset)
Initiate bleeding precautions, assess ECG, minimize anything that causes bleeding
Must be given in a compressible site

59
Q

can’t use Fibrinolytics if BP is…

A

BP is higher than 180 or 100 diastolic

60
Q

Fibrinolytics nursing considerations - when can you use an invasive device?

A

closely monitor, control high BP, avoid invasive device for 24 hrs, observe response, screen with provider all antiplatet or anticoagulants Rx

61
Q

what labs to monitor with fibrolytics

A

hemoglobin, hematocrit, platelets, anti-Xa, PTT, INR/PT, fibrinogen

62
Q

nursing management ACS/MI

A

Oxygen and medication therapy
Frequent VS assessment
Physical rest in bed with head of bed elevated
Relief of pain helps decrease workload of heart
Monitor I&O and tissue perfusion
Frequent position changes to prevent respiratory complications
Report changes in patient’s condition
Evaluate interventions!!!!

63
Q

invasive coronary artery procedures

A

Percutaneous transluminal coronary angioplasty (PTCA)
Coronary artery stent
Coronary artery bypass graft (CABG)
Cardiac surgery

64
Q

chest pain after PCI - percutaneous coronary intervention (basically just a stent) - could mean

A

stent moved.

65
Q

PCI (Angie is PCP)

A

Known as balloon angioplasty or percutaneous transluminal angioplasty

66
Q

PCI

A

Known as balloon angioplasty or percutaneous transluminal angioplasty

67
Q

PCI - invasive or not?

A

non invasive

68
Q

PCI used to treat

A

CAD, angina, acute MI in order to re-perfuse and save cardiac muscle. often combined with stent.

69
Q

Coronary Artery Bypass Graft (CABG) (Cab in my thorax)

A

type of thoracic surgery

70
Q

The choice of bypass graft depends on

A

where the blockage is, how much, size of arteries.

71
Q

Left ventricular assist device (LVAD)

A

is a pump
Patients will only have a MAP, no pulse

72
Q

exertion angina - causes (my hypo is exerting my hyper)

A

Exercise, stress anxiety, large meals, tachycardia, anemia, hypoglycemia, hyperthyroidism

73
Q

angina - eating?

A

Avoid overeating
Avoid excess caffeine or any drugs the increase HR
Lose weight if overweight
Diet modifications/changes
small meals

74
Q

angina - how long to wait after eating before exercise?

A

Wait 2 hours after eating to exercise

75
Q

angina - how to dress?

A

Dress warmly in cold weather
Adhere to medication regimen
Take NTG prophylactically
Stop smoking
Manage diabetes

76
Q

can’t use fibrinolytics with…

A

CNS disease or CVD

77
Q

no fibrinolytics if pt had trauma or stroke how soon?

A

last 3 weeks

78
Q

no fibrinolytics if pt had surgeries within

A

surgeries within 4 weeks

79
Q

no fibronolytics if pt has what type of bleeding? And liver?

A

intercranial bleed, blood thinners, kidney liver disease, pregnant

80
Q

after removing a client’s femoral sheath after cardiac catheterization, have what med available?

A

atropine. can cause vagal stimulation and bradycardia

XIO (393 decks)

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