Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

MedSurg P.M > CAD and CHF > Flashcards

CAD and CHF Flashcards

1
Q

Reveals MI, ischemic changes.

A

Electrocardiography (EKG)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

onset of acute episodes of dyspnea at night. The cause
is unknown; but thought to be due to improved cardiac

A

Paroxysmal Nocturnal dyspnea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

 –atrial contraction against the noncompliant ventricle

A

S4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

s. Inflammation of heart muscle caused by
bacterial, viral, or other infection. Damages heart muscle and
impairs pumping ability

A

Myocarditis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Reveals whether the heart is misshapen or enlarged due to disease and if
abnormal calcification (hardened blockage due to cholesterol build up) in the main
blood vessels exists.

A

Chest x-ray

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q
  • Release of Rennin from ** of the kidney.
A

juxtaglomerular cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

prevent additional fluid retention

A

Low-sodium diet

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

) refers to any narrowing or obstruction of arterial lumina
that interferes with cardiac perfusion. Deprived of sufficient blood, the myocardium can
develop various ischemic diseases, including angina pectoris, MI, heart failure, sudden
death, and cardiac arrhythmias

A

CORONARY ARTERY DISEASE (CAD)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Precipitating (Secondary) Causes:

A

o Hypertension
o E - Infective Endocarditis
o Anemia
o Rheumatic –fever (Recurrence)
o Thyrotoxicosis
o Fetus (pregnancy)
o Arrhythmias
o Infections
o Lung problems (pathologies)
o Stress, salts, etc.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

reduce risk of heart attack

A

ACE inhibitors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

–the primary cause of right-sided heart failure because
of back ward effect of LHF which causes pulmonary vascular congestion
(hypertension)

A

Left-sided failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

occurs when the output of the right ventricle is less than the input from
systemic venous circulation. As the result, the systemic venous circuit is
congested and the output to the lungs decreased.

A

RIGHT-SIDED HEART FAILURE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

binds bile acid in the intestine

A

Bile acid binding resins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

DIAGNOSIS for CAD

A

Acute pain
Activity intolerance
Impaired gas exchange

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Shows ischemia as “cold spots.

A

Myocardial perfusion imaging with thallium 201 during treadmill exercise

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

CLINICAL MANIFESTATIONS

A

 Hepatomegaly and Splenomegaly
 Epigastric Tenderness
 Ascites
 Edema
 Anorexia, fullness, nausea
 Jugular venous distension (JVD)
 Weight gain
 Nocturia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

CLINICAL MANIFESTATIONS of LHF

A

 Moist, bibasilar crackles, rhonchi, and expiratory wheezing
Dyspnea
Nonproductive cough
Blood tinged, frothy sputum
Restlessness
Tachycardia
S3 gallop
S4
Paroxysmal Nocturnal dyspnea
Cool, pale skin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

LABORATORY/DIAGNOSTIC PROCEDURES for CHF

A
  1. B-type natriuretic peptide (BNP) immunoassay : the level is elevated
  2. Chest X-ray:
  3. Electrocardiography (ECG):
  4. Pulmonary Artery Pressure (PAP) :
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Views heart’s pumping activity. Parts that move weakly may have been damaged
during a heart attack or may be receiving too little oxygen. This may indicate CAD.

A

Echocardiography

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

e most common causes of LHF are:

A

 Myocardial infraction (MI) –most common cause.
 Systemic Hypertension
 Aortic stenosis or insufficiency
 Cardiomyopathy
 Mitral stenosis and insufficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

n to ease breathing and enhance diaphragmatic excursion

A

High Fowler’s position

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Forward or low output syndrome dominate

A

Left-sided Heart Failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

CLINICAL MANIFESTATIONS of CAD

A

Elevated blood pressure
Decreased peripheral pulses -
Nausea and vomiting
Fainting
Sweating
Cool extremities
Shortness of breath
Angina (Chest pain)
MI (Chest pain)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

most common causes of RHF are:

A

 Left-sided failure
 COPD (cor pulmonale)
 Pulmonary embolism
 Right ventricular infarction
 Congenital heart disease.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

formed from Angiotensinogen in the liver by the
action of rennin)

A
  • Formation of Angiotensin- I
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Treatment of CHF is aimed to

A

improve left ventricular
function by decreasing intravascular volume, decreasing venous return, deceasing afterload,
improving gas exchange and oxygenation, increasing CO, and reducing anxiety.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

In acute or short-term mechanisms, as the end-diastolic fiber length increases,
the ventricular muscle responds with dilatation and increased force of
contraction (Starling’s Law)

A

Myocardial dilatation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

lower sodium, lower cholesterol and fat, decreased calorie intake, increased
dietary fiber.

A

Diet change

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

results of chest xray in LHF

A
  • Pulmonary congestion
  • Enlarged left ventricle
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

CHF occurs in a
***, progressing from the left ventricle (LV) to the pulmonary system to
the right ventricle (RV

A

retrograde fashion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

f the coronary arteries narrow again after stent placement,
radiation may be used to help open the artery again.

A

Coronary brachytherapy:

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

dilate blood vessels, decreasing afterload.

A

ACE inhibitors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

t results in increase pre-load (fluid-over
load) on the heart

A

aldosterone effect

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Narrowing of heart valves
causes backward flow of blood. The heart enlarges and cannot
pump effectively. This decreases CO.

A

Congenital Valvular Heart Disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Checks arteries for areas of narrowing or blockages—although the details may not
be as clear as those provided by an angiogram.

A

Magnetic resonance angiography (MRA)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Cardiac compensatory mechanisms

A

Myocardial dilatation
Myocardial Hypertrophy

37
Q

CAUSES OF CHF

A

Underlying Causes
Precipitating (Secondary) Causes:

38
Q

results of chest xray in RHF

A
  • Pulmonary congestion
  • Accumulation of fluid in the pleural cavity
  • Enlarged heart (cardiomegaly)
39
Q

two types of compensatory mechanisms

A

Systemic compensatory mechanisms
Cardiac compensatory mechanisms

40
Q

Subsequent effects of compensatory mechanisms

A

Sympathetic Responses
Rennin- Angiotensin-Aldosterone system
Anaerobic metabolism
Myocardial Hyper trophy and Myocardial Dilatation

41
Q

lowers cholesterol.

A

HMG CoA reductase inhibitors (statins

42
Q

strengthen myocardial contractility:
 Digoxin

A

r inotrope

43
Q

What law: In acute or short-term mechanisms, as the end-diastolic fiber length increases,
the ventricular muscle responds with dilatation and increased force of
contraction

A

Starling’s Law

44
Q

MGT for CHF

A

diuretics
ACE inhibitors
Beta blockers
Anticoagulants
Inotrope
Vasodilator
High fowler
heart transplant

45
Q

an extra heart sounds that occurs when the heart fails. It is described as a
“floppy” sort of sound caused by extra fluid in the ventricles.

A

S3 gallop

46
Q

Determines safe exercise prescription and presence of ischemia

A

Stress test

47
Q

reduces production of VLDL

A

Nicotinic acid

48
Q

the earliest manifestation of LHF

A

dyspnea

49
Q

opens
artery wall; some stents slowly release medication to help keep the artery open.

A

Angioplasty and stent placement (percutaneous coronary revascularization)

50
Q

typically shows elevated pulmonary artery wedge
pressures, left ventricular end-diastolic pressure in left sided heart failure, and
elevated right atrial or central venous pressure in right-sided heart failure

A

Pulmonary Artery Pressure (PAP)

51
Q

Valvular & Endocardial lesions

A

Endocarditis
Congenital Valvular Heart Disease
Rheumatic Heart Disease (RHD)

52
Q

Systemic compensatory mechanisms

A

a. Reflex increase in sympathetic activity.
b. Release of rennin from the kidneys.
c. Anaerobic metabolism by affected tissues.
d. Increased extraction of oxygen by the peripheral cells.

53
Q

interfere with epinephrine and norepinephrine, thus reducing heart rate
and blood pressure.

A

Beta-blockers

54
Q

thin blood and decrease chances of clot

A

Antiplatelets

55
Q

NURSING DIAGNOSES for CHF

A

 Impaired gas exchange
 Decreased cardiac output
 Excess fluid volume

56
Q

e pressure during filling of the ventricles or tension on
myocardium due to congestion.

A

Preload

57
Q

when aggressive medical treatments are not effective.

A

Heart transplant

58
Q

laser beam makes tiny new channels in the wall of the heart
muscle. New vessels may grow through these channels and into the heart to provide
additional paths for blood flow.

A

Laser revascularization:

59
Q

reflect heart strain or enlargement or ischemia. It may
also reveal atrial enlargement, tachycardia, extrasystole, or atrial fibrillation

A

Electrocardiography (ECG):

60
Q

increased after-load due to vasoconstriction

A

Angiotensin-II.

61
Q

dilate blood vessels; decrease pain.

A

Nitrates

62
Q

Dye used in conjunction with x-ray outlines blockages.

A

Angiogram

63
Q

changes in tissue metabolic rate, accelerating HR and
work load of the heart.

A

Thyrotoxicosis

64
Q

reduce synthesis and increase breakdown of VLDL particles

A

Fibric acid derivatives

65
Q

prevent blood vessels from narrowing and counter coronary
artery spasm.

A

Calcium-channel blockers:

66
Q

Risk factors for CAD

A

Age
Men
Positive family history
Diets high in cholesterol and fat
Hypertension
Smoking
Diabetes Mellitus (DM)
Chronic Kidney Disease (CKD
Abdominal Obesity
Sedentary lifestyle
Autoimmune disorders

67
Q

the arterial pressure against which the ventricles must contract.

A

After load

68
Q

Right-sided failure can occur without preceding LV failure as a result of

A

ventricular MI or cor pulmonale.

69
Q

Blockage of coronary artery impedes
forward blood flow, resulting in cardiac tissue ischemia. This
reduces cardiac contraction and cardiac output.

A

Myocardial Infarction

70
Q

graft created to bypass blocked coronary arteries
using a vessel from another body part. This allows blood to flow around the blocked or
narrowed coronary artery. Because this requires open heart surgery, its most often
reserved for cases of multiple narrowed coronary arteries.

A

Coronary artery bypass surgery (CABG):

71
Q

refers to fluid build-up in the heart from myocardium that can’t provide sufficient
cardiac output. It also refers to a constellation of signs and symptoms that result from
the heart’s inability to pump enough blood to meet the body’s metabolic demands. The
pump itself is impaired and unable to supply adequate blood to meet the cellular needs.

A

HEART FAILURE (HF) / CONGESTIVE HEART FAILURE (CHF)

72
Q

o In long-term mechanisms, ventricular hypertrophy increases the ability of the
heart muscle to contract and push its volume into the circulation.

A

Myocardial Hypertrophy

73
Q

NURSING INTERVENTION for CHF

A

 Monitor vital signs and look for changes.
 Record fluid intake and output—weigh daily to assess for fluid overload.
 Position patient in semi-Fowler’s position to ease breathing.
 Administer oxygen as ordered because it helps to decrease workload of heart
 Client teachings:
o Eat foods low in sodium to avoid fluid retention. (For these patients, there
is no such thing as “low-salt” cold cuts.)
o Raise legs when sitting to lessen dependent edema.
o Call the HCP if experiencing fluid retention, such as a weight gain of several pounds
in 1 to 2 days

74
Q

Underlying Causes

A

o Myocardial lesions
o Valvular & Endocardial lesions
o Pericardial – lesions

75
Q

Pericardial – lesions

A

Pericarditis
Cardiac-tamponade

76
Q

Reveals MI

A

Holter monitoring for 24 hours

77
Q

(by enzyme reaction in the pulmonary-capillary
bed)

A

Formation of Angiotensin –II

78
Q

help to raise ejection fraction, and decrease ventricular
size, and slow the heart rate.

A

beta blockers

79
Q

congestive phenomenon dominates.

A

Right-sided Heart Failure

80
Q

t occurs when the output of the left ventricle is less than the total volume of
blood received from the right side of the heart through the pulmonary
circulation. As a result, the pulmonary circuit becomes congested with blood that
cannot be moved forward and the systemic blood pressure falls

A

LEFT-SIDED HEART FAILURE

81
Q

NURSING INTERVENTIONS for CAD

A

 Monitor vital signs—signs of hypertension, irregular heart rate
 Monitor electrocardiogram—look for end organ damage, signs of heart disease
 Monitor labs—periodic lipid panel, liver function for patients on statins
 Monitor for myalgias (muscle aches)
 Explain to the patient:
* Stop smoking
* Reduce alcohol consumption
* Change to a lower-fat, lower-cholesterol diet, as well as increased dietary fiber intake
* Increase daily activity
* Weight reduction
* Stress management

82
Q

reduce preload, relieve dyspnea:

A

vasodilator

83
Q

Myocardial lesions

A

Cardiomyopathy
Myocarditis
Myocardial Infarction

84
Q

for symptom control resulting in patient comfort by reducing blood
volume.
 Furosemide, bumetanide, metolazone, hydrochlorothiazide, spironolactone
—be aware of electrolyte imbalance—these medications may alter the K+
level.

A

diuretics

85
Q

A large amount of liquid accumulates in
the pericardium, creating pressure on the heart that reduces
the filling of ventricles with blood. This results in a low volume
of blood being pumped with each contraction.

A

Cardiac-tamponade

86
Q

MEDICAL MANAGEMENT for CAD

A

Beta-blockers:
Nitrates
Antiplatelets:
Calcium-channel blockers:
ACE inhibitors:
HMG CoA reductase inhibitors (statins
Fibric acid derivatives
Bile acid binding resins
Nicotinic acid
Angioplasty and stent placement (percutaneous coronary revascularization)
Coronary artery bypass surgery (CABG):
Coronary brachytherapy:
Laser revascularization
Diet change:

87
Q

Detects calcium within fatty deposits that narrow coronary arteries. If a substantial
amount of calcium is discovered, CAD is likely.

A

Electron beam computerized tomography (EBCT)/Ultrafast CT scan

88
Q

ASSESSMENT AND DIAGNOSTIC FINDINGS for CAD

A

Chest x-ray
Electrocardiography (EKG)
Holter monitoring for 24 hours
Echocardiography
Stress test
Angiogram
Electron beam computerized tomography (EBCT)/Ultrafast CT scan
Magnetic resonance angiography (MRA)
Myocardial perfusion imaging with thallium 201 during treadmill exercise

MedSurg P.M (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions