CAD/Atherosclerosis/Chest Pain

Question 1

what is atherlosclerosis

Answer 1

accumulation of lipid, or fatty substances in vessel walls

Question 2

what is the most common place for the buildup of atherosclerosis

Answer 2

coronary artery disease

Question 3

atherosclerosis can cause ischemia which is what

Answer 3

not getting enough o2

Question 4

what are non-modifiable risk factors for CAD/atherosclerosis

Answer 4

age
gender
family history
ethnicity

Question 5

what are modifiable risk factors for CAD/atherosclerosis

Answer 5

high cholesterol
smoking
hypertension
hyperglycemia
obesity
physical inactivity
stress

Question 6

after what age for women is CAD incidence equal to men

Answer 6

55

Question 7

CAD is the ______ killer of women

Answer 7

1

Question 8

what is myocardial ischemia

Answer 8

pathological mechanisms interfere with blood flow through the coronary arteries

Question 9

what are the 3 possible causes of myocardial ischemia

Answer 9

atherosclerosis
thrombus formation - blood clot
vasoconstriction

Question 10

with myocardial ischemia you either have a ______ supply of blood flow/o2 or an ______ demand for blood flow/o2

Answer 10

decreased
increased

Question 11

what is angina pectoris

Answer 11

chest pain caused by myocardial ischemia

Question 12

what causes angina pectoris

Answer 12

insufficient coronary blood flow results in decreased o2 supply to meet the myocardial demand for o2

Question 13

what 4 things can precipitate angina pectoris

Answer 13

physical exertion
exposure to cold
eating a heavy meal
stress or emotional situation

Question 14

what are the 4 types of angina

Answer 14

stable
prinzmetal
silent ischemia
unstable (preinfarction)

Question 15

what is the stable angina

Answer 15

predictable pain on exertion

Question 16

what is prinzmetal angina

Answer 16

unpredictable, caused by vasospasm

Question 17

what is silent ischemia

Answer 17

EKG changes but no reported symps

Question 18

what is unstable (preinfarction) angina

Answer 18

occurs @ rest or during minimal activity; increasing severity or frequency

Question 19

angina occurs before a major _____ event

Answer 19

cardiac

Question 20

elderly, diabetic, and women have different ______ symps

Answer 20

MI

Question 21

what prevention/treatments can we do for CAD/atherosclerosis

Answer 21

diet
exercise
meds
tobacco cessation
managing HTN
controlling DM
managing stress

Question 22

how can we evaluate chest pain (3)

Answer 22

physical assessments
EKG
lab

Question 23

what do we do in a physical exam for chest pain

Answer 23

auscultation (extra/rapid heartbeat)
s/s

Question 24

what are s/s of angina

Answer 24

feeling of indigestion
choking or heavy pressure in sternum
pain may radiate to neck, jaw, shoulders, arms, usually left arm
weakness or numbness in arms, wrists, and hands
SOB, pallor, dyspnea
dizziness, nausea, & vomiting
sense of impending doom

Question 25

what is a significant s/s for chest pain in the elderly

Answer 25

SOB

Question 26

what is a significant s/s for chest pain in women

Answer 26

fatigue

Question 27

what does an ST depression on an EKG mean

Answer 27

ischemia

Question 28

what does an ST elevation on an EKG indicate

Answer 28

injury/infarction

Question 29

what is acute coronary syndrome

Answer 29

an umbrella term for unstable angina and myocardial infarction

Question 30

what is the lab we will look at for cardiac injury

Answer 30

troponin

Question 31

we want total cholesterol to be ____

Answer 31

low

Question 32

we want LDL to be _____

Answer 32

low

Question 33

we want HDL to be _____

Answer 33

high

Question 34

what are lipid lowering drugs (3)

Answer 34

statins niacin fibrates

Question 35

what statin will we give for lowering lipids

Answer 35

atorvistatin

Question 36

what niacin will we give for lowering lipids

Answer 36

B vitamins

Question 37

what fibrate can we give for lowering lipids

Answer 37

gemfimbrozil

Question 38

when should a pt take a statin drug

Answer 38

with evening meal or at bedtime

Question 39

what are the side effects of statin drugs (4)

Answer 39

hepatotoxicity myopathy muscle pain or tenderness

Question 40

call the dr if what side effects are happening (3)

Answer 40

myopathy muscle pain or tenderness

Question 41

what tests can we do to evaluate chest pain (3)

Answer 41

stress tests echo coronary angiography (cardiac cath)

Question 42

what is the treatment for angina

Answer 42

decrease bp decrease hrt rate assist contractility decrease lft ventricular volume

Question 43

what should always initiate @ the start of chest pain

Answer 43

o2

Question 44

what nursing interventions do we do with angina (6)

Answer 44

o2!!! quick assessment of chest pain PQRST vital signs monitor respiratory status 12 lead EKG nitro

Question 45

how does nitro help with angina

Answer 45

decreases preload higher doses decrease afterload reduces myocardial o2 consumption

Question 46

what can increase when taking nitro

Answer 46

bp

Question 47

if a pt is taking an erectile dysfunction med can they take nitro for chest pain

Answer 47

no

Question 48

how does a pt take nitro (what mode)

Answer 48

sublingually

Question 49

how many tabs will a pt take

Answer 49

takes 3 tabs @ 5 min intervals

Question 50

what are the side effects for nitro

Answer 50

flushing HA (headache) decreased bp tachycardia

Question 51

if nitro doesn't sting under the tongue when taking it, the drug is _____

Answer 51

expired

Question 52

nitro is put in special bottles because it is sensitive to _____

Answer 52

light

Question 53

how do beta blockers help chest pain

Answer 53

reduce myocardial o2 consumption reduce HR reduce bp reduce contractility

Question 54

beta blockers also help prevent ____

Answer 54

recurrent MIs

Question 55

a pt with asthma should take which beta blocker because it has a less bronchospasm effect

Answer 55

metoprolol

Question 56

why shouldn't diabetics take beta blockers

Answer 56

because it can mask signs of hypoglycemia

Question 57

what things should we monitor pts for when they are on beta blockers

Answer 57

bradycardia check bp monitor for bronchospasm monitor for hypoglycemia

Question 58

a pt taking a beta blocker should never stop it _____

Answer 58

abruptly

Question 59

what side effects can a pt have when taking a beta blocker

Answer 59

bradycardia lethargy GI disturbance CHF decreased bp depression

Question 60

a calcium channel blocker can help chest pain how

Answer 60

slows hr relaxes blood vessels good for coronary vasospasms

Question 61

what type of angina are calcium channel blockers good at treating

Answer 61

prinzmetal's angina

Question 62

what should a pt not drink or eat when they are taking a calcium channel blocker

Answer 62

grapefruit juice/grapefruit

Question 63

what are the 4 antiplatelet & anticoagulants meds

Answer 63

aspirin clopidogrel heparin enoxaparin

Question 64

aspirin is an anti ____ (4 of these)

Answer 64

anti-inflammatory anti-pain anti-pyretic anti-platelet aggregation

Question 65

what should we monitor pts for when they're taking aspirin

Answer 65

tinnitus stomach pain GI bleed thrombocytopenia

Question 66

how can a pt manage angina at home

Answer 66

reduce activities that reduce chest pain/dyspnea avoid temp extremes maintain normal bp avoid OTC meds that can increase bp stop smoking take aspirin & beta blockers as prescribed carry nitro @ all times