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IM3 > CAD/Atherosclerosis/Chest Pain > Flashcards

CAD/Atherosclerosis/Chest Pain Flashcards

1
Q

what is atherlosclerosis

A

accumulation of lipid, or fatty substances in vessel walls

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2
Q

what is the most common place for the buildup of atherosclerosis

A

coronary artery disease

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3
Q

atherosclerosis can cause ischemia which is what

A

not getting enough o2

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4
Q

what are non-modifiable risk factors for CAD/atherosclerosis

A

age
gender
family history
ethnicity

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5
Q

what are modifiable risk factors for CAD/atherosclerosis

A

high cholesterol
smoking
hypertension
hyperglycemia
obesity
physical inactivity
stress

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6
Q

after what age for women is CAD incidence equal to men

A

55

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7
Q

CAD is the ______ killer of women

A

1

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8
Q

what is myocardial ischemia

A

pathological mechanisms interfere with blood flow through the coronary arteries

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9
Q

what are the 3 possible causes of myocardial ischemia

A

atherosclerosis
thrombus formation - blood clot
vasoconstriction

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10
Q

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

A

decreased
increased

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11
Q

what is angina pectoris

A

chest pain caused by myocardial ischemia

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12
Q

what causes angina pectoris

A

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

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13
Q

what 4 things can precipitate angina pectoris

A

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

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14
Q

what are the 4 types of angina

A

stable
prinzmetal
silent ischemia
unstable (preinfarction)

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15
Q

what is the stable angina

A

predictable pain on exertion

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16
Q

what is prinzmetal angina

A

unpredictable, caused by vasospasm

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17
Q

what is silent ischemia

A

EKG changes but no reported symps

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18
Q

what is unstable (preinfarction) angina

A

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

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19
Q

angina occurs before a major _____ event

A

cardiac

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20
Q

elderly, diabetic, and women have different ______ symps

A

MI

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21
Q

what prevention/treatments can we do for CAD/atherosclerosis

A

diet
exercise
meds
tobacco cessation
managing HTN
controlling DM
managing stress

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22
Q

how can we evaluate chest pain (3)

A

physical assessments
EKG
lab

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23
Q

what do we do in a physical exam for chest pain

A

auscultation (extra/rapid heartbeat)
s/s

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24
Q

what are s/s of angina

A

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

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25
Q

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

A

SOB

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26
Q

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

A

fatigue

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27
Q

what does an ST depression on an EKG mean

A

ischemia

28
Q

what does an ST elevation on an EKG indicate

A

injury/infarction

29
Q

what is acute coronary syndrome

A

an umbrella term for unstable angina and myocardial infarction

30
Q

what is the lab we will look at for cardiac injury

A

troponin

31
Q

we want total cholesterol to be ____

A

low

32
Q

we want LDL to be _____

A

low

33
Q

we want HDL to be _____

A

high

34
Q

what are lipid lowering drugs (3)

A

statins
niacin
fibrates

35
Q

what statin will we give for lowering lipids

A

atorvistatin

36
Q

what niacin will we give for lowering lipids

A

B vitamins

37
Q

what fibrate can we give for lowering lipids

A

gemfimbrozil

38
Q

when should a pt take a statin drug

A

with evening meal or at bedtime

39
Q

what are the side effects of statin drugs (4)

A

hepatotoxicity
myopathy
muscle pain or tenderness

40
Q

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

A

myopathy
muscle pain or tenderness

41
Q

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

A

stress tests
echo
coronary angiography (cardiac cath)

42
Q

what is the treatment for angina

A

decrease bp
decrease hrt rate
assist contractility
decrease lft ventricular volume

43
Q

what should always initiate @ the start of chest pain

A

o2

44
Q

what nursing interventions do we do with angina (6)

A

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

45
Q

how does nitro help with angina

A

decreases preload
higher doses decrease afterload
reduces myocardial o2 consumption

46
Q

what can increase when taking nitro

A

bp

47
Q

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

A

no

48
Q

how does a pt take nitro (what mode)

A

sublingually

49
Q

how many tabs will a pt take

A

takes 3 tabs @ 5 min intervals

50
Q

what are the side effects for nitro

A

flushing
HA (headache)
decreased bp
tachycardia

51
Q

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

A

expired

52
Q

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

A

light

53
Q

how do beta blockers help chest pain

A

reduce myocardial o2 consumption
reduce HR
reduce bp
reduce contractility

54
Q

beta blockers also help prevent ____

A

recurrent MIs

55
Q

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

A

metoprolol

56
Q

why shouldn’t diabetics take beta blockers

A

because it can mask signs of hypoglycemia

57
Q

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

A

bradycardia
check bp
monitor for bronchospasm
monitor for hypoglycemia

58
Q

a pt taking a beta blocker should never stop it _____

A

abruptly

59
Q

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

A

bradycardia
lethargy
GI disturbance
CHF
decreased bp
depression

60
Q

a calcium channel blocker can help chest pain how

A

slows hr
relaxes blood vessels
good for coronary vasospasms

61
Q

what type of angina are calcium channel blockers good at treating

A

prinzmetal’s angina

62
Q

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

A

grapefruit juice/grapefruit

63
Q

what are the 4 antiplatelet & anticoagulants meds

A

aspirin
clopidogrel
heparin
enoxaparin

64
Q

aspirin is an anti ____ (4 of these)

A

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

65
Q

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

A

tinnitus
stomach pain
GI bleed
thrombocytopenia

66
Q

how can a pt manage angina at home

A

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

IM3 (47 decks)

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