CARDIAC

Question 1

Coronary Arteries

Answer 1

deliver oxygenated blood to the heart; encapule around the heart; arteries that provide the heart blood
- give the heart its blood supply

Question 2

Risk Factors of CAD

Answer 2

High Cholesterol
Smoking
Alcohol
Diabetes
Diet
No exercise
-start by educating patients about the risk factors

Question 3

Atherosclerotic Plaque

Answer 3

artery is narrowed d/t plaque —> ISCHEMIA

Question 4

when sites of the heart die off and aren’t getting any 02 or blood supply from the infarcted vessel it will die off

Answer 4

MI occurs 24-48 hours after

Question 5

potassium starts to leak out and cause

Answer 5

V-FIB
now working 24-48 hours to make sure no complications of v-fib or rupture

Question 6

Cardiomyocites have potassium in them–>die off the heart–> leads to ischemia

Question 7

how do we treat hyperlipidemia?

Answer 7

statins
( Simvastatin, atorvastatin, suvastatin)

Question 8

what will statins do? and ranges?

Answer 8

Will decrease our total cholesterol 200
Decrease Triglycerides 150
Decrease LDL 100
Increase HDL 50

Question 9

if a patients cholesterol went from 380-340 but normally its 200, is medication working?

Answer 9

YES; it dropped.

Question 10

when do we give statins?

Answer 10

AT BEDTIME
- thats when we go into a fasting state
when we’re in a fasting state we release cholesterol; its the perfect time to attack them.

Question 11

prior to administering the drug what are we going to check?

Answer 11

LIVER FUNCTION TESTS
ALT
AST
ALK

Question 12

side effect of ‘STATINs

Answer 12

MYOPATHY
muscle pathology; specific myopathy we’re concerned about it
RHABDOMYOLYSIS (rhabdomeres of muscle is breaking down)
— muscle is made of protein: protein is going to get dispersed, excreted and cloggs glomeruli– will develop ACUTE KIDNYE INJURY
- if we don’t aggresively hydrate with IV fluids: will lead to ACUTE RENAL FAILURE

Question 13

they’re going to come in with muscle pain, muscle weakness, tenderness

Answer 13

red flag for ‘STATIN
- check kidney function (BUN/CREATININE)
- LIVER TESTS

Question 14

A clogged artery will cause

Answer 14

Chest Pain, developing ANGINA

Question 15

2 types of angina

Answer 15

1. STABLE ANGINA
2. UNSTABLE ANGINA

Question 16

STABLE ANGINA IS

Answer 16

PREDICATABLE- Chest pain w/ Exertion

Question 17

UNSTABLE

Answer 17

UNPREDICTABLE
- without any notification; chest pain at rest!

Question 18

what would we need to do to help the vessel get blood supply?

Answer 18

VASODILATION

Question 19

how do we vasodilate?

Answer 19

NITRATES,

Question 20

WHAT IS A NITRATE?

Answer 20

POTENT VASODILATOR

Question 21

Side effects of NITRATES

Answer 21

Headaches, Flushing,

Question 22

Nitrates come in what forms

Answer 22

(pill)Sublingual, Spray

Question 23

how many doses total? and minutes apart?

Answer 23

3 doses 5 min apart

Question 24

Do NOT take NItrates with

Answer 24

‘Nafil ‘afil; used for erectile dysfunction, and pulmonary HTN (vasoconstriction of pulmonary htn)

• THIS COMBO WILL LOWER THE BP EVEN FURTHER

Question 25

With Patches (Nitrate)

Answer 25

rotate sites, don’t use with cardioversion

Question 26

if the 3 nitro pills didn’t work? take them too

Answer 26

Cardiac Cath Lab

Question 27

What type of surgery will you need to do to open up the vessels of the heart?

Answer 27

Stent (Femoral)

Question 27

What type of surgery will you need to do to open up the vessels of the heart?

Answer 27

Stent (Femoral)

Question 28

What if area of the Heart is infected?

Answer 28

DONT GO IN WITH STENT—> SEPSIS/INFECTION

Question 29

what education do we give after a STENT placement?

Answer 29

DONT want them to sit up & put pressure on that area blood will spew out!–hemorrhage

DONT strain–STOOL SOFTENER–docusate
Antiplatelet ( Clopidogrel + Aspirin) – Stent sites are a good place for platelet aggregation

Question 30

what happens when the stent doesn’t work anymore or it’s not doing its job?

Answer 30

CABG- Coronary Artery Bypass Graft

Question 31

what side effects can we see after a CABG?