CARDIAC Flashcards
Coronary Arteries
deliver oxygenated blood to the heart; encapule around the heart; arteries that provide the heart blood
- give the heart its blood supply
Risk Factors of CAD
High Cholesterol
Smoking
Alcohol
Diabetes
Diet
No exercise
-start by educating patients about the risk factors
Atherosclerotic Plaque
artery is narrowed d/t plaque —> ISCHEMIA
when sites of the heart die off and aren’t getting any 02 or blood supply from the infarcted vessel it will die off
MI occurs 24-48 hours after
potassium starts to leak out and cause
V-FIB
now working 24-48 hours to make sure no complications of v-fib or rupture
Cardiomyocites have potassium in them–>die off the heart–> leads to ischemia
how do we treat hyperlipidemia?
statins
( Simvastatin, atorvastatin, suvastatin)
what will statins do? and ranges?
Will decrease our total cholesterol 200
Decrease Triglycerides 150
Decrease LDL 100
Increase HDL 50
if a patients cholesterol went from 380-340 but normally its 200, is medication working?
YES; it dropped.
when do we give statins?
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.
prior to administering the drug what are we going to check?
LIVER FUNCTION TESTS
ALT
AST
ALK
side effect of ‘STATINs
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
they’re going to come in with muscle pain, muscle weakness, tenderness
red flag for ‘STATIN
- check kidney function (BUN/CREATININE)
- LIVER TESTS
A clogged artery will cause
Chest Pain, developing ANGINA
2 types of angina
- STABLE ANGINA
- UNSTABLE ANGINA
STABLE ANGINA IS
PREDICATABLE- Chest pain w/ Exertion
UNSTABLE
UNPREDICTABLE
- without any notification; chest pain at rest!
what would we need to do to help the vessel get blood supply?
VASODILATION
how do we vasodilate?
NITRATES,
WHAT IS A NITRATE?
POTENT VASODILATOR
Side effects of NITRATES
Headaches, Flushing,
Nitrates come in what forms
(pill)Sublingual, Spray
how many doses total? and minutes apart?
3 doses 5 min apart
Do NOT take NItrates with
‘Nafil ‘afil; used for erectile dysfunction, and pulmonary HTN (vasoconstriction of pulmonary htn)
- THIS COMBO WILL LOWER THE BP EVEN FURTHER
With Patches (Nitrate)
rotate sites, don’t use with cardioversion
if the 3 nitro pills didn’t work? take them too
Cardiac Cath Lab
What type of surgery will you need to do to open up the vessels of the heart?
Stent (Femoral)
What type of surgery will you need to do to open up the vessels of the heart?
Stent (Femoral)
What if area of the Heart is infected?
DONT GO IN WITH STENT—> SEPSIS/INFECTION
what education do we give after a STENT placement?
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
what happens when the stent doesn’t work anymore or it’s not doing its job?
CABG- Coronary Artery Bypass Graft
what side effects can we see after a CABG?
