Cardiac Flashcards

1
Q

What is angina?

A
  • Symptom of coronary artery disease
  • Type of chest pain due to lack of blood supply and oxygen to the heart
  • Pain often spreads to shoulders, arm, neck and jaw
  • Feels like squeezing, pressure, heaviness, tightness or pain in the chest.
  • Can be sudden or recur over time
  • Depending on severity, can be treated by lifestyle changes, medication, angioplasty or surgery
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2
Q

What is chronic stable angina?

A
  • Same pattern of onset, duration, intensity of symptoms
  • Pain lasts 5-15 mins
  • Usually predictable - provoked by exertion
  • Relieved by rest or GTN
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3
Q

What is unstable angina?

A
  • New in onset, occurs at rest, has a worsening pain
  • Other symptoms of SOB, fatigue, indigestion, anxiety
  • Not relieved with GTN
  • Associated with plaque rupture exposing a thrombus
  • Medical emergency
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4
Q

What is Acute Coronary Syndrome (ACS)?

A

The name given to three types of cardiovascular diseases that are associated with sudden plaque rupture

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5
Q

What are three types of CAD that are associated with sudden plaque rupture?

A

UA
N-STEMI
STEMI

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6
Q

How does a patient with acute coronary syndrome present with?

A
  • Collapse
  • Sweating
  • Pallor
  • Chest pain
  • Dyspnoea
  • Nausea
  • Vomiting
  • Pale and clammy
  • Pulmonary oedema
  • Hypotensive
  • Brady/tachycardia
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7
Q

What are the modifiable risk factors for CAD?

A
  • Elevated serum lipids
  • HTN
  • Tobacco use
  • Sedentary lifestyle
  • Obesity
  • DM
  • Metabolic syndrome
  • Stress
  • Homocysterine levels
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8
Q

What are the non-modifiable risk factors for CAD?

A
  • Age
  • Gender
  • Ethnicity
  • Family history and genetics
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9
Q

What are the complications of MI?

A
  • Arrythmias (atrial fibrillations, ectopic beats)
  • Cardiac arrest
  • Heart failure
  • Cardiogenic shock
  • Pulmonary oedema
  • Acute respiratory failure
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10
Q

What are some diagnostic studies done for cardiac diseases?

A

Lab tests

  • Lipid profile
  • Serum cardiac markers (Trop & T)

Medical imaging

  • 12-lead ECG
  • Cardiac cathtensation + coronary angiography
  • Chest x-ray
  • Echocardiogram
  • Exercise stress testing
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11
Q

What are the priorities of nursing care (acute interventions)?

A
  • Pain assessment and relief - IV access, morphine if needed
  • Ongoing physiological monitoring and assessment, continuous cardiac monitoring, frequent vitals
  • Promotion of rest and comfort; positioning, bed rest, limited activity for 12-24 hours
  • Alleviation of stress and anxiety
  • Understanding patients emotional and behavioural reactions - life defining event - loss, grief, depression
  • Oxygen therapy, drug therapy, GTN and aspirin, cared for in critical care unit, coronary care or setting with telemetry
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12
Q

What are the priorities for the multidisciplinary team?

A
  • Rapid diagnosis and treatment is extremely important
  • Clinical decision making re-treatment, pharmacology, surgical management
  • Best practice treatment
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13
Q

How to reperfuse STEMI’s

A
  • STEMI’s need immediate reperfusion
  • Stop the infarction process by dissolving thrombus and reperfusing myocardium
  • Treatment if no PCI available in timely manner
  • Mortality reduced by 25% if reperfusion occurs within 6 hours
  • Inclusion criteria
  • Safety alert - risk of bleeding
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14
Q

What are the nursing interventions for acute heart failure; pulmonary oedema?

A
  • C-XRAY
  • Monitoring
  • Treat cause
  • Positioning
  • Oxygen therapy - nasal prong, high flow
  • Drug therapy
  • Daily weight
  • Rest
  • Regular assessment
  • Combine physical, psychosocial and relational needs with each care encounter
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15
Q

What needs to be included in patient education?

A
  • Needs to occur at every stage of the hospitilisation and recovery/rehab journey
  • For teaching to be meaningful, the patient must be aware of the need to learn
  • Timing is important - initially in crisis - shock, disbelief
  • Simple, brief language
  • Learning what to expect = sense of control
  • Use evidence-based teaching duides
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16
Q

What does a ST-segment elevation mean?

A
  • The higher the elevation and the more leads involved, the larger the infarct and the greater the mortality
  • Watch out for other causes of ST-segment elevation, such as pericarditis and LV hypertrophy, PE, Digoxin
17
Q

What are the nursing assessments for chest pain?

A
  • Pain assessment
  • Vital signs
  • Precipitating factors
  • Skin
  • ECG
  • Blood work
  • Medications
  • Patient history - cardiac history
  • Perfusion: capillary refill
18
Q

What is MI?

A
  • Occlusion of coronary artery for over 4-6 hours

- Cell death - irreversible necrosis of myocardium

19
Q

What are the characteristics of unstable angina?

A

No change in ECG, possible ST elevations and T wave depression
- No change in biomarkers

20
Q

What are the characteristics of NSTEMI?

A
  • Possible ST elevations and Q waves
  • Can be St depression or T wave inversion
  • Change in biomarkers
21
Q

What are the characteristics of STEMI?

A
  • ST elevation, presence of Q wave

- Change in biomarkers

22
Q

What does MONATAS stand for

A
M - morphine
O - oxygen
N - nitrates
A - aspirin
T - thrombolytics
A - anticoagulants
S - stool softener
23
Q

What does MONATAS stand for

A
M - morphine
O - oxygen
N - nitrates
A - aspirin
T - thrombolytics
A - anticoagulants
S - stool softener
24
Q

What is heart failure?

A

Linked to cardiovascular disease

25
Q

What are the symptoms of heart failure?

A
  • Breathlessness
  • Tachycardia
  • Hypotension
  • Anxiety
  • Fatigue
26
Q

What are the types of heart failure?

A
  • LVF, left ventricular failure
  • RHF, cor pulmonale
  • Bilateral - biventricular heart failure
27
Q

What is the normal ejection fraction?

A

55% to 70%

28
Q

When is heart failure end-stage?

A
  • Confirmed diagnosis
  • EF less than 20%
  • Not a candidate for device therapy or surgery
  • BNP greater than 200 on maximal therapy
  • Persistent NYHA class III-IV symptoms
  • Multiple comorbidities which influence initiating HF therapy
  • Inability to optimise medical therapy