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NUR 329 > Cardiac Medical Patient > Flashcards

Cardiac Medical Patient Flashcards

0
Q

Def atherosclerosis

A

Fatty deposits that harden over time

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1
Q

Major cause of CAD

A

Atherosclerosis

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2
Q

Etiology of CAD

A

Focal deposits of lipids and cholesterol within intimal walls of artery

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3
Q

Name the theories of atherogenesis (7)

A
  • Endothelial injury
  • lipid infiltration
  • aging
  • thrombogenic
  • vascular dynamics
  • capillary hemorrhage
  • lipid metabolic
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4
Q

Endothelial injury theory

A

Endothelium is injured by HTN, HLD, chemical irritants
Platelets and other clotting factors form
Lesions assoc super imposed thrombus develops

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5
Q

Lipid infiltration theory

A

Lipids from circulation enter and accum in smooth muscle cells
Mechanical/ inflammatory trauma
Lipoproteins become trapped and damage occurs
Endothelial permeability compromised

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6
Q

Aging theory

A

Atherosclerosis happens in everyone and is more prevalent in older people

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7
Q

Thrombogenic theory

A

RBCs, lipids, and platelets accum in the intima of arteries
Micro thrombi form
Plts aggregate

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8
Q

Vascular dynamics theory

A

Mechanical factors (HTN, incr intraluminal pressure) lead to altered membrane perm —> lipid infiltration

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9
Q

Capillary hemorrhage theory

A

Lipids accum in plaques as a result of capillary hemorrhage

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10
Q

Lipid metabolic theory

A

Low density lipoproteins migrate into arterial wall, accum, and lipids are deposited

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11
Q

Stages of CAD (4)

A

Fatty streaks
Raised fibrous plaques
Complicated lesion
Collateral circulation

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12
Q

3 most significant risk factors for CAD

A

Elevated serum lipids
Smoking
HTN

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13
Q

Cholesterol lowering meds (6)

A 
Statins
- Lipitor, Crestor, zocor
Fibrin acids
- tricor, lopid
Bile acid sequestrans
- quest ran
Cholesterol absorption inhibitors
- Zetia
Omega 3
- fish oils, flax seeds
Red rice
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14
Q

What do u need to monitor for with chol meds

A

Hepatic fx

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15
Q

Def angina pectoris

A

Ischemia of coronary muscle that temporarily compromises tissue and is caused by an imbalance bx O2 supply and O2 demand

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16
Q

Def MI

A

Myocardial O2 demand exceeds supply

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17
Q

At is the primary cause of angina

A

Narrowing of coronary arteries by atherosclerosis

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18
Q

Angina precip factors

A 
Phys exertion
Strong emotions
Consumption of heavy meals
Temp extremes
Smoking
Sexual activity
Stimulants ( caffeine, cocaine)
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19
Q

Types of angina (4)

A

Stable / classic
Unstable
Prinzmetal
Nocturnal

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20
Q

What is Stable angina

A

Angina that occurs with occurs with consistent onset, duration, and intensity
Usually induced by activity
EKG shows ST segment depression

21
Q

Unstable angina

A

Unpredictable
Occurs with little - no activity
A/w incr stenosis and multivessel disease
May have spasm

22
Q

Prinzmental angina

A

Occurs at rest or sleep
Due to spasm of coronary artery
EKG shows transient ST elevation
Pain may be relieved by some exercise or may go away on its own

23
Q

Nocturnal angina

A

Occurs at night whether sleeping or not
Occurs when lying down
Relieved by sitting up

24
Q

Angina dx studies and why

A 
CBC to r/o anemia
CRP shows inflammation
Homocysteine shows damage to arterial lining
Lipoproteins
Resting EKG
EKG stress test
Radionuclide imaging
Radionuclide ventriculography 
Cardiac cath
Positron emissions tomography (PET scans)
25
Q

What meds are given for angina

A 
BB
CCB
Ace inhib
Anti lipids
Anti plt 
Folic acid
B vit complex
26
Q

Angina mgmt (4)

A 
Percutaneous coronary interventions
Percutaneous transluminal angioplasty
Cardiac cath
Intra coronary stent
Coronary artery bypass graft
Trans myocardial revascularization
27
Q

Complications to angina mgmt

A 
Hemorrhage at site
Hematoma at site
Retro peritoneal bleeding
Pseudo aneurysm 
Renal
28
Q

Def pseudo aneurysm

A

Out pocketing of blood

29
Q

Pathophys of MI

A

Plaque rupture
Plt aggregation at site
Activation of exposed platelets cause expression of glycoproteins I A/ b (bond fibrinogen)

30
Q

What dose of aspirin do u give an MI PT

A

160-325 mg

31
Q

Def cardiogenic shock

A

Failure of heart to pump blood adequately to meet O2 demands

32
Q

When does cardiogenic shock occur

A

When the heart loses contractile power

33
Q

What can cause cardiogenic shock

A

Cardiomyopathy
Severe valvular dsfx
Ventricular aneurysms

34
Q

Clinical manif of cardiogenic shock (10)

A 
Confusion
Restlessness
Low BP < 80
Oliguria < 30 mL / hr
Cold and clammy
Weak and threads pulse
Dyspnea, tachypnea, cyanosis
Dysrhythmias
Chest pain
Decr bowel sounds
35
Q

Cardiogenic shock interventions

A

Incr CO
O2
Maintain tissue perfusion

36
Q

Potential complications of pericarditis

A

Pericardial effusion

Cardiac tamponade

37
Q

Causes of pericarditis (9)

A 
Infection
Auto immune ct disease
Hypersensitivity states
Neoplastic conditions
Radiation
Trauma
Renal failure
Tb
Idiopathic
38
Q

Pericarditis clinical manif

A 
Atypical chest pain
Pain on inspiration 
Fever
Incr WBC, CRP, ESR
pericardial friction rub
39
Q

Pericarditis tx

A

Pericardiocentesis
Steroids in severe cases
NSAIDS
monitor for decr CO

40
Q

Def pericardial effusion

A

Accum of fluid in the pericardial sac

41
Q

Def cardiac tamponade

A

Restriction of heart fx due to fluid in the pericardial sac

42
Q

Pericardial effusion/ tamponade clinical manif

A 
Ill defined chest pain/ fullness
Pulsus paradoxis
Engorged neck veins
Labile or low BP
SOB
43
Q

Cardinal signs of cardiac tamponade

A

Falling systolic BP
Narrowing pulse pressure
Rising venous pressure
Distant heart sounds

44
Q

Pericardial effusion and tamponade interventions

A

Pericardiocentesis

Pericardotomy

45
Q

Low doses of dopamine is used for …

A

Renal perfusion

46
Q

High doses of dopamine

A

For BP

47
Q

What does the med Primacore do?

A

Reduces workload of the heart

48
Q

Diuretics decrease ________

A

Preload

49
Q

Name the 4 inotropes

A

Dobutamine
Dopamine
Digoxin
Primacore

50
Q

Mi meds (10)

A 
Diuretics
Inotropes
Vasodilators
Ace inhib
Arbs
BB 
Aldosterone inhibitors
BNP
hydra lazing
Nitrates
51
Q

Iv diuretics

A

LASIx
Bumex
Edecrin

NUR 329 (6 decks)

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