Cardio2 Flashcards
1
Q
Arteriosclerosis
A
thickening or hardening of the arterial wall often associated with aging
2
Q
Atherosclerosis
A
type of arteriosclerosis involving the formation of plaque within the arterial wall
3
Q
Factors related to atherosclerosis
A
obesity, lack of exercise, smoking, and stress.
biggest one is GENETICS
4
Q
Total Cholesterol
A
> 200 high
5
Q
LDL: bad
A
160 or higher
high
6
Q
optimal HDL level
good
A
greater than 60
at least above 40
7
Q
adequate triglycerides range
A
less than 150
8
Q
smoking
A
changes the inside of the artery walls and plaques easier
9
Q
hypertension is considered
A
> 130/>80
10
Q
prehypertension
A
120-129/ <80
11
Q
normal blood pressure
A
<120/<80
12
Q
Essential Hypertension Risks
A
Age >60 years Family history of hypertension Excessive calorie consumption Physical inactivity Excessive alcohol intake Hyperlipidemia: high cholesterol African-American ethnicity High intake of salt or caffeine Obesity Smoking Stress
13
Q
secondary hypertension
A
renal disease: fluid overload
primary aldosteronsim: fluid retention
Cushing’s syndrome: fluid retention
14
Q
interventions for hypertension
A
Sodium restriction Weight reduction Moderation of alcohol intake Exercise Relaxation techniques Tobacco and caffeine avoidance
15
Q
how diuretics reduce blood pressure
A
increases fluid output, lowering fluids throughout blood vessels
potassium wasting
16
Q
how calcium channel blockers reduce blood pressure
A
Lowers conduction, therefore arteries do not thicken/hypertrophy.
17
Q
beta blockers, ACE inhibitors, calcium channel
A
works directly on the vessel to vasodilate
18
Q
ACE inhibitors
A
do not drop heart rate
19
Q
beta blockers, calcium channel blockers patient teaching
A
teach to check heart rate, don’t let drop below 60
20
Q
beta blockers
A
end in lol
21
Q
these drugs end in “pril”
A
ACE inhibitors
22
Q
hydrochlorothiazide
A
diuretic
potassium wasting
consume foods with potassium
23
Q
Whats the number one cause of heart failure?
A
Uncontrolled hypertension
24
Q
Peripheral Arterial Disease
A
Disorders that alter the natural flow of blood through the arteries and veins of the peripheral circulation
25
physical assessment of peripheral arterial disease
Pain that occurs even while at rest; numbness and burning
Hair loss and dry, scaly, pale or mottled skin and thickened toenails
Severe arterial disease—extremity is cold and gray-blue or darkened; pallor may occur with extremity elevation; dependent rubor; and/or muscle atrophy
26
nonsurgical management for peripheral arterial disease
```
Exercise
Positioning
Promoting vasodilation
Drug therapy
Percutaneous transluminal angioplasty
Atherectomy
```
27
surgical management for peripheral arterial disease
Aortoiliac and aortofemoral bypass surgery
28
Why should high intensity exercise NOT be done by a patient with PAD?
Because of supply and demand of blood flow.
Patient should do low intensity exercise; enough to get the blood flowing.
29
What does a warm blanket do for someone with PAD?
Vasodilation
30
percutaneous transluminal coronary angioplasty (PTCA)
A balloon enters the leg, and pushes plaque against the walls.
31
Atherectomy
surgical removal of plaque buildup from the interior of an artery
32
Aneurysm
a permanent localized dilation of an artery, enlarging the artery to twice its normal diameter
weakening of the arterial wall and a bulging occurs, one of the walls has to be intact, prerupture
33
Dissecting aneurysm (aortic dissection)
a split or tear of the arterial wall
34
Abdominal aortic aneurysm
| triple A
When the large blood vessel (aorta) that supplies blood to the abdomen, pelvis, and legs becomes abnormally large or balloons outward.
35
Thoracic aortic aneurysm
widening or bulging of the upper portion of the aorta that may occur in the descending thoracic aorta, the ascending aorta, or the aortic arch.
36
saccular aneurysm
Bulge on side of the artery
37
fusiform aneurysm
dilation of the entire circumference of the artery
38
Abdominal Aortic Aneurysm
(AAA)
assessment:
Gnawing pain
Felt in the abs, flank, or back
Pulsatile
do not palpate, can cause to rupture and it is life threatening
39
diagnostic AAA assessment
x-ray(eggshell appearance), CT (gold standard), aortic arteriography, ultrasound
40
Aneurysms of the Peripheral Arteries
femoral and popliteal
S/S- limb ischemia, diminished or absent pulses, cool to cold skin, and pain
treatment- surgery
post op- monitor for pain
CHECK NEUROSENSORY ASSESSMENT
41
Aortic Dissection
may be caused by a sudden tear in the aortic intima, opening the way for blood to enter the aortic wall
pain described as tearing, ripping, and stabbing
42
goals of emergency care for aortic dissection
eliminate pain
reduce blood pressure(control bp to PREVENT)
decrease in the velocity of left ventricular ejection
43
Thromboangiitis obliterans
| Buerger's Disease
relatively uncommon occlusive disease limited to the medium and small arteries and veins
fingers and toes randomly have a vasospasm, death of tissue can occur
44
How is raynaud's disease different from Buerger Disease.
Buerger's has larger arteries and veins that are affected.
45
Raynaud's phenomenon
Vasospasm of arterioles and arteries in extremities.
46
Why should you avoid the cold if you have Raynaud's?
Causes intense constriction, which is bound to cause vasospasms.
restrict cold exposure PATIENT TEACHING
47
Thrombus
a blood clot
48
DVT
| deep vein thrombosis
formation of a blood clot in a deep vein of the body, occurring most commonly in the legs or thighs
immobility will cause this, potential to break off and go to the lungs
49
treatment for DVT
bedrest and anticoagulants
50
How do anticoagulants treat DVT?
It PREVENTS GROWTH
IT. DOES. NOT. BREAK. IT. DOWN.
51
prevent DVT
SCD's, TED's
52
When a DVT forms
no scd, no ted, no walking
we don't want to dislodge it
53
DVT S/S
calf pain
sudden onset
localized edema
ultrasound
54
what med do we use to prevent DVT?
Blood thinners, anticoagulants
55
Intra-Vena cava Filter (IVC)
right side of the heart to filter out clots
| post DVT, prevents a pulmonary embolism
56
Varicose Veins
Distended, protruding veins that appear darkened and tortuous
occur in people who stand on their feet a lot
57
Phlebitis
inflammation of the veins
common from IV interventions in a hospital
manage with warm, moist soaks and elastic stockings if swelling involved
58
Coronary Artery Disease
disease of the arteries surrounding the heart
Most serious disease of Atherosclerosis
59
ischemia
insufficient oxygen supply to meet the requirements of the myocardium
60
infarction
necrosis or cell death that occurs when severe ischemia is prolonged and decreased perfusion causes irreversible damage to tissue
61
Stable vs Unstable Ischemia
Stable is reversible
Unstable is irreversible
62
Angina
chest pain
63
Acute Coronary Syndromes
unstable angina, infarction
64
Chronic Stable Angina Pectoris
Temporary imbalance between coronary artery's ability to supply oxygen and cardiac muscle's demand for oxygen
Ischemia limited in duration and does not cause permanent damage to myocardial tissue
65
What does chronic stable angina pectoris feel like?
Strangling of the chest
66
What segment is a traditional manifestation of an infarction?
ST elevation MI
67
ST depression is a traditional sign of what
ischemia
68
ST elevation or depression
which is worse?
ST elevation
69
How does STEMI
(ST elevated MI)
compare to a normal heartbeat.
The S wave sits just below the R
70
How does ST depression compare to a normal heartbeat?
The S wave sits way below the T.
71
The most serious acute coronary syndrome
Myocardial Infarction
72
myocardial infarction
myocardial tissue is abruptly and severely deprived of oxygen
occlusion of blood flow, necrosis, hypoxia
73
diagnosis of diabetes + high cholesterol increases your risk for developing what
heart attack
74
Labs to look at for MI (5):
Troponin
CK-MB
Myoglobin
MRI
12-lead EKG
75
Most common lab for MI:
Troponin
76
During lab tests for MI, what must you do to get an accurate diagnosis regarding lab data:
Multiple Sets of multiple lab assessments,
OVER 6 HOURS, must be done.
DO NOT SEND THEM HOME
77
interventions for angina
Provide pain-relief modalities, drug therapy.
Decrease myocardial oxygen demand.
Increase myocardial oxygen supply.
78
Diabetes may not have the same chest pain that non-diabetes do
neuropathy may mess this up
| cannot perceive pain bc of the neuropathy
79
What does MONA mean?
Morphine
oxygen
nitroglycerine
aspirin
80
Order for MONA
Oxygen
Aspirin(anti-clot)
Nitroglycerin (vasodilates)
Morphine(pain, anxiety, helps with oxygenation)
81
goal of mona
prevent lack of oxygen and reinstate perfusion
82
fibrinolytics
dissolve thrombi in the coronary arteries and restore myocardial blood flow.
83
Cardiac catheterization
Percutaneous Transluminal Coronary Angioplasty (PTCA)
intracoronary stent
following must flush with fluid cause it is nephrotoxic
84
This cardiac catheterization works like a spring.
Intracoronary Stent.
85
The leading cause of death in patients with MI before hospitalization
Dysrhythmias
86
cardiogenic shock signs
Necrosis of >40% of left ventricle.
Hypotension
Oliguria
Cold
Both Tachys
87
PTCA
Clopidogrel (Plavix) before the procedure
IV heparin after the procedure
IV or intracoronary nitroglycerine or diltiazem
Long-term therapy, antiplatelet therapy, beta blocker, ACE inhibitor or ARB
88
CABG (Coronary Artery Bypass Graft)
Open heart surgery involving arterial bypass using a transplanted vein.
to risky for a stint or angioplasty
