Cardiovascular disorders, diagnostic, and therapeutic procedures

Question 1

Modifiable risk factors of CAD

Answer 1

Elevated serum cholesterol
Cigarette smoking
Hypertension
Impaired glucose tolerance/DM
Obesity
Excessive alcohol
Limited physical activity
Stress 
Postmenopause (modification is controversial)

Question 2

non modifiable risk factors of CAD

Answer 2

Age
Gender
Family history
Ethnic background

Question 3

collateral circulation

Answer 3

tiny blood vessels form to re route blood around a blocked artery

Question 4

2 types stable angina

Answer 4

Silent ischemia -Associated with diabetes mellitus (neuropathy-client does not feel painful sensations) and hypertension

Prinzmetal’s (variant) angina- Occurs at rest usually in response to spasm of major coronary artery

Question 5

STEMI

Answer 5

ST elevation myocardial infraction

Question 6

s/sx of MI

Answer 6

Chest pain , shortness of breath, diaphoresis, unstable angina

Question 7

women s/sx of MI

Answer 7

includes regular signs of MI and fatigue pain in their back , shoulders, or jaw, N/V

Question 8

Labs/Diagnostics of MI

Answer 8

Cardiac enzymes and abnormal ST elevation or depression, thallium scan , cardiac catherization,

Question 9

Medications used for MI

Answer 9

Antiplatelet : Aspirin, Clopidogrel, 
Thrombolytics
anticoagulants
antihypertensive
Betablockers
Ace inhibitors
statins

Question 10

Surgical treatments for MI

Answer 10

PCI - Percutaneous Coronary intervention
CABG- Coronary Artery bypass graft
Atherectomy- removal of plaque from artery

Question 11

Nursing care of MI

Answer 11

• admin oxygen for an sp02 less than 90% per order
• monitor PT for complications such as cardiogenic shock and HF
• initiate cardiac rehabilitation- program focuses on education and exercise for Patient

Question 12

s/sx of cardiogenic shock

Answer 12

hypotension, tachycardia, tachypnea, and weak pulses

Question 13

What is a PCI ?

Answer 13

Percutaneous coronary intervention- a procedure used to open up the coronary arteries and it must be done within 90min or less if hospital is PCI capable, if not then patient needs to be transported to hospital that has PCI within 120min or less of the onset of symptoms of MI

Question 14

how does PCI procedure work ?

Answer 14

A catheter with a balloon is threaded through a blood vessel usually at the femoral artery , up to the blocked coronary artery. Then the balloon is inflated and a stent is placed to restore blood flow to the heart.

Question 15

What happens after a PCI ? What should the nurse do ? Post OP?

Answer 15

• Monitor insertion site for bleeding and check perfusion to the extremity that is distal from that insertion site (check for for pulse, color and temperature)
• Monitor for complications : Artery dissection and re-occlusion of the coronary artery. Lookout for S/SX of SOB, chest pain, tachypnea, and tachycardia.

Question 16

CABG procedure

Answer 16

Coronary Artery bypass graft (CABG) - bypasses one or more of the patients coronary arteries due to blockage or persistent ischemia, and usually uses the saphenous vein from the patients leg, however synthetic grafts can be used as well.

Question 17

MIDCAB

Answer 17

Minimally invasive direct coronary artery bypass

alternative to CABG

Question 18

Post OP for CABG Procedure

Answer 18

• monitor BP- hypertension/hi BP can cause bleeding from graph sites and Hypotension can cause collapse of the graft site
• monitor PTs temperature- post op hypothermia is a potential complication.
• monitor for bleeding, chest tube will be used after surgery so monitor for drainage of chest tube. if exceeds 150 ml per hour, notify HCP
• monitor LOC,F&E, cardiac rhythm and pain level. also monitor neurovascular level of donor site
• monitor Pts for complication of cardiac tamponade