CARDIOVASCULAR SYSTEM Chronic Stable Angina Flashcards
CHRONIC STABLE ANGINA:
caused by decreased ____ to the myocardium which leads to ____ or ____.
This leads to temporary pain and ___ in the chest.
it’s usually caused by_____.
- blood flow
- ischemia
- pressure
- coronary artery disease
What brings the pain on?
Low oxygen usually due to exertion
What relieves the pain?
Rest and or sublingual nitroglycerin.
Nitroglycerin causes venous and arterial____. This includes coronary arteries.
the vasodilation will cause a decrease in ___ and ____.
- vasodilation
- preload and afterload
Since the nitroglycerine has decreased the preload and after load, this causes a decrease in _____ for the heart.
workload;
heart won’t have to work as hard and demand as much oxygen.
*with all heart failure patients, the main thing we worry about is not increasing the workload of the heard *
NITROGLYCERINE PATIENT TEACHING:
Take 1 tablet every___ mins.
How many times?
Do they need to sit down or stand when taking it?
why?
What must they do with the cotton from the container?
why?
Can they swallow it?
How should they store the bottle?
Will it always burn or fizz when placed under the tongue?
How often should they renew the prescription?
What will happen to the BP after taking nitro?
- 5 mins;
3 times
- sit down because it causes hypotension immediately
- remove it; it absorbs the drug
- no
- dark, glass bottle, dry, and cool
- no
- every 6 months
- drop
You just gave a nitroglycerine tab to a patient. Is it ok to leave and come back in 5 mins?
why?
No;
you must stay with them because this patient is unstable. their bP may not always come back up.
Inderal
Lopressor
Tenormin
Coreg
are all____
Beta blockers
Why are beta blockers given to a patient with angina?
It decreases pulse, BP, and contractility ; therefore, decreasing the workload of the heart.
Procardia
Calan
Norvasc
are all____
Calcium channel blockers
Why are calcium channel blockers given to angina patients?
They decrease blood pressure and also dilate the coronary arteries; therefore, decrease cardiac workload and increasing blood flow to the heart muscle.
Why are they also put on aspirin?
it has an anti-platelet effect.
PATIENT EDUCATION:
Avoid____ exercises.
____ overeating
rest____
Avoid excess___
or any drug that increases____
wait ____ hours after eating to exercise
dress____ in cold weather. why?
take NTG_____
____ smoking
____ weight.
- isometric (lifting weights.. or anything that makes your muscles tense and squeeze)
- avoid overeating
- rest frequently
- avoid excess caffeine
- wait 2 hours
- dress warm; cold weather can exacerbate angina (ANY temperature extreme can precipitate an attack. that includes hot weather)
- take prophylactically
- stop smoking - lose weight
What if my patient drinks a HUGE 7-11 slurpee really fast. can that precipitate an attack?
yes; any temperature extreme.
THE #1 THING WHEN IT COMES TO ANGINA PATIENT IS TO DO EVERYTHING YOU CAN TO____
DECREASE CARDIAC WORKLOAD.
