ch 23 coronary vascular disorders Flashcards
plaque on the inner lumen of arteries is mostly composed of what
lipids and fibrous tissue
angina is most often attributed to what cause
coronary arteriosclerosis
what nursing diagnosis underlies the discomfort associated with angina
ineffective cardiopulmonary tissue perfusion related to coronary artery disease (CAD)
if the clients symptoms are due to an MI what will have happed to the myocardium
it may have developed an increased area of infarction during the time without treatment
family members bring a client to the ed with pale cool skin, sudden mid stern al chest pain, and a history of cad. how would you interpret this data
the symptoms indicate an acute coronary episode and should be treated as such
an or nurse is preparing to assist with a coronary artery bypass graft (CABG). what vessel is most commonly used as the source for the graft
greater saphenous vein
what are the complications associated with percutaneous transluminal coronary angioplasty (PTCA)
bleeding at insertion site
a patient with type 2 diabetes and hypertension weighs 250 lbs/113.4 kg, waist circumference 40 in/101.6cm, bp 162/84, fasting blood glucose 220
metabolic syndrome, major risk factor for cardiovascular disease
for cardiac surgery to have absence of blood from surgical field while maintaining perfusion of body organs and tissues, what technique would the nurse describe
cardiopulmonary bypass
if a client is afraid of dying during cardiac surgery, how should the nurse respond
explore the factors underlying the clients anxiety
potential adverse effects nitroglycerin
throbbing headache and dizziness
what risk factors for coronary artery disease (CAD) can be controlled or modified
cholesterol levels, hypertension, smoking
for a diagnosis of myocardial infarction what nursing assessment is a priority upon admission
begin ecg monitoring
a patient has a history of hypertension and smokes one pack of cigarettes a day but denies any of the most common manifestations of CAD. the nurse should expect the focuses of cad treatment to be
diet therapy and smoking cessation
for a patient who has just had an MI and is now in rehab, the nurse should cease activity if which of the following occurs?
the client experiences chest pain, palpitations or dyspnea
a client with cardiovascular disease is being treated with amlodipine, which has what therapeutic effect?
reducing the heart’s workload by decreasing heart rate and myocardial contraction
the desired goal for cholesterol levels is which of the following
low LDL and high HDL
what are the primary ways that tobacco use impacts CAD? select all that apply
-decreases the supply of oxygen to the myocardium
-increases platelet adhesion
-raises the heart rate and blood pressure
-increases blood carbon monoxide level
what change on an ecg most strongly suggests that ischemia is occurring
t wave inversion
an adult client is admitted to the ed with chest pain for more than 20 minutes. what intervention to minimize cardiac damage
morphine sulfate, oxygen, bed rest
in a patient with hypertension and chest pain during ambulation, in which order would the nurse assess and treat the client?
1.the client is instructed to stop all activity
2. the nurse assesses the client’s angina
3. the first set of vitals are done
4. a 12 lead ecg is performed
5. the client is transferred to a higher acuity unit
6. the client receives first dose of nitroglycerin
what statement indicated understanding of venous thromboembolism prevention?
ill make sure that i don’t cross my legs when im resting in bed
when assessing a client with angina pectoris it is most important for the nurse to gather what information
the clients symptoms and the activities that precipitate attacks
which nursing diagnosis suggests distress and shock by a diagnosis of angina pectoris
anxiety related to cardiac symptoms
what is the most appropriate initial action for an angina attack
place the client on bed rest in a semi fowler position
which clients test results best demonstrate the specific diagnosis of unstable angina (USA)
a 72 yr old patient with an increased myoglobin, no elevation in the ST segment, and no elevation in troponins
what med for suspected mi
morphine, aspirin, nitroglycerin, iv beta blocker (-olol)
s/s acute coronary syndrome (ACS)
dyspnea, unusual fatigue, syncope
what nursing action should be included for patient care plan for acute coronary syndrome
administer supplementary oxygen as needed
what goal should guide the care team’s selection of assessments, interventions, and treatments for ACS
balancing myocardial oxygen supply with demand
how can the nurse best meet patients psychosocial needs for ACS
directly address anxieties and fears
what is a major indicator that a percutaneous transluminal coronary angioplasty (PTCA) was successful
increase in the size of the artery’s lumen
for a patient who had a coronary artery stent placed yesterday what medication would be administrated today
clopidogrel (antiplatlet)
what nursing education for percutaneous coronary intervention (PCI)
a sheath will be placed over the insertion site after the procedure is finished
what nursing education for intraoperative regimen for coronary artery revascularization
intubation and mechanical ventilation
a patient has begun bleeding from PCI access site in femoral region. what is most appropriate action
call for help and apply pressure to the access site
what complications for post PTCA
-abrupt closure of the coronary artery
-bleeding at insertion site
-retroperitoneal bleeding
-arteria occlusion
a client who is post op following a CABG has produced 20 ml of urine in the past three hours has confirmed the patency of the urinary catheter. what is the most appropriate action
contact the health provider and continue to assess fluid balance and renal function
what intervention best addresses risk for ineffective airway clearance related to pulmonary secretions?
client’s consistent performance of deep breathing and coughing exercises
s/s MI seen in women
indigestion, nausea
