Chapter 27 Flashcards
CAD results in interruption of blood flow that can cause _______ or _______ as a results of __________________.
Ischemia
Infarction
Coronary Atherosclerosis
What is the most prevalent type of cardiovascular disease in adults?
CAD
The _______ attracts _____ and binds them to the site. The ___________ core of the LDLs is spilled into the underlayer of the _______ _________ envelop these fats and are now termed “foam cells.”
Inflammation
LDL
Triglyceride
Intima macrophages
This is the “_______ _______” seen in early stages of atherosclerosis. As the area enlarges, more ______, ________, ________, and smooth muscle fibers are drawn to the site and accumulate under the intima, _________ the vessel.
Fatty streak LDL Macrophages Platelets Narrowing
This causes ______ blood flow and ______ BP in the small coronary vessels.
Reduced
Higher
Diagnostic and clinical findings of CAD
SOB with activity
History of elevated blood lipids, smoking, poor dietary habits, secretary lifestyle and obesity.
Angina pectoris- chest pain due to myocardial ischemia
Women often have artificial signs and symptoms such as dyspnea, nausea, and weakness.
Major risk factors of coronary artery disease
Dyslipidemia, HTN, smoking, diabetes mellitus, obesity and sedentary lifestyle.
Nonmodifiable risk factors of CAD
- family history of CAD (first degree relative with cardiovascular disease at 55 years of age or younger for men and at 65 years of age or younger for women)
- increasing age (45 men; 55 woman)
- gender (more likely for woman)
- race (African Americans)
Modifiable risk factors of CAD
Hyperlipidemia Cigarette smoking, tobacco use Hypertension Diabetes Metabolic syndrome Obesity Physical inactivity
Myocardial Ischemia cause clinical signs and symptoms of chest pain _________ of a major coronary artery by more than ______ impairs blood flow enough to hamper ________ _________ when myocardial demand increases.
Narrowing
50%
Cellular metabolism
Myocardial ischemia develops if the ______ or oxygen content of coronary blood is insufficient to meet the _______ ________ of myocardial cells.
Flow
Metabolic demands
Causative events of angina pectoris include the 4 E’s:
- Eating a large meal
- Excitement
- Environment
- Exercise
And smoking
When _____ ______ diminishes to the heart muscle, the ___________ nervous system is activated, _______ the BP and heart rate. This ________ the oxygen and glucose needs of the cardiac cells.
Blood flow
Sympathetic
Raising
Increases
Cardiac ________ from lack of ________ occurs centrally, surrounded by varying levels of ________ tissue radiating outward from the site.
Necrosis
Perfusion
Ischemic
Necrotic cardiac tissue will ______ resume its prior ability to ______ but rather will form _____ ________.
Never
Contract
Scar tissue
Damage can occur to the ______ ______ of the heart, causing ______ arrhythmias.
Pacing system
Lethal
Assessment and diagnostic findings for myocardial infarction
- EKG changes (ST segment elevation)
- abnormalities in a 12-lead EKG
- elevation of cardiac enzymes
- elevated pulse and bp
- decreased O2 saturation
- CBC showing an elevation of WBC’s
- electrolyte abnormalities
Treatment/Medical intervention for CP/MI
M-morphine
O-oxygen
N-nitroglycerin (vasodilator)
A-aspirin
Morphine effect on CP/MI
Morphine reduces preload and afterload, which decreases the workload of the heart, relaxes bronchioles and enhances oxygenation.
ACE1- causes a ______ in BP and ______ (kidneys _____ sodium and water) which ________ oxygen demands of the heart.
Decrease
Dieresis
Excrete
Decreases
Thrombolytics- dissolve _______ in the coronary arteries and allow ______. Caution in patients at risk for ________.
Clots
Reprofusion
Bleeding
A thrombus is a dangerous complication of atherosclerosis because it can lead to __________ and ____________.
Acute MI
Sudden death
A person at increased risk for heart disease is encouraged to stop _______ through any means possible.
Smoking
________________ use by woman who smoke is i advisable because these medications significantly increase the risk got CAD and SCD
Oral contraceptives
Hypertension is defined as blood pressure measurements that repeatedly exceed _________ mmHg.
140/90
The patient with suspected MI should immediately receive
M-morphine
O-oxygen
N-nitrogen
A-aspirin
The most common cause of Cardiovascular disease is
Atherosclerosis
The most frequently occurring sign if myocardial ischemia is
Chest pain = angia pectoris
More than 50% of people with coronary artery disease have the risk factor of
Age= older than 65
Management of coronary heart disease requires a therapeutic range of cholesterol and lipoproteins. An acceptable blood level of total cholesterol is ___________ with an LDL\HDL ratio of ________. The desired level of LDLS should be ________ and the HDL level should be ________. Triglycerides should be less than _________.
Less than 200 mg/dL 3.5/1.0 Less than 100 mg/dL Greater than 60 mg/dL Less than 150 mg/dL
The American heart association recommends that an average American diet contain about _______ % fat.
25-35
The key, diagnostic indicator for MI seen on an EKG is
An elevated ST segment in 2 continuous leads
The vessel most commonly used for coronary artery bypass grafting (cabg) is the
Greater saphenous vein
A possible complication of rupture or hemorrhage of the lipid core into the plaque issue
The formation of a thrombus
A positive diagnosis of metabolic syndrome occurs when three of the following six conditions are met:
Insulin resistance Dyslipidemia Elevated levels of CR protein Central obesity Hypertension Elevated fibrinogen levels
List seven symptoms seen in postpericardiotomy syndrome:
Fever, pericardial pain, pleural pain, dyspnea, pericardial effusion, pericardial friction rub and arthralgia
What is an atheroma
Plaque is a fibrous cap of smooth muscle cells that form over lipid deposits within the arterial vessels, protrude and narrow the lumen, and obstructs blood flow.
What does the phrase door to balloon time mean?
Because the duration of oxygen deprivation determines the number of myocardial cells that die, the time from the patients arrival in the ER to the time PCI is performed should be less than 60 minutes.
Omega-3-acid-ethyl esters
Fish oil capsule
Fibric acids
TriCor
Bile acid sequestrants
Colestid
Cholesterol absorption inhibitor
Zetia
Nicotinic acid
Niacor
HMG-CoA reductase inhibitor
Pravachol
The nurse is reviewing the results of a total cholesterol level for a patient who has been taking Zocor. What results display the effectiveness of the medication?
160-190mg/dL
