chapter 28- Coronary Artery Disease Flashcards
what is CAD caused by
build-up of lipids in arteries AKA atherosclerosis
what does chest pain signal is CAD
decreased oxygen to the tissues
CAD risk factors
-smoking
-hyperlipidemia
-HTN
-obesity –specifically abdominal
-sedentary life
-age >45 men >55 female
-ethnicity
-preeclampsia
genetics
stable angina — when and why
-exercise, exertion, stress, cold
-o2 demand being greater than supply
substernal CP symptoms
squeezing feeling radiates into the jaw, neck, shoulders, arm
-should be brief
-comes with SOB, sweating, N/V
-can be mistaken for GI or arthritis pain
-gender differences in symptoms
treatment of stable angina/substernal CP
thrombolytics and interventional therapy
IE: heart cath, stent
when does variant angina occur
during rest, bedtime is common and can last for 3-6 months daily
treatment for variant angina
calcium channel blocker, beta blocker, nitrates
-increase exercise tolerance and prevent progression
what is acute coronary syndrome
unstable angina, acute pain lasting longer than 20 minutes while at rest.
WARNING SIGN TO MI
what is an NSTEMI MI
non-ST elevation heart attack
what is a STEMI MI
ST elevation for 20 minutes on ECG
MORE SEVERE
Labs done after MI
Creatine Kinase: cardiac isoenzyme test (represents cardiac muscle damage)
Cardiac troponin 1 & T: shows cardiac cell damage
what is a heart cath
diagnostic test.
-done through groin or radial can clear blockages and place stents
what is a graft
cutting of an artery and reconnecting when it can not be reopened
how do Nitrates work
Potent vasodilator
-increase blood flow, lower pressure, and relieve pain by allowing more oxygen to the tissues
DECREASES PRELOAD AND AFTERLOAD
common nitrates
NITROGLYCERIN: sublingual for emergencies can give 3 times 5 minutes apart, call 911 after 3rd dose
-isosorbide dinitrate, isosorbide mononitrate
adverse effects of nitrates
headache, dizziness, bradycardia, syncope, HYPOTENSION
how do beta blockers work
decrease workload, increase oxygen to the heart
common beta blockers
SELECTIVE: atenolol, metoprolol, bisoprolol
who should not take beta blockers/caution in
2nd/3rd-degree block, cardiogenic shock, bradycardia, hypotension, heart failure
how do calcium channel blockers work
produces vasodilation
WILL NOT EFFECT HR
example of calcium channel blocker
nifedipine
adverse effects of calcium channel blockers
hypotension, headache, dizziness, edema, reflex tachycardia
DOSE RELATED
nursing considerations with Calcium channel blockers
grapefruit and can increase digoxin levels
what does ranolazine do
anti-ischemic
-first-line treatment for chronic angina
what do dyslipidemic drugs do
reduces lipids in the blood
examples of dyslipidemics
ATORVASTATIN, cholestyramine and niacin
what do antihypertensives do
decrease peripheral vascular resistance
examples of antihypertensives
ACE inhibitors
what does morphine do
analgesic, treats pain and anxiety, decreases preload
-used on MI patients in unmanageable pain
what do antiplatelets do
suppress platelet aggregation, needed after MI
DIFFERENT THAN THROBOLYTICS
examples of antiplatelets
Aspirin, adenosine diphosphate, glycoprotein
