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Med- Surg Nursing > Chapter 33 Coronary Artery Disease and Acute Coronary Syndrome > Flashcards

Chapter 33 Coronary Artery Disease and Acute Coronary Syndrome Flashcards

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1
Q

What is Atherosclerosis?

A

Hardening of the arteries due to focal deposits of lipids

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2
Q

Where does atherosclerosis primarily occur in the body?

A

The coronary arteries

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3
Q

What lifestyle choices cause atherosclerosis?

A

Tobacco use, hyperlipidemia, hypertension, diabetes, toxins

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4
Q

What is C-reactive Protein and how does it relate to atherosclerosis?

A

It is a protein produced by the liver that is a marker of inflammation and is often seen in patients with CAD.

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5
Q

What are both some modifiable and non-modifiable risk factors for CAD?

A 
Non-modifiable= Age, gender, ethnicity, family history, genetics
Modifiable= Tobacco use, elevated serum lipids, Hypertension, obesity, lack of physical activity
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6
Q

What age group has the highest incidence of CAD?

A

Middle aged men have the highest risk.

Past the age of 75 the risk is the same for each gender.

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7
Q

What is the difference between Whites, African Americans, Native Americans, and Hispanics in CAD?

A

Whites= have the highest incidence
African Americans= have the earliest onset and highest death from CV disease
Native Americans= die from heart disease at the earliest age
Hispanics- have the lowest death rates from CAD.

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8
Q

What kind of disease is the leading cause of death in women?

A

Heart Disease

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9
Q

At how high of a level does ones serum cholesterol have to be at to be at a high risk for CAD?

A

The individual has to have a serum cholesterol level of 200mg/dL
OR
A fasting triglyceride level of greater than 150mg/dL

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10
Q

After what age do men and women have the same risk for heart disease?

A

Age 75

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11
Q

What are the three classes of lipoproteins, what are their desired levels, and which one is good, bad, and very bad

A

HDL (good)- desired levels are high
LDL (bad)- desired levels are low (under 160mg/mL for pt with low risk of CAD & under 70mg/dL for high risk CAD pt)
VLDL (Very bad)- desired levels are very low

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12
Q

what are the guidelines used to help treat LDL cholesterol (10 year risk and lifetime risk for heart disease or stroke)

A

1) age
2) gender
3) race
4) use of tobacco
5) diabetes
6) systolic BP
7) diastolic BP
8) use of BP drugs
9) total cholesterol level
10) HDL cholesterol

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13
Q

What is the second biggest risk factor in CAD?

A

Hypertension (BP greater than 140/90

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14
Q

What is the recommended BP for individuals over the age of 60?

A

A goal BP of under 150/90 to prevent stroke, CVD, and heart failure

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15
Q

What is the FITT formula?

A

Frequency
Intensity
Type
Time

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16
Q

According to the AHA, how often should people eat fish to lower their CAD risk and what kind of fish are ok to eat?

A

The AHA recommends eating fish two times a week (salmon and tuna)

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17
Q

At what age should an individual start getting a complete lipid profile and how often should one get done?

A

A complete lipid profile should be completed every 5 years starting at age 20

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18
Q

What kind of drug inhibits the synthesis of cholesterol in the liver?

A

HMG-CoA reductase inhibitor (statins)

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19
Q

What is the PQRST for assessment of angina

A

P- precipitating events (ask what led up to the pain)
Q- Quality of Pain (what does the pain feel like)
R- Region (where is the pain)
S- Severity of the pain
T- Timing (when did the pain begin? Has it gotten better?)

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20
Q

What is angina?

A

Chest Pain

21
Q

What is Chronic stable angina?

A

Chest pain that occurs intermittently and is often provoked by physical exertion, stress, or emotional upset (usually SL NTG fixes it)

22
Q

What is Silent Ischemia?

A

Ischemia that occurs in the absence of any subjective symtpoms (can have pain or have no pain) USUALLY SHOWN BY AN EKG

23
Q

What is Prinzmetal’s angina?

A

Angina that is extremely rare and occurs at rest with no increase in physical demand

24
Q

What is microvascular angina?

A

Angina that occurs due to atherosclerosis (or spasm) of the small distal branch of vessels of the coronary microcirculation (occurs more often in women)

25
Q

What is the first line drug for angina treatment?

A

Short-acting Nitrates

26
Q

What are the a,b,c,d,e,f of chronic angina tx?

A

A- antiplatelet, antianginal, and ACE inhibitor therapy
B- Beta blocker, BP Control
C- cigarette cessation, cholesterol management, CCB, Cardiac rehab
D- diet, diabetes management, depression screening
E- education, exercise,
F- flu vaccine

27
Q

What is the drug ending for ACE inhibitors?

A

-pril

28
Q

What are Statin drugs used for?

A

lowering cholesterol levels

29
Q

What kind of drugs are Sartans?

A

Angiotensin 2 Receptor blockers (results in vasodilation)

30
Q

What is the recommended way of taking SL NTG?

A

Take one tablet with angina every 5 minutes for a maximum of 3 times if angina is not getting better. After the third call EMS

31
Q

How long are opened NTG tablets good for?

A

6 months

32
Q

What is a major complication of all nitrates?

A

Orthostatic hypotension

33
Q

What are some common routine procedures for a patient with suspected CAD?

A

12 lead EKG, echocardiogram, Electron beam computed tomography (EBCT), Coronary computed tomography angiography, stress testing

34
Q

What percentage of coronary blockage must be present before a stress picks it up?

A

At least 70%

35
Q

What is the nurses best intervention if a patient is allergic to the IV contrast dye used fro a CCTA or a cardiac cath?

A

Premedicate with corticosteroids

36
Q

What is the nurses best intervention for a patient with chronic kidney disease getting a cardiac cath or a CCTA?

A

Pre and Post procedure hydration

37
Q

Describe a balloon angioplasty

A

A balloon angioplasty has a catheter with a deflated balloon tip inserted into the occluded artery (usually coronary artery), then the balloon is inflated in the vessel and a stent is placed in to hold it in place

38
Q

What are the two types of stents

A

Bare metal stent and a drug-eluting stent (coated with drugs to reduce risk of overgrowth of the intimal lining)

39
Q

How long should a post balloon angioplasty patient be on dual antiplatelet drugs and what is one drug that is used indefinitely one this plan?

A

Usually a minimum of 12 months and aspirin

40
Q

What is enhanced external counterpulsation (EECP)?

A

two large inflatable BP cuffs are placed around the legs and are deflated on systole and inflated during diastole 5 days a week for a total of 35 treatments.

41
Q

A patient with acute coronary syndrome will have what EKG abnormality?

A

ST elevation

42
Q

What is unstable angina?

A

Angina that occurs at rest and progressively increases in frequency, duration, and pain (usually lasts 10 or more minutes)

43
Q

What is a STEMI?

A

MI caused by an occlusive thrombus that causes ST elevation

44
Q

What is the most common complication after an MI?

A

Dysrhythmias

45
Q

What are the most common dysrhythmias that lead to death?

A

V tach and V fib

46
Q

What is a basic assessment to help the nurse indicate that pericarditis is present?

A

Listening to heart sounds for pleural friction rub

47
Q

What is Dressler Syndrome?

A

Pericarditis and fever that occurs 1-8 weeks after an MI. Pt will have angina, fevere, pericardial friction rub.

48
Q

What cardiac biomarker is used when an MI is suspected?

A

Cardiac specific troponin (highly specific and a better indicator than creatine kinase)

Med- Surg Nursing (3 decks)

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