Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

NURS 347 EXAM 3 > Chronic Stable Angina > Flashcards

Chronic Stable Angina Flashcards

1
Q

CAD is a progressive disease that can lead to what?

A

Chronic stable angina

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

When the demand for myocardial oxygen exceeds the ability of the coronary aterties to supply the heart with o2, what occurs?

O2 demand > O2 supply

A

Myocardial ischemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the clinical manifestation of myocardial ischemia?

A

Angina ( chest pain )

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Is angina reversible ischemia?
Explain how?

A

Yes

Because we can support our patient by teaching good ways to increase blood flow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the 2 most common reason for angina to develop?

A

Significant narrowing of 1 or more coronary arteries by atheroscleorsis (70%) blocked

Or 50% more for left main coronary artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are cells become what within 10 seconds of occlusion/wedges into the blood vessel/muscle spasm during chronic stable angina ?

A

Hypoxic ( lack of oxygen )

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Can the tissue be saved in chronic stable angina?? And how so/time frame?

The patient will have what ??

A

Yes
Within 20 minutes
Cell death

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the 3 clinical manifestations of angina?

A

Lack of oxygen and glucose leads to anaerobic metabolism of cardiac tissue

Lactic acid produced by anaerobic metabolism irritates nerve fibers - pain in Cardiac nerves

Referred pain from transmission to the upper thoracic posterior nerve roots

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the 4 types of angina
Think of the imagine in the PowerPoint
And elaborate what each of them have

A
  1. Normal
  2. Stable angina - atherosclerosis
  3. Unstable angina atherosclerosis & blood clot
  4. Variant angina - coronary spams
    ( drugs like cocaine usage ^ )
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Chronic stabke angina is what?

A

Predictable !!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Chronic stable angina is the intermittent ??

A

Intermittent chest pain that occurs over a long period with similar pattern of onset, Duration, intensity of symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the onset of chronic stable angina, what often provoked it? (3)

A

Physical exertion
Stress
Emotional upset

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

It’s always important to get an accurate assessment of Chronic stable angina why? (2)

A

PQRST(precipitating factors, quality, region, severity, time)
some patients may deny feeling pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Symptoms may include for patients when having chronic stable angina? (5)

A

Pressure
Heaviness
Discomfort in chest
Dyspnea
Fatigue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

The one main factor of chronic stable angina is that it can not be helped even with what? (2)

A

Change in position/ breathing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

It’s super important to encourage patients to what even having chest pain/ chronic stable angina ?

A

To sit up to open up there diaphragm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

How is anginal pain described as?(9)

A

Pressure/aches
Squeezing
Heavy
Chokina/ Suffocating sensation
Rarely sharp/stabbing
Indigestion
Burning
Can be between shoulder blades
Have various locations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What’s an anagram that can help me remember how anginal pain is described as?

A

Press
Squeeze
Heavy
Chair
Rarity
In
Burning
Shoulders
Locations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are the 4 common locations of angina ?

A
  1. Mid Sternum ( both arms & neck )
  2. All sternum ( left arm )
  3. Epi gastric ( like a tie/ both arms)
  4. Intrascapular ( middle back )
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is the duration of pain for patients when having chroni stable angina?

A

Few minutes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are some things that help subside chronic stable angina? From the textbook table, just name a few

A

Circadian rthym patterns
Consumption of heavy meal
Physical exertion
Sexual activity
Stimulatanrs
Temperature extremes
Strong emotions
Temperature
Tobacco

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

How does chronic stable angina actually subside? Doing what? (3)

A

Resting
Calming down
sublingual nitroglycerin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What type of changes do we see on 12-lead ECG?
What does that mean?
How do we resolve this?

A

Ischemic ( poor blood flow )
ST depression or T wave Inversion
When blood flow is restored/pain relief

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Additional information I didn’t mention before we give out sublingual nitroglycerin to help with pain but what does it do?

A

Vasodilators

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What is silent ischemia?

A

Ischemia that occurs in absence of any subjective symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

In patients who have this thing can effect or be associated with silent ischemia?
In which they do what to the cardiovascular system?

A

Diabetes Neuropathy nerves
Innervate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

How can we confirm silent ischemia?

A

Using an ECG

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

It’s important to know that patients either with pain or no pain ( asymptomatic) can have the same what?

A

Prognosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Silent ischemia can develop into unstable angina because patients who have what condition ; in which that condition does what to them?

A

Diabetic neuropathy
Makes them asymptotic to the pain & can’t feel it compared to others

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Prinzmental variant angina is?
And occurs when?
With or without?

Also known as cyclic

A

Rare form of angina that occurs at rest with or without CAD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Risk factors of prinzmetal angina is? (4)

A

Heavy migraine
Headaches
Raynaud’s phenomenon
Heavy smoking

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Prinzmental angina is usually due to the what?
And causes what type of activity in what??
And results in?

A

Hyperactivity of smooth muscle of a major coronary artery resulting in spasms from increased intracellular calcium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What are some contributing factors of Prinzmental angina? (2)

A

Increased levels of certain substances ( alcohol, cocaine )

Narrowed blood vessels from medications:cold weather

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What’s the treatment for Prinzmental variant angina? (5)

A

Moderate exercise
Sublingual nitroglycerin
Calcium channel blockers
Stop using substances

It can disappear on its own

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What is microvascular angina? (MVD)

A

Chest pain occurs in the absence of significant CAD or coronary spans of a major coronary artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

MVD is related to ? (2)

A

Myocardial ischemia associated with atherosclerosis or
distal coronary branches

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

MVD is more in who?
And during what?

A

Women
Physical exertion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What’s the treatment of MVD?

A

The same as CAD
( lipid lower medication )

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Inter-professional and nursing care for chronic stable angina

What’s the main goal? (2)

A

Reduce oxygen demand
Increase oxygen supply

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

To optimize myocardial perfusion we want to what? (6)
What type of medications do we want to give

A

Administer oxygen
Antiplatelet & lipid lowering drugs
( aspirin )
Nitrates
ACE
( lower bp )
B blockers
CCB calcium channel blockers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

What’s the planning goals for chronic stable angina ?? (6)
( what do we as a nurse want to give and teach the patient when outside of our care )
think of coping!! Planning goals OUTSIDE!!

A

Relief pain
Immediate and appropriate treatment
Preservation of heart muscle if MI sus
Effective copin with illness associated anxiety
Participation in a rehabilitation plan
Reduction of risk factors

42
Q

What’s an anagram that can help me remember the 6 planning for chronic stable angina ?

A

Really
Immediate
Preserve
Effective
Part
Risky

43
Q

Acute care for chronic stable angina
What are you as a nurse going to want to do? (8)
Think about what we are going to be having or doing in the hospital setting
(OBTAINS!!)

A

Sit them up
Apply oxygen
Asses BS
ECG monitor
Pain relief - SUB NTG
Obtain chest X ray
Obtain cardiac biomakers
Provide support / reduce anxiety

44
Q

NTG and IV morphine are what?

A

Vasodilators to help pain

45
Q

Patient education
Ambulatory care ( outside patient ) (5)
Avoiding what??
And performing what??
A,D, P, M, PSY

A

Avoid & control risk factors
Diet
Physical activity
Medications
Psychological support

46
Q

What are the 9 nursing care chronic stable angina drug therapy?

A

Aspirin
Short acting nitrates
Sublingual nitroglycerin
Long acting nitrates
ACE & ARBS
B adrenergic blockers
calcium channel blockers
Lipid lowering
Sodium current inhibitor

47
Q

Aspirin is given as a what prevention and in the absence of what? (2)

A

Secondary prevention ( diagnosed with CAD )

True aspirin allergy

48
Q

Short acting nitrates work how?

And this will help what?

A

Dilating peripheral blood vessels & dilating coronary arteries & collateral vessels

Increase blood flow

49
Q

Sublingual nitroglycerin usually will relieve the pain within ?? (1)
What’s the recommend dose?? (1)
May cause ?? (4)
Patient teaching?? (1)
And we want to use prophylactic ? Why? (1)

A

5minutes
1 dose ( 1 tablet )
Headache, dizziness, flushing, orthostatic hypotension
Proper usage/storage

Prophylactic is to prevent, so use this to prevent angina

50
Q

Nitroglycerin can not be exposed to what?

A

Sunlight & heat

51
Q

What does long acting nitrates help with & treats what?

A

To reduce frequency of angina
Treats Prinzmental angina

52
Q

What are the 2 main side effects of long acting nitrates?

A

Headaches
Orthostatic hypotension

53
Q

What’s the 3 methods of admistrstion of long acting nitrates?

A

Oral
HTG ointment
Transdermal controlled release NTG

54
Q

Short vs Long nitrates?

A

Short - short term
Long - long term ( longer time )

55
Q

angiotensin converting enzyme inhibitors
Angiotensin receptor blockers
Do what and precent what?

A

Vasodilator & reduce blood volume
Prevents/reverse ventricle remodeling

56
Q

What does B adrenergic blockers do?
(4)

A

Reduce myocardial contractility
Decrease heart rate
Decrease SVR
Decrease blood pressure

57
Q

What are the side effects of B adrenergic blockers? (3)

A

Bradycardia
Hypotension
wheezing

58
Q

What are the Gi effects of B adrenergic blockers? (4)

A

Weight gain
Depression
Fatigue
Sexual dysfunction

59
Q

What are the serious contraindicated of B adrenergic blockers? (2)

A

Severe bradycardia
Acute decompenstated heart failure

60
Q

We should be cautious when using B adrenergic blockers to patient who have ? (2)

A

Asthma & diabetes

61
Q

If the blood pressure/heart rate is too low you never wanna give what type of medications?

A

B adrenergic blocker

62
Q

What is calcium channel blockers ( CCBS) (4)

A

Systemic vasodilation with reduced SVR
Reduced myocardial contractility
Reduced Heart rate
coronary vasodilation

63
Q

What are the common side effects after taking Calcium channel blockers ? (5)

A

Dizziness
Fatigue
Flushing
Headache
Peripheral edema

64
Q

What is lipid lowering drugs?

A

Drugs that lowers your bad LDL

65
Q

When do we use sodium current for inhibitor? And is it a last resort medication?

A

We use this when patient have inadequate response to other anti anginal drugs

Yes

66
Q

What are common side effects of sodium current inhibitor? (4)

A

Constipation
Dizziness
Headache
Nausea

67
Q

What are the diagnostic/intervention studies we can use to determine if someone is chronic stable angina is ? (7)

A

12 lead ECF
Laboratory studies
Chest X ray
Echocardiogram
Excerise stress test
Electron beam computed tomography
Coronary computed tomography aniography

68
Q

How will a 12 LEAD ecg help us determine chronic stable angina?

A

Longer ST depression
T wave inversion

69
Q

How will laboratory studies, like cardiac bio markers, lipid profile or CRP help us determine chronic stable angina?

A

Identifying risk factors for CAD

70
Q

How will a chest X ray help us determine chronic stable angina? (3)

A

Aortic calcifications
Enlarged heart
Pulmonary congestion

71
Q

How will an echocardiogram help us determine chronic stable angina?

A

Detect resting LV wall motion abnormalities

72
Q

How will exercise stress test help us determine chronic stable angina ?

And we’ll see what (2)

A

Seeing any physical limitations in walking

We’ll see 1 or more artieries 70% blocked
Or 50% block of Left main coronary artery

73
Q

Electron beam computed Tomography & Coronary computed tomography angiography will help us determine chronic angina how?

A

It’s the last resort if our patient doesn’t have any chest pain to see it on a system

74
Q

Cardiac catherteruzation is the gold standard test and functions how?

And how is it done?

A

To visualize blockage
Using a long catheter from the arm or leg threaded into your heart

75
Q

Not only is cardiac catheterization can visualize blockages it also can what?

And what is this intervention called?

A

Open them

Percutaneous coronary intervention ( PCI )

76
Q

We can do PCI while doing a Cardiac catheterization, however what is the procedure called when we detect that Blockage?

A

Balloon angioplasty

77
Q

How does Ballon Angioplasty work?
And results in what? (3)

A

Catheter inserted with deflated ballon
Inflate ballon in blockage

Vasodilation

78
Q

What after usually placed after a balloon angioplasty? And what does it do? (2)

A

Intracoronary stents

Keeping the vessel open by supporting the arterial wall

79
Q

What are the 2 types of stents ?

And what do they ?
Explain them & disease

A

Bare metal stent
- basic

Drug eluting stent
- preventing scar tissue to grow over stent by drug ( neointimal hyperplasia )

80
Q

Inter professional and nursing care chronic stable angina
Stents are used to prevent?
During PCI we want to give what? (1)
After PCI what will we do? (3)

A

Platelet aggregation & acute stent thrombosis

Heparin

Dual Antiplatelet therapy
- aspirin, Tricagerolor/Clopidigrel

81
Q

After cardiac Catherterization we are going to give a patient what?

We have to be mindful of this because patients can be ?

A

A dye
Allergic

82
Q

What are the pre procedures that a nurse is going to do for cardiac Catherizarion? (5)
ALP! Say it outloud

A

Allergy ( contrast dye )
Asses VS
Administer drugs
Lab studies
Patient educate

83
Q

Contrast dye
Have what two things that can indict allergic reaction?

A

Iodine or fish allergy

84
Q

What are the nursing managements of cardiac catheterization post procedure that a nurse will do? (6)
Comparing what???
What type of infusion??
Monitor what??

A

Compare assessments
Assess insert every 15mins for any bleeding, bruit
ECG for dysrthythmia
IV infusion
Monitor complications
Education on discharge, drugs, signs, symptoms

85
Q

In the event that the doctor can not break the clot of place a stent what is the surgery they are going to do?

A

Coronary artery bypass graft surgery

86
Q

When will we do a coronary artery bypass graft surgery? (4)

A

Medical treatment fail
Disease involves left coronary artery
PCI cannot be done
Failed PCI or chest pain contuines

87
Q

What are 3 other outside factors that we might see when PCI fails and we need to do coronary artery bypass graft?

A

Diabetes
LV dysfunction
CKD

88
Q

Traditional CABG surgery
( coronary artery bypass graft surgery ) requires what? (2)

How does it work?
Placed and distal to?

Where are the common grafts used?
Which locations main used^ (3)

A

Sternotomy & cardiopulmonary bypass
In order to open the chest

Arterial or venous grafts are placed from aorta/branch to heart muscle distal to blockage

Internal mammory artery
Saphernous vein
Radial artery

89
Q

What is minimally invasion direct coronary artery bypass using what ?

A

Small incisions between ribs or mini thoracotomy using a thoracoscope or robotic assistance

90
Q

What is off pump coronary artery bypass?

A

Uses a median sternotomy to access all coronary vessels & has fewer complications

91
Q

What is Totally endoscopic coronary artery bypass?

A

Robotic technology to perform CABG

92
Q

What’s transmyocardial laser revascularization?
And used for who?

A

Laser used to create channels to get blood flow to ischemia areas

Advanced CAD who aren’t candidates for CABG

93
Q

Whats the post op care for CABG surgery for chronic stable angina?? (9)
HEMO ART!!!

A

In the ICU for 24-36 hours

Hemodynamic monitoring
Arterial line for BP
Pleural/Mediastinal tubes
Continuous ECG
Endotracheal tube to ventilate
Epicardial pacing
Urinary catheter
Nasogastric tube

94
Q

What an anagram to help me remember the 9 CABG post op surgery?

A

Hemo
Art
Pleasure
Continuous
Endo
Epis
Urine
Nasal

95
Q

What are the complications of postoperative care after CABG surgery? (5)

A

Anemia
Bleeding
Hypothermia
Infection
Systemic inflammation

96
Q

Another complication for post op CABG is dysrthythmia, so we will see a patient go into?

A

Afib

97
Q

Another complication post op CABG is wound care, like what? (2)?

A

Chest wound
Harvest site

98
Q

What are the inventions nurses are expected to do when a patient is post op CABG? (3)
EIP!!! Out loud

A

Early ambulating
incentive spirometer
Pain management

99
Q

It’s super important to be help patients who are PCOD, but post operative cognitive dysfunction because?

A

They are anxious and panic
Bring comfort for them

100
Q

What’s an alternative therapy for refractory chronic stable angina?

A

Enhanced external counterpulsation
( EECP )

101
Q

EECP how do you do it?
Benefits? (2)

A

Placing inflatable cuffs around legs

Improves diastolic filling
Helps with collateral circulation

102
Q

Don’t do EECP on patients who have? (3)

A

Decompensated heart failure
Severe PVD
Seever aortic insufficiency

NURS 347 EXAM 3 (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions