Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

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
What is silent ischemia?
Ischemia that occurs in absence of any subjective symptoms
26
In patients who have this thing can effect or be associated with silent ischemia? In which they do what to the cardiovascular system?
Diabetes Neuropathy nerves Innervate
27
How can we confirm silent ischemia?
Using an ECG
28
It’s important to know that patients either with pain or no pain ( asymptomatic) can have the same what?
Prognosis
29
Silent ischemia can develop into unstable angina because patients who have what condition ; in which that condition does what to them?
Diabetic neuropathy Makes them asymptotic to the pain & can’t feel it compared to others
30
Prinzmental variant angina is? And occurs when? With or without? Also known as cyclic
Rare form of angina that occurs at rest with or without CAD
31
Risk factors of prinzmetal angina is? (4)
Heavy migraine Headaches Raynaud’s phenomenon Heavy smoking
32
Prinzmental angina is usually due to the what? And causes what type of activity in what?? And results in?
Hyperactivity of smooth muscle of a major coronary artery resulting in spasms from increased intracellular calcium
33
What are some contributing factors of Prinzmental angina? (2)
Increased levels of certain substances ( alcohol, cocaine ) Narrowed blood vessels from medications:cold weather
34
What’s the treatment for Prinzmental variant angina? (5)
Moderate exercise Sublingual nitroglycerin Calcium channel blockers Stop using substances It can disappear on its own
35
What is microvascular angina? (MVD)
Chest pain occurs in the absence of significant CAD or coronary spans of a major coronary artery
36
MVD is related to ? (2)
Myocardial ischemia associated with atherosclerosis or distal coronary branches
37
MVD is more in who? And during what?
Women Physical exertion
38
What’s the treatment of MVD?
The same as CAD ( lipid lower medication )
39
Inter-professional and nursing care for chronic stable angina What’s the main goal? (2)
Reduce oxygen demand Increase oxygen supply
40
To optimize myocardial perfusion we want to what? (6) What type of medications do we want to give
Administer oxygen Antiplatelet & lipid lowering drugs ( aspirin ) Nitrates ACE ( lower bp ) B blockers CCB calcium channel blockers
41
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!!
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
What’s an anagram that can help me remember the 6 planning for chronic stable angina ?
Really Immediate Preserve Effective Part Risky
43
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!!)
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
NTG and IV morphine are what?
Vasodilators to help pain
45
Patient education Ambulatory care ( outside patient ) (5) Avoiding what?? And performing what?? A,D, P, M, PSY
Avoid & control risk factors Diet Physical activity Medications Psychological support
46
What are the 9 nursing care chronic stable angina drug therapy?
Aspirin Short acting nitrates Sublingual nitroglycerin Long acting nitrates ACE & ARBS B adrenergic blockers calcium channel blockers Lipid lowering Sodium current inhibitor
47
Aspirin is given as a what prevention and in the absence of what? (2)
Secondary prevention ( diagnosed with CAD ) True aspirin allergy
48
Short acting nitrates work how? And this will help what?
Dilating peripheral blood vessels & dilating coronary arteries & collateral vessels Increase blood flow
49
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)
5minutes 1 dose ( 1 tablet ) Headache, dizziness, flushing, orthostatic hypotension Proper usage/storage Prophylactic is to prevent, so use this to prevent angina
50
Nitroglycerin can not be exposed to what?
Sunlight & heat
51
What does long acting nitrates help with & treats what?
To reduce frequency of angina Treats Prinzmental angina
52
What are the 2 main side effects of long acting nitrates?
Headaches Orthostatic hypotension
53
What’s the 3 methods of admistrstion of long acting nitrates?
Oral HTG ointment Transdermal controlled release NTG
54
Short vs Long nitrates?
Short - short term Long - long term ( longer time )
55
angiotensin converting enzyme inhibitors Angiotensin receptor blockers Do what and precent what?
Vasodilator & reduce blood volume Prevents/reverse ventricle remodeling
56
What does B adrenergic blockers do? (4)
Reduce myocardial contractility Decrease heart rate Decrease SVR Decrease blood pressure
57
What are the side effects of B adrenergic blockers? (3)
Bradycardia Hypotension wheezing
58
What are the Gi effects of B adrenergic blockers? (4)
Weight gain Depression Fatigue Sexual dysfunction
59
What are the serious contraindicated of B adrenergic blockers? (2)
Severe bradycardia Acute decompenstated heart failure
60
We should be cautious when using B adrenergic blockers to patient who have ? (2)
Asthma & diabetes
61
If the blood pressure/heart rate is too low you never wanna give what type of medications?
B adrenergic blocker
62
What is calcium channel blockers ( CCBS) (4)
Systemic vasodilation with reduced SVR Reduced myocardial contractility Reduced Heart rate coronary vasodilation
63
What are the common side effects after taking Calcium channel blockers ? (5)
Dizziness Fatigue Flushing Headache Peripheral edema
64
What is lipid lowering drugs?
Drugs that lowers your bad LDL
65
When do we use sodium current for inhibitor? And is it a last resort medication?
We use this when patient have inadequate response to other anti anginal drugs Yes
66
What are common side effects of sodium current inhibitor? (4)
Constipation Dizziness Headache Nausea
67
What are the diagnostic/intervention studies we can use to determine if someone is chronic stable angina is ? (7)
12 lead ECF Laboratory studies Chest X ray Echocardiogram Excerise stress test Electron beam computed tomography Coronary computed tomography aniography
68
How will a 12 LEAD ecg help us determine chronic stable angina?
Longer ST depression T wave inversion
69
How will laboratory studies, like cardiac bio markers, lipid profile or CRP help us determine chronic stable angina?
Identifying risk factors for CAD
70
How will a chest X ray help us determine chronic stable angina? (3)
Aortic calcifications Enlarged heart Pulmonary congestion
71
How will an echocardiogram help us determine chronic stable angina?
Detect resting LV wall motion abnormalities
72
How will exercise stress test help us determine chronic stable angina ? And we’ll see what (2)
Seeing any physical limitations in walking We’ll see 1 or more artieries 70% blocked Or 50% block of Left main coronary artery
73
Electron beam computed Tomography & Coronary computed tomography angiography will help us determine chronic angina how?
It’s the last resort if our patient doesn’t have any chest pain to see it on a system
74
Cardiac catherteruzation is the gold standard test and functions how? And how is it done?
To visualize blockage Using a long catheter from the arm or leg threaded into your heart
75
Not only is cardiac catheterization can visualize blockages it also can what? And what is this intervention called?
Open them Percutaneous coronary intervention ( PCI )
76
We can do PCI while doing a Cardiac catheterization, however what is the procedure called when we detect that Blockage?
Balloon angioplasty
77
How does Ballon Angioplasty work? And results in what? (3)
Catheter inserted with deflated ballon Inflate ballon in blockage Vasodilation
78
What after usually placed after a balloon angioplasty? And what does it do? (2)
Intracoronary stents Keeping the vessel open by supporting the arterial wall
79
What are the 2 types of stents ? And what do they ? Explain them & disease
Bare metal stent - basic Drug eluting stent - preventing scar tissue to grow over stent by drug ( neointimal hyperplasia )
80
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)
Platelet aggregation & acute stent thrombosis Heparin Dual Antiplatelet therapy - aspirin, Tricagerolor/Clopidigrel
81
After cardiac Catherterization we are going to give a patient what? We have to be mindful of this because patients can be ?
A dye Allergic
82
What are the pre procedures that a nurse is going to do for cardiac Catherizarion? (5) ALP! Say it outloud
Allergy ( contrast dye ) Asses VS Administer drugs Lab studies Patient educate
83
Contrast dye Have what two things that can indict allergic reaction?
Iodine or fish allergy
84
What are the nursing managements of cardiac catheterization post procedure that a nurse will do? (6) Comparing what??? What type of infusion?? Monitor what??
Compare assessments Assess insert every 15mins for any bleeding, bruit ECG for dysrthythmia IV infusion Monitor complications Education on discharge, drugs, signs, symptoms
85
In the event that the doctor can not break the clot of place a stent what is the surgery they are going to do?
Coronary artery bypass graft surgery
86
When will we do a coronary artery bypass graft surgery? (4)
Medical treatment fail Disease involves left coronary artery PCI cannot be done Failed PCI or chest pain contuines
87
What are 3 other outside factors that we might see when PCI fails and we need to do coronary artery bypass graft?
Diabetes LV dysfunction CKD
88
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)
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
What is minimally invasion direct coronary artery bypass using what ?
Small incisions between ribs or mini thoracotomy using a thoracoscope or robotic assistance
90
What is off pump coronary artery bypass?
Uses a median sternotomy to access all coronary vessels & has fewer complications
91
What is Totally endoscopic coronary artery bypass?
Robotic technology to perform CABG
92
What’s transmyocardial laser revascularization? And used for who?
Laser used to create channels to get blood flow to ischemia areas Advanced CAD who aren’t candidates for CABG
93
Whats the post op care for CABG surgery for chronic stable angina?? (9) HEMO ART!!!
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
What an anagram to help me remember the 9 CABG post op surgery?
Hemo Art Pleasure Continuous Endo Epis Urine Nasal
95
What are the complications of postoperative care after CABG surgery? (5)
Anemia Bleeding Hypothermia Infection Systemic inflammation
96
Another complication for post op CABG is dysrthythmia, so we will see a patient go into?
Afib
97
Another complication post op CABG is wound care, like what? (2)?
Chest wound Harvest site
98
What are the inventions nurses are expected to do when a patient is post op CABG? (3) EIP!!! Out loud
Early ambulating incentive spirometer Pain management
99
It’s super important to be help patients who are PCOD, but post operative cognitive dysfunction because?
They are anxious and panic Bring comfort for them
100
What’s an alternative therapy for refractory chronic stable angina?
Enhanced external counterpulsation ( EECP )
101
EECP how do you do it? Benefits? (2)
Placing inflatable cuffs around legs Improves diastolic filling Helps with collateral circulation
102
Don’t do EECP on patients who have? (3)
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.
© 2025 Bold Learning Solutions. Terms and Conditions