Concepts Exam #2 (Ch. 38)

Question 1

Angina

Answer 1

Chest Pain or discomfort caused when your heart muscle doesn’t get enough oxygen-rich blood.

Question 2

Features of Angina

Answer 2

Substernal Chest discomfort radiating to the left arm, precipitated by exertion or stress (or rest in variant angina), relieved by nitroglycerin or rest, lasting lest than 15 minutes.

Question 3

ACS

Answer 3

Acute Coronary Syndrome - Falls into category of coronary artery disease

Question 4

Acute Coronary Syndrome

Answer 4

used to describe patients who have either unstable angina or an acute myocardial infarction. Atherosclerotic plaque in the coronary artery ruptures, resulting in platelet aggregation (clumping), thrombus (clot) formation, and vasoconstriction.

Question 5

AMI

Answer 5

Occurs when myocardial tissue is abruptly and severely deprived of oxygen. When blood flow is quickly reduced by 80-90%, ischemia develops.

Question 6

Repercussion Therapy

Answer 6

Thrombolytic Therapy or percutaneous coronary intervention (PCI

Question 7

Thrombolytic Therapy

Answer 7

Uses fibrinolytic to dissolve thrombi int he coronary arteries and restores myocardial blood flow

Question 8

Percutaneous Coronary Intervention

Answer 8

Used to reopen the clotted coronary artery and restore perfusion. (usually performed by cardiologist within 2-3 hours of onset of symptoms).

Question 9

MONA

Answer 9

Morphine, Oxygen, Nitroglycerin, Aspirin

Question 10

PTCA (Percutaneous Transluminal Coronary Angioplasty

Answer 10

minimally invasive procedure to open up blocked coronary arteries, allowing blood to circulate unobstructed to the heart muscle.

Question 11

Sudden Cardiac Death

Answer 11

95% of sudden cardiac victims die before reaching the hospital, largely b/c of ventricular fibrillation. Prevalence of AEDs helps prevent death.

Question 12

Ischemia

Answer 12

Lack of oxygen - when it occurs with angina is limited in duration and does not cause permanent damage of myocardial tissue.

Question 13

Infarction

Answer 13

Necrosis (cell death), occurs when severe ischemia is prolonged and decreased perfusion causes irreversible damage to tissue

Question 14

Which race groups have higher genetic risk for CAD than others

Answer 14

Black Americans, Hispanic Women, American Indians, Alaskan Natives (18 yrs +)

Question 15

Many women of any age experience atypical angina. Manifestations?

Answer 15

Indigestion, pain between shoulders, actin jaw, choking sensation that occurs with exertion.

Question 16

Nitroglycerin (NTG) Drug Alert

Answer 16

Before giving, ensure patient has not taken any phosphodiesterase inhibitors for erectile dysfunction (Cialis, Viagra) within 24-48 hours. Can cause severe hypotension. Hold under tongue and drink 5mL of water to allow tablet to dissolve.

Question 17

Glycoprotein (GP) Drug Alert

Answer 17

When giving, asses patient closely for bleeding or hypersensitivity reactions. If they occur, notify provider or Rapid Response team ASAP. Monitor Platelet level 4 hours after starting the drug and once daily after that. Notify cardiologist if patient experiences a significant decrease in plt count.

Question 18

Beta Blocker Alert

Answer 18

Do not give beta blockers if pulse is below 55 or systolic BP is below 100 without checking with provider first.

Question 19

Thrombolytic Drug Alert

Answer 19

Report ASAP any indications of bleeding to provider or rapid response. Monitor hgb, hct, bp, test stools, urine, emesis for occult blood, observe bleeding at iv sites, monitor clot studies.