Coronary Artery Disease Flashcards
Atherosclerosis is a disease associated with injury to which structured or cells
Arteries
What factors are known sources of chronic endothelial injury
- HTN
- Vasoconstriction
- High cholesterol
- Cig. smoking
- High glucose
CAD is most commonly caused by what pathophysiologic event?
Atherosclerotic plaque
What medical conditions are considered acute coronary syndromes? SATA
- Unstable angina
- Aortic aneurysm
- MI
- HF
- PE
1, 3,
therapies to increase myocardial perfusion include which goals? SATA
- reducing the area of infraction
- increasing the likelihood that LV function will be preserved
- Decreasing the demand for oxygen by the myocardium
- Restoring myocardial tissue perfusion
ALL 1,2,3,4
What type of chest pain is not related to physical activity and often occurs at night
- variant angina
- Stable angina
- unstable angina
- silent myocardial ischemia
- Unstable angina
angina Pectoris secondary to atherosclerotic disease. The exertion causes an increase in the heart demand for
oxygen
Don’t give nitro if their systolic BP is less than
90
What is Mona (for MI tx)
morphine
oxygen
nitro
aspirin
A patient is ruled out for MI if which diagnostic findings are present
ECG and cardiac markers remain unchanged for 12-24 hours
The client has a 2mm ST-segment depression from baseline. What initial action should the nurse take?
- Continue to monitor this is normal
- Assess the client and collaborate with the HCP
- Administer nitroglycerin as ordered
- Move the leads on the ECG
2
A client walks up to the nurse’s station and says, “My chest really hurts.” What is the nurse’s first action?
- Have the client sit down
- Ask the client if he ever experienced this type of pain before
- Ask the client if he would like some medication for anxiety
- Call the client’s spouse to obtain health information
have them sit down!! SAFETY
Patients with ST segment elevation and presence of elevated serum cardiac markers are diagnosed as having ____________________________
STEMI
T wave inversion and ST depression (ischemia) in two or more contiguous leads are hallmarks of
______________________________
Non-STEMI
It is bc it is DEPRESSION of ST
STEMI would be Elevation
Nursing care priorities of a patient with a diagnosis of ACS are SATA
- Relieve chest pain
- Reduce myocardial oxygen demand
- Offer psychosocial support for patient and family
- Reassure patient and family they will be fine and not worry
1, 2, 3
How do you calculate MAP
{(2x DBP) +SBP} / 3
Want MAP above
65
After cardiac surgery, a client’s blood pressure measures 126/80 mm Hg. The Nurse determines that mean arterial pressure (MAP) is:
_____________________________________________
{(80x2) +126} / 3 = 95
______ diuretics are the fastest acting
loop
what do you give a patient with fash Pulmonary edema (HF)
oxygen, nitro, morphine and a loop diuretics
Cardiac ischemia is characterized on the EKG by
inverted T waves or depressed T waves
what type of patient other than heart patients have freq. eposides of cardia ischemia
Renal failure pt
A patient with a recent MI suddenly develops has a loud systolic murmur. Most likely has
- PE
- HF
- ruptured papillary muscle
- inscreade systemic vascular resistance
MI makes a patient go into “HF”
Phyical changes that suggest a severe cardiovasular disorder, such as pulmonary edema and heart failure include ________ cyanosis
central
Examination of a pt. in the supine position shows JVD. This indicates
1 declared venous return
2 increased central venous pressure
3 increased pulomary artery capillary pressure
4 left sided HF
JVD is the veins swelling = increased central venous pressure
What is the primary consideration when giving thrombolytic therapy to a patient?
The time since onset of symptoms
Greatest risk within the first 24 hours of sustaining an MI is
Ventricular fibrillation
Patient has chest pain and a neg troponins. The nurse should…
obtain a 12-lead EKG
A patient comes into the ED w chest discomfort and nausea
Put him on a stretcher Oxygen cardiac monitor --> shows ST elevation --> STEMI Cardiac blood draw (troponin and CPK) check BP and then give Nitro
About to go to cath lab what labs do you need first?
INR, CBC, BNP,
After the cath lab, the patient has poor perfusion in the hand. What do u do?
call the HCP
Cardia cath ___ will decrease urine output and increase their Cr level
dye from cardiac cath will affect the kidneys
