Coronary Artery Disease Flashcards
Exam 2
Coronary Artery Disease
Epidemiology
16.5 million people over age 20
Coronary Artery Disease:
What are the two broad groups of Risk Factors
Modifiable
Nonmodifiable
Coronary Artery Disease:
Pathophysiology:
Atherosclerosis forms and occludes coronary arteries
Reduced blood flow through coronary microvasculature
Coronary Artery Disease:
Modifiable Risk Factors
Increased total cholesterol, hypertension, diabetes, obesity, smoking, physical activity
Coronary Artery Disease
Pathophysiology:
Atherosclerosis forms and occludes coronary arteries
This leads to:
Unstable angina
Myocardial infarction
Sudden cardiac death
Coronary Artery Disease:
NonModifiable Risk Factors
Gender, race, heredity, age
Coronary Artery Disease:
Medical Management- Diagnostic test includes:
Labs
EKG
Exercise Stress Test
Coronary angiography
Coronary Artery Disease:
Pathophysiology:
Reduced blood flow through coronary microvasculature leads to:
Ischemic symptoms
Coronary Artery Disease:
Medications- What do they do?
Stop aggregation of blood components to endothelium
Control factors leading to endothelial damage
Relief of symptoms
If someone is having a heart attack, what is the treatment?
MONA
Morphine
Oxygen
Nitroglycerin
Aspirin
Coronary Artery Disease:
Surgical Management includes:
Percutaneous transluminal coronary angioplasty
Coronary artery bypass graft
Coronary Artery Disease:
Medical Management – Lifestyle management includes:
Maintain healthy body weight
Diet
Physical activity
Smoking cessation
Screening and treatment for depression
Refraining from excessive alcohol use
Cardiac rehabilitation
Coronary Artery Disease:
Complications includes:
Myocardial infarction
What to know about nicotine patch?
When placing a nicotine patch, make sure to alternate sides;
Patch users can have nightmares so they remove at night
Coronary Artery Disease:
Nursing Management- Assessment and analysis
Careful assessment of chest pain
Be mindful of nonspecific symptoms
Coronary Artery Disease
Nursing Management- Nursing Diagnoses
Decreased tissue perfusion
Coronary Artery Disease:
Nursing Interventions – Assessments
Vital signs
Pain
Electrocardiogram
Physical assessment
Patient history
Recreational drug use
Depression screening
Laboratory values
Coronary Artery Disease:
Nursing Interventions – Actions
Administer oxygen
Obtain E C G
Administer medications as ordered
Coronary Artery Disease:
Nursing Interventions – Actions after P C I
Cardiac catheterization care
Report and treat chest pain immediately
Administer anticoagulants
Maintain fluids
Maintain bedrest
Coronary Artery Disease:
Nursing Interventions – Teaching
Medication regimen
Angina management
Bleeding precautions
Risk factor reduction
When to call emergency services
Encourage cardiac rehabilitation
Coronary Artery Disease
Evaluating care outcomes
Comply with medication therapy
Maintain healthy diet
Limit alcohol
Engage in regular exercise
Infective Endocarditis
Infection of endocardium affecting heart valve
Usually bacterial
Infective Endocarditis:
Risk Factors:
Age
Immunodeficiency
I V drug use
Diabetes mellitus
Prosthetic heart valves
Prior history endocarditis
Congenital/structural heart defect
Intravascular access or cardiac device
Infective Endocarditis:
Clinical Manifestations
Osler’s nodes
Janeway lesions
Splinter hemorrhage
Murmur
Fever
Fatigue
Confusion
Infective Endocarditis: Nursing Management- Diagnosis made how?
Blood cultures
Echocardiogram
Elevated white blood cell count
Infective Endocarditis:
Medications
I V antibiotic therapy
Infective Endocarditis:
Surgical Management
Valve repair or replacement
Infective Endocarditis:
Complications
Embolic events
Transient ischemic attack or stroke
Pulmonary emboli
Heart failure
Dysrhythmia
Infective Endocarditis:
Nursing Management- Assessment and analysis
Signs and symptoms due to infection
Sepsis is possible
Infective Endocarditis:
Nursing diagnoses
\
Infection
Ineffective tissue perfusion
Decreased cardiac output
Infective Endocarditis :
Nursing Interventions – Assessments
Vital signs
Auscultate breath and heart sounds
Neurologic function
Extremities
Skin assessment
Diagnostic test results
History of drug use, invasive procedures, implanted devices, valve replacement surgery
Infective Endocarditis:
Nursing Interventions – Actions
Administer antibiotics as prescribed
Maintain IV access
Administer heart failure medications
Provide social support
Refer to addiction counseling
Infective Endocarditis:
Teaching
Good oral hygiene
Inform healthcare provider of history
Complete antibiotic regimen
Pericarditis
Inflammation of pericardium
Pericarditis:
Epidemiology
5% of ED patients with nonischemic chest pain
15%-20% of post-M I patients
Pericarditis:
Clinical Manifestations
Pleuritic chest pain
New or worsening pericardial effusion
E C G changes
Fever
Pericarditis:
How is it most times?
bacterial in nature, and it can be described as something either infectious.
It can be autoimmune, or it can be neoplastic,
meaning it has to do with some type of cancer going on in.
Pericarditis:
Medical Management- Diagnosis
E C G
Chest x-ray
Echocardiogram
Cardiac C T scan
M R I
Pericarditis
Nursing Management- Medications- What are meds and what are they for?
Alleviate pain
Stop inflammatory process
Aspirin NSAIDs anti-inflammatories
Supportive therapy (ex; oxygen)
Pericarditis:
Complications
Pericardial effusion- fast or slow
Fast- cardiac tamponade
Pericarditis:
Nursing Management- Assessment and analysis
Signs and symptoms due to friction between inflamed layers of the heart with movement
Pericarditis:
Nursing diagnoses
Chest pain
Risk for decreased cardiac output
Pericarditis: Assessments
Vital signs, Pain
Auscultate heart sounds, E C G
Pericarditis:
Nursing Intervention- Actions
Keep head of bed elevated
Administer medications as ordered
Provide emotional support
Pericarditis:
Teaching
Avoid strenuous activities
Distinguish between pericarditis and heart attack
Pericarditis:
Evaluating care outcomes
Relief of pain
Free from shortness of breath
