Coronary Artery Disease

Question 1

Is the narrowing or blockage of the coronary arteries, usually caused by atherosclerosis.

Answer 1

Coronary Artery Disease

Question 2

the hardening or clogging of the arteries) is the build-up of
cholesterol and fatty deposits(plaques) on the inner walls of the arteries.

Answer 2

Atherosclerosis

Question 3

can restrict the blood flow to the heart muscle by physically cloggingthe artery or by causing abnormal artery tone function.

Answer 3

Plaques

Question 4

the heart can’t pump blood wellto the rest of the body.

Answer 4

Heart failure

Question 5

are changes in the normal rhythm of the heart.

Answer 5

Arrhythmias

Question 6

Risk factors non modi

Answer 6

Gender
Family hx
Race
Age

Question 7

Modifiable

Answer 7

Cigarette smoking
High blood cholesterol, high triglycerides
Hypertension
Uncontrolled Diabetes
Sedentary Lifestyte
obesity
Uncontrolled Stress and anger
Unhealthy Diet

Question 8

Sx

Answer 8

Angina pectoris, and radiates in left shoulder, arms, neck, back or jaw
Arrhythmias
Dizzines
√ Sweating
√ Fatigue
√ Nausea
√ Palpitations

Question 9

Measures the electrical activity, rate and regularity of your heartbeat

Answer 9

ECG or EKG

Question 10

Uses ultrasound to cardiac structure assess and mobilty

Answer 10

Echocardiogram

Question 11

Measures heart rate while walking on a treadmill.Helps to determine how well the heart functions while it has to pump more blood.

Answer 11

Exercise stress test

Question 12

Lab tests

Answer 12

Hemoglobin
Total cholesterol
LDL
HDL
Triglycerides
Lipoprotein
Creatinine-Kinase (CK-MB)

Question 13

increases the risk of oxygen deficit in the tissues when cardiovascular disease is present.

Answer 13

Decreased hgb

Question 14

causes accumulation of fatty deposits in arteries, which reduces blood flow

Answer 14

Too much LDL

Question 15

is a LDL. High level of this increase the risk of heart attack, stroke, blood clots, fatty build-up.

Answer 15

Lipoprotein

Question 16

is a cardiac muscle cells that therefore increase when there is damage to these cells.

Answer 16

√. Creatinine-Kinase CK MB

Question 17

Origin. Right aortic sinus

Answer 17

Right Coronary Artery (RCA)

Question 18

Origin. Left aortic sinus

Answer 18

Left Main Coronary Artery (LMCA)

Question 19

Passes along the right atrioventricular groove, then descends to the posterior
Left aortic sinus interventricular groove.

Answer 19

RCA

Question 20

Passes between the left ventricle and left atrial appendage, then
divides into the left anterior descending (LAD) and left.circumflex arteries

Answer 20

LMCA

Question 21

Branches of RCA

Answer 21

“Right marginal artery
* Posterior descending artery (in most
people)
* Sinoatrial nodal artery
* Atrioventricular nodal artery

Question 22

LMCA Branches

Answer 22

Left anterior descending (LAD)artery
*Left circumflex (LCX) arter

Question 23

RCA SUPPLY

Answer 23

• Right atrium
  “ Right ventricle
• Posterior part of the left venitricle
  *SA node
  AV node

Question 24

LMCA Supply

Answer 24

·Left ventricle
* Left atrium
* Inter ventricular septum
* Anterior part of the right ventricle

Question 25

is the most common cause of anterior
myocardial infarction

Answer 25

Blockage of the LAD

Question 26

cause lateral myocardial infarction

Answer 26

Blockage of LCS

Question 27

Coronary arteries of the heart

Answer 27

Right coronary artery
Right (acute) marginal artery
Left coronary artery
Circumflex artery
Left (obtuse) marginal artery
Left anterior descending artery
Diagonal arteries

Question 28

Pathophysiology

Answer 28

Coronary arteries can become damaged or diseased, often due to a buildup of cholesterol-containing plaques. or as a result of infammation.
Plaque forms in the linint of artery
Plaque grows, lining of artery us damaged
Plaque raptures
It the plaque ruptures, platelats will try to repair the artery. This clotting can block the artery leading to a heart attack.

Question 29

Medical mgt

Answer 29

Cholesterol modifying medications
Platelet aggregation inhibitors
Nitroglycerin
ACE inhibitors and ARBS
Analgesics: morphine sulfate

Question 30

by decreasing the amount of cholesterol in the blood, especially LDL,these drugs decrease the primary material that deposits on the coronary arteries.

Answer 30

Cholesterol modifying medications

Question 31

class of drug that decreases platelet aggregation and inhibit thrombus formation

Answer 31

Platelet aggregation inhibitors

Question 32

Inreases blood flow by dilating coronary arteries and improving collateral flow to ischemic regions. Decreases blood pressure.

Answer 32

Nitroglycerin

Question 33

These similar drugs decrease blood pressure and help in preventing the progression of coronary artery disease.

Answer 33

AcE inhibitors and ARBS

Question 34

may be used in acute onset because of its several beneficialeffects,

Answer 34

Analgesics, morphine sulfate

Question 35

Beneficial effect of morphine sulfate

Answer 35

peripheral vasodilation and
reduces myocardial workload,
has sedative effect to produce relaxation.

Question 36

Medical procedures

Answer 36

√ Angioplasty and stent replacement (Percutaneous coronary revascularization)
Coronary bypass surgery

Question 37

Nitroglycerin therapy

Answer 37

√ Assume sitting or reclining position when taking the drug.
√ Caution patient to change position slowly.
√ If to be taken sublingually, offer sips of water before administration
because dryness of mouth may inhibit drug absorption.
√ Instruct client to avoid drinking alcohol, to avoid hypotension,
weakness and faintness.
√ Inform patient that headache, flushed face, dizziness, faintness,
tachycardia are common side effects during first few doses.
√ Transderm- nitropatch applied OD in the morning.
√ Evaluate effectiveness: relief of chest pain

Question 38

Nursing interventions

Answer 38

*Instruct patient and watchers to notify nurse immediately when chest pain occurs.
*Identify any precipitating event: frequency, duration, intensity, and location of pain.
*Assess and document patient’s response to medication.
*Observe for associated symptoms: dyspnea, nausea, vomiting, dizziness, palpitations, desire to urinate.
*Evaluate pain reports in jaw, neck, shoulder, arm, or hand, typically on the left side.
*Obtain cardiac marker results: creatinine, CK-MB, total cholesterol, LDL, HDL, lipoprotein, hemoglobin, and triglycerides as ordered.
*Place patient at complete rest during anginal episodes.
*Position patient in a moderate high backrest to improve chest expansion and oxygenation.
*Monitor vital signs and O2 saturation during pain; note heart rhythm.
*Monitor and obtain ECG results to detect abnormal tracings.
*Provide oxygen as needed or as ordered.
*Administer vasodilators, beta-blockers, calcium-channel blockers, and platelet aggregation inhibitors as ordered.
*Monitor vital signs every 15 minutes during the initial anginal attack.
*Maintain a quiet, comfortable environment and restrict visitors as necessary.
*Advise patient to minimize emotional outbursts, worry, and tension, as stress often triggers anginal pain.
*Assist the patient with activities to avoid overexertion.
*Stay with the patient if they are experiencing pain or anxiety.
*Provide light meals or small frequent feedings; ensure the patient rests for 1 hour after meals.

Question 39

Home teachings

Answer 39

*Take hypertension medications regularly for daily management.
*Stop smoking, as it reduces oxygen to the heart, increases heart rate, and raises blood pressure, which can trigger angina.
*Follow a heart-healthy diet: low sodium, low fat, low cholesterol, and high fiber. Avoid saturated fats.
*If overweight or obese, work on losing weight.
*Reduce stress, as it increases norepinephrine levels, causing vasoconstriction, tachycardia, and anginal pain.
*Ensure adequate time for rest and relaxation.