Coronary Artery Disease

Question 1

What is coronary artery disease also known as?

Answer 1

Ischemic heart disease

Question 2

What can coronary artery disease be described as?

Answer 2

Impaired blood flow to myocardium

Question 3

What is the leading cause of death in the United States for men and women of all racial and ethnic groups?

Answer 3

Cardiovascular disease

Question 4

What is the percentage of deaths after an MI within the first hour?

Answer 4

60%

Question 5

What is the percentage of death after an MI before hospitalization?

Answer 5

40%

Question 6

What is arteriosclerosis?

Answer 6

Thickening and reduced elasticity of arterial walls

Question 7

Atherosclerosis is a type of what?

Answer 7

Arteriosclerosis

Question 8

What is the most common culprit of CAD?

Answer 8

Atherosclerosis

Question 9

How is atherosclerosis described?

Answer 9

The abnormal accumulation of lipid deposits (LDL) and fibrous tissue within arterial walls and lumen

Question 10

Where is the most common place for arteriosclerosis?

Answer 10

Vessels of heart

Question 11

What is the usual first sign of coronary atherosclerosis?

Answer 11

Angina

Question 12

What is occurring in coronary atherosclerosis?

Answer 12

Blockages and narrowing of the coronary vessels reduce blood flow to the myocardium

Question 13

What is the most prevalent cardiovascular disease in adults?

Answer 13

Coronary artery disease (CAD)

Question 14

True or False:

CAD is typically symptomatic that leads to sudden death?

Answer 14

False:

It is asymptomatic to sudden death

Question 15

What deposits on plaque and initiates clot formation?

Answer 15

Platelets and fibrin

Question 16

Where do blockages due to coronary artery disease mostly occur?

Answer 16

In the branching of the coronary arteries

Question 17

What are the non-modifiable risk factors associated with coronary artery disease?

Answer 17

Advanced age
Male gender
Genetics

Question 18

What are the three modifiable diseases a patient can have that increases their risks for coronary artery disease?

Answer 18

Hypertension
Diabetes mellitus
Hyperlipidemia

Question 19

What are the four modifiable risk factors that increases a patients risk for coronary artery disease?

Answer 19

Cigarette smoking
Obesity (diet)
Physical inactivity
Stress

Question 20

What are the three emerging risk factors for coronary artery disease?

Answer 20

Elevated levels of homocysteine
Inflammatory processes
Metabolic syndrome

Question 21

What is the protein associated with inflammatory processes?

Answer 21

C-reactive protein

Question 22

What are the three risk factors for coronary artery disease that is unique to women?

Answer 22

• Premature menopause
• Oral contraceptive use
• Hormone replacement therapy

Question 23

What are the four things that blood flow is regulated by?

Answer 23

• Aortic pressure
• Heart Rate
• Collateral circulation
• Atherosclerosis

Question 24

What type things can cause ischemia?

Answer 24

Increases oxygen demand

Inadequate oxygen supply

Question 25

How is angina pectoris described?

Answer 25

A temporary and reversible imbalance between supply and demand of oxygen

Question 26

What are the typical symptoms of angina?

Answer 26

- Transient pain or pressure due to insufficient coronary blood flow - Tachycardia - Hypo or hyper -tension - Pallor and cool or clammy skin

Question 27

What are the three categories of angina?

Answer 27

- Stable - Unstable - Prinzmetal

Question 28

What 5 factors do you need to assess for angina?

Answer 28

- Description of symptoms - Info about history of CAD - Sex - Age - Number of risk factors present

Question 29

What is the first nursing intervention you need to do for a patient complaining of angina?

Answer 29

Administer oxygen

Question 30

What type of EKG should you conduct if a patient is experiencing angina pain?

Answer 30

12 lead

Question 31

Other than oxygen- what should you administer to a patient experiencing angina pain?

Answer 31

Nitrates and narcotics

Question 32

What do most patients say they were doing when they began experiencing angina pain?

Answer 32

Some sort of exercise

Question 33

What could you see on an ECG that would indicate a patient is experiencing an angina episode?

Answer 33

ST segment depression and T wave inversion

Question 34

What labs do you draw in a patient experiencing angina?

Answer 34

``` Cardiac specific troponin and myoglobin Coagulation studies Full lipid profile C-reactive protein Homocysteine levels ```

Question 35

When do most people experience stable angina?

Answer 35

During exercise

Question 36

When do most people experience unstable angina?

Answer 36

During relaxation

Question 37

When does Prinzmetal angina typically occur?

Answer 37

In younger people, at rest, typically in the middle of the night

Question 38

What other diagnostic tests do you do for a patient experiencing angina?

Answer 38

- Chest X-ray - Echocardiogram - MRI - Coronary computed tomographic angiography - Stress test - Invasice coronary angiography

Question 39

What is the main goal of treatment for angina?

Answer 39

Decrease myocardial oxygen demand and increase oxygen supply

Question 40

What are the two types of repercussion therapy?

Answer 40

- Percutaneous transluminal coronary angioplasty (PTCA) | - Coronary artery bypass graft (CABG)

Question 41

What does PTCA stand for?

Answer 41

Percutaneous Transluminal Coronary Angioplasty

Question 42

What does CABG stand for?

Answer 42

Coronary artery bypass graft

Question 43

What should you always assess for I'm a patient that just had a PTCA?

Answer 43

Swelling, bleeding, and hematoma around the incision site

Question 44

Upon sheath removal what could occur as a vasovagal response?

Answer 44

Decrease heart rate with hypertension

Question 45

How long do you hold pressure to the incision site after sheath removal?

Answer 45

Minimum of 5 minutes

Question 46

What happens during a PTCA?

Answer 46

A balloon tipped catheter is threaded through the arteries. The plaque that is causing the occlusion gets smashed against the vessel. A stent can then be placed if necessary.

Question 47

What are the five conservative managements recommended for a patient with angina pectoris?

Answer 47

``` Smoking cessation Diet change Exercise Hypertension control Diabetes control ```

Question 48

What medication are prescribed to patients with angina pectoris?

Answer 48

``` Nitroglycerin Beta-adrenergic blocking agents Calcium channel blocking agents Drugs used to lower cholesterol Antiplate/anticoagulant drugs ```

Question 49

What is the main difference occurring in the heart when comparing angina and myocardial infarction?

Answer 49

Heart muscle damage | Angina typically has none and MI typically has damage

Question 50

True or False: | A patient who is experiencing angina should expect to have pain relief after resting and taking nitroglycerin

Answer 50

True

Question 51

How is acute myocardial infarction described?

Answer 51

Chest pain that is sudden and not relieved by rest or nitroglycerin

Question 52

What could cause a myocardial infarction?

Answer 52

Unstable angina

Question 53

What is the definition of myocardial infarction?

Answer 53

Acute cardiac ischemia leading to cardiac tissue death. May lead to cardiac failure and ultimately death if lead untreated.

Question 54

What is a STEMI?

Answer 54

ST elevation myocardial infarction

Question 55

Where do more MIs occur?

Answer 55

In the Left anterior deceasing artery | AKA widow maker

Question 56

What are the five things you need to administer NOW to a patient experiencing an MI?

Answer 56

``` MONA: Morphine Oxygen Nitroglycerin Aspirin ```

Question 57

What are the cardiac makers tested in a patient experiencing a myocardial infarction? AKA A cardiac injury panel:

Answer 57

Creatine kinase MB: CK-MB Troponin I and T Myoglobin

Question 58

What typically happens to a patient ECG when they are experiencing a myocardial infarction?

Answer 58

ST elevation, T wave inversion, and new bizarre looking Q wave.

Question 59

What are the type main side effects of nitroglycerin?

Answer 59

Headache and dizziness

Question 60

After a patient has a undergone a heart catheterization- how frequently should you assess their vital signs?

Answer 60

Every 15 minutes

Question 61

What occurs during a CABG?

Answer 61

A bypass of the occluded artery is surgically done. A vein taking from a leg is connected to the Aorta and a place in the heart to bypass the occluded artery.

Question 62

Why would a patient who is experiencing an acute myocardial infarction have decreased urine output?

Answer 62

Due to the kidneys not getting enough blood flow

Question 63

What are the two nursing diagnoses associated with an acute myocardial infarction?

Answer 63

Ineffective tissue perfusion and Deficient Knowledge.

Question 64

What are the two lifestyle changes that a patient needs to enact once they experience a myocardial infarction?

Answer 64

Diet (reduction of salt and cholesterol) | Exercise