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Nursing 2 > Coronary Artery Disease > Flashcards

Coronary Artery Disease Flashcards

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1
Q

CVD (cardiovascular disease) cause

A

atherosclerosis

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2
Q

atherosclerosis is

A

abnormal accumulation of fatty substances and lipids and fibrous tissue on arterial walls

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3
Q

atherosclerosis in heart

A

block or narrow coronary arteries which reduce blood flow to myocardium

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4
Q

tachycardia effect on oxygen

A

high, rapid HR will increase demand for oxy

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5
Q

3 reasons low serum oxygen supply

A

anemia, blood loss, low blood pressure, hypovolemia

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6
Q

low blood supply/ deprive heart muscle cells of oxy

A

myocardial ischemia - oxy demand ^ supply

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7
Q

myocardial ischemia reversible or chronic?

A

reversible but if progress to necrosis no

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8
Q

chest pain from myocardial ischemia

A

angina pectoris> low oxy> dead muscle cells>MI

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9
Q

MI myocardial infarction

A

blood clot blocks blood flow to heart

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10
Q

angina pectoris pain

A

crushing, substernal, SOB, n/v, diaphoresis, relieved by rest or nitrates

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11
Q

MI myocardial pain

A

same as angina but no relief from rest or nitrates

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12
Q

diabetes/hyperglycemia and CVD

A

diabetes>hyperlipidemia>increased platelet aggregation>altered RBC function>thrombus formation

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13
Q

predictable and consistent chest pain

A

stable angina pectoris

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14
Q

angina cause

A

obstruction/atherosclerosis of major coronary artery

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15
Q

nitrates/nitroglycerin action

A

reduce myocardial oxy demand, so ischemia and pain decreased, dilate veins and arteries, relax alveoli so increase oxy

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16
Q

nitrates routes

A

oral, transdermal, sublingual

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17
Q

why assess for hypotension before nitrate admin

A

small doses of nitro can trigger hypotension and bradycardia

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18
Q

nitrates prevent or treat angina?

A

both, nitroglycerine part of nitrates class of drugs

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19
Q

nitrates: 2 types

A

daily maintenance/prevention and acute response

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20
Q

sublingual nitrate administration for acute cases

A

sit and place under tongue, take up to 3 doses 5 minutes apart, no relief after 15 min call 911, do not drive to hospital

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21
Q

sublingual nitrate storage

A

dark brown container, expires 6 months after opening, store in neutral temperature

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22
Q

sublingual nitrate reversal agent/antidote

A

atropine - IV

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23
Q

nitrate transdermal admin

A

wear gloves when prepare and admin patch/ointment

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24
Q

pain relief for nitrate patient

A

aspirin or acetaminophen

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25
Q

notify HCP after nitrates if

A

dry mouth or blurry vision

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26
Q

oxygen admin for angina/chest pain when, action, result, monitor

A

initiate at onset of pain, inc myocardial oxy supply and decrease oxy demand, decreases chest pain and monitor Sa02

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27
Q

Sa02 is

A

oxygen saturation; measure % of hemoglobin is bound/saturated to oxygen; arterial blood measure vs Sp02 with pulse oximeter (peripheral)

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28
Q

cardiovascular disease: 4 diagnostics

A

Serum Cardiac Markers
Lipid profile
Stress test
Cardiac Catherization

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29
Q

serum cardiac markers are

A

biomarkers used to evaluate heart function

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30
Q

serum cardiac markers appear

A

released in circulation after stress like myocardial infarction or ischemia/decreased oxy to heart

31
Q

serum cardiac markers purpose

A

diagnose size and severity of MI

32
Q

serum cardiac markers: 2 types

A

CK - Creatinine Kinase: CK-MB specific to heart tissue

Troponin

33
Q

CK - Creatinine Kinase

A

enzyme in heart, skeletal system and brain, high level indicate damage or MI. CK-MB specific to myocardium

34
Q

troponin

A

a protein in blood of heart muscle. damaged cells release troponin. needed for contractions,

35
Q

coronary artery disease lipid profile

A

total cholesterol <200
triglycerides <150
cholesterol: LDL <100 HDL >60

36
Q

coronary artery perfusion imaging

A

spect or pet; radioactive isotopes injected intravenously; patient urine radioactive for 24 hours post testing

37
Q

cardiac catherization CAD

A

evaluate patency of coronary arteries, catheter insert into radial/femoral artery, NPO

38
Q

PTCA post procedure complications

A

bleeding, cardiac, perfusion, acute kidney injury

39
Q

maintenance nitrates

A

extended release capsule and transdermal daily use for angina prevention

40
Q

2 type transdermal nitrates

A

paste/ointment and patch

41
Q

acute use nitrates

A

sublingual: powder and tablet under tongue at onset of angina

42
Q

transdermal nitrates nursing care

A

wear gloves

43
Q

nitrates goal

A

vasodilation of blood vessels/coronary arteries

44
Q

PQRST

A

pain measurement; Provokes, Quality, Radiates, Severity and Timing

45
Q

beta blockers effect

A

reduce HR, BP and force of contractions so decrease the amt of oxy needed to pump blood

46
Q

calcium channel blockers effect

A

dilate arteries, decrease force of heart contractions so lower BP

47
Q

vein dilation effect

A

dilated veins reduce amt of blood flow back to heart so reduce heart workload

48
Q

artherosclerosis is

A

fatty streaks, cholesterol, calcium and fibrin (a clotting material)

49
Q

PQRST P is what?

A

provokes; what causes pain? what makes it better or worse?

50
Q

PQRST Q is what?

A

quality: describe it? what does it feel it? sharp, stabbing, dull, burning

51
Q

PQRST R is what?

A

radiates: does pain travel?

52
Q

PQRST S is what?

A

severity: rate on scale of 1-10

53
Q

PQRST T is what?

A

timing? when does pain occur? how long does it last?

54
Q

troponin stays elevated how long?

A

up to 3 weeks

55
Q

stress test followed by

A

EKG

56
Q

2 types of stress test

A

exercise and pharmacologic

57
Q

cardiac catherization process

A

incision into artery at femor, catheter tube inserted in artery and moved up to aorta, left ventricle and into coronary arteries

58
Q

cardiac catherization risks

A

bleeding at incision site or internally,

59
Q

cardiac catherization allows for test

A

coronary angiography, dye injected into cardiac catheter to show via xray blockage, etc.

60
Q

Percutaneous Transluminal Coronary Angioplasty PCTU

A

minimally invasive procedure that opens blocked coronary arteries

61
Q

PCTU catheter

A

balloon catheter into narrowed/blocked artery and inflated/deflated to open vessel. stent may be used to keep open

62
Q

angioplasty

A

surgical repair of narrowed or blocked coronary artery

63
Q

PCTU nursing intervention post op

A

bed rest, HOB less than 30 degrees, VS, EKG, pain mgmt, hydration

64
Q

STEMI is

A

ST elevated myocardial infarction

65
Q

ST in STEMI refers to

A

ST pattern (the last two) on an EKG

66
Q

stress tests: 2 types

A

exercise or pharmacologic

67
Q

physical stress test

A

determine activity of heart during rest and physical activity on stationary bike or treadmill. heart rate, rhythm, breathing.

68
Q

pharmacologic stress test

A

radioactive dye injected in blood vessel and image created to determine if blood flow to heart is adequate during rest and activity.

69
Q

troponin diagnostic test

A

measures amt of troponin in serum to determine heart damage, high level indicates damage

70
Q

how long can troponin be elevated?

A

up to 3 weeks

71
Q

acute heart failure starts with

A

shortness of breath

72
Q

nitrates side effects

A

headache, dizzy, syncope, hypotension

73
Q

CVD/nitrate self-administer teach includes

A

when to call HCP

74
Q

ct scan, echocardiogram, anything with dye

A

assess kidneys for renal dysfunction or allergy to iodine/shellfish

Nursing 2 (9 decks)

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