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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
notify HCP after nitrates if
dry mouth or blurry vision
26
oxygen admin for angina/chest pain when, action, result, monitor
initiate at onset of pain, inc myocardial oxy supply and decrease oxy demand, decreases chest pain and monitor Sa02
27
Sa02 is
oxygen saturation; measure % of hemoglobin is bound/saturated to oxygen; arterial blood measure vs Sp02 with pulse oximeter (peripheral)
28
cardiovascular disease: 4 diagnostics
Serum Cardiac Markers Lipid profile Stress test Cardiac Catherization
29
serum cardiac markers are
biomarkers used to evaluate heart function
30
serum cardiac markers appear
released in circulation after stress like myocardial infarction or ischemia/decreased oxy to heart
31
serum cardiac markers purpose
diagnose size and severity of MI
32
serum cardiac markers: 2 types
CK - Creatinine Kinase: CK-MB specific to heart tissue | Troponin
33
CK - Creatinine Kinase
enzyme in heart, skeletal system and brain, high level indicate damage or MI. CK-MB specific to myocardium
34
troponin
a protein in blood of heart muscle. damaged cells release troponin. needed for contractions,
35
coronary artery disease lipid profile
total cholesterol <200 triglycerides <150 cholesterol: LDL <100 HDL >60
36
coronary artery perfusion imaging
spect or pet; radioactive isotopes injected intravenously; patient urine radioactive for 24 hours post testing
37
cardiac catherization CAD
evaluate patency of coronary arteries, catheter insert into radial/femoral artery, NPO
38
PTCA post procedure complications
bleeding, cardiac, perfusion, acute kidney injury
39
maintenance nitrates
extended release capsule and transdermal daily use for angina prevention
40
2 type transdermal nitrates
paste/ointment and patch
41
acute use nitrates
sublingual: powder and tablet under tongue at onset of angina
42
transdermal nitrates nursing care
wear gloves
43
nitrates goal
vasodilation of blood vessels/coronary arteries
44
PQRST
pain measurement; Provokes, Quality, Radiates, Severity and Timing
45
beta blockers effect
reduce HR, BP and force of contractions so decrease the amt of oxy needed to pump blood
46
calcium channel blockers effect
dilate arteries, decrease force of heart contractions so lower BP
47
vein dilation effect
dilated veins reduce amt of blood flow back to heart so reduce heart workload
48
artherosclerosis is
fatty streaks, cholesterol, calcium and fibrin (a clotting material)
49
PQRST P is what?
provokes; what causes pain? what makes it better or worse?
50
PQRST Q is what?
quality: describe it? what does it feel it? sharp, stabbing, dull, burning
51
PQRST R is what?
radiates: does pain travel?
52
PQRST S is what?
severity: rate on scale of 1-10
53
PQRST T is what?
timing? when does pain occur? how long does it last?
54
troponin stays elevated how long?
up to 3 weeks
55
stress test followed by
EKG
56
2 types of stress test
exercise and pharmacologic
57
cardiac catherization process
incision into artery at femor, catheter tube inserted in artery and moved up to aorta, left ventricle and into coronary arteries
58
cardiac catherization risks
bleeding at incision site or internally,
59
cardiac catherization allows for test
coronary angiography, dye injected into cardiac catheter to show via xray blockage, etc.
60
Percutaneous Transluminal Coronary Angioplasty PCTU
minimally invasive procedure that opens blocked coronary arteries
61
PCTU catheter
balloon catheter into narrowed/blocked artery and inflated/deflated to open vessel. stent may be used to keep open
62
angioplasty
surgical repair of narrowed or blocked coronary artery
63
PCTU nursing intervention post op
bed rest, HOB less than 30 degrees, VS, EKG, pain mgmt, hydration
64
STEMI is
ST elevated myocardial infarction
65
ST in STEMI refers to
ST pattern (the last two) on an EKG
66
stress tests: 2 types
exercise or pharmacologic
67
physical stress test
determine activity of heart during rest and physical activity on stationary bike or treadmill. heart rate, rhythm, breathing.
68
pharmacologic stress test
radioactive dye injected in blood vessel and image created to determine if blood flow to heart is adequate during rest and activity.
69
troponin diagnostic test
measures amt of troponin in serum to determine heart damage, high level indicates damage
70
how long can troponin be elevated?
up to 3 weeks
71
acute heart failure starts with
shortness of breath
72
nitrates side effects
headache, dizzy, syncope, hypotension
73
CVD/nitrate self-administer teach includes
when to call HCP
74
ct scan, echocardiogram, anything with dye
assess kidneys for renal dysfunction or allergy to iodine/shellfish

Nursing 2 (9 decks)

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