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Nursing Theory IV A- Cindy'S Class > Coronary Artery Disease and Coronary Syndrome > Flashcards

Coronary Artery Disease and Coronary Syndrome Flashcards

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1
Q

What are the four developmental stages of CAD?

A
  • Fatty streak
  • Fibrous plaque
  • Complicated lesion
  • Collateral circulation
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2
Q

What is the range for sodium?

A

135-145

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3
Q

What is the range for potassium?

A

3.5-5

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4
Q

What is the range for glucose?

A

3.9-7.8

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5
Q

What is the range for leukocytes?

A

4.5-11

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6
Q

What is the range for hemoglobin?

A

female: 120-160
male: 135-180

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7
Q

What are some health promoting behaviours for CAD?

A
  • physical fitness
  • nutritional therapy
  • cholesterol-lowering drug therapy
  • anti platelet therapy
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8
Q

What is angina?

A

Chest pain that is the clinical manifestation of reversible myocardial ischemia

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9
Q

What are the symptoms of angina?

A
  • tightness, choking, or a heavy sensation
  • anxiety
  • retrosternal and may radiate to neck, jaw, shoulders, back, or arms (usually left)
    -dyspnea or shortness of breath, dizziness, nausea, and vomiting
  • SUBSIDES WITH REST
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10
Q

What is stable symptoms of angina?

A
  • Usually follows a predictable pattern.
  • Pain generally happens at about the same point with exercise or emotional stress.
  • Pain is usually relieved with rest or medication.
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11
Q

What are unstable symptoms of angina?

A
  • Unexpected chest pain at rest or without stimulating activity.
  • If the chest pain is new, worsening or constant, there is a greater risk of having a heart attack, an irregular heartbeat (arrhythmia), and even sudden death.
  • See doctor as soon as possible.
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12
Q

What is chronic stable angina?

A

Reversible (temporary) myocardial ischemia = angina (chest pain)
- O2 demand > O2 supply

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13
Q

What is the S&S of chronic stable angina?

A
  • Pressure/ache in chest
  • Pain usually lasts 3 to 5 minutes.
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14
Q

What are the 5 types of stable angina?

A
  1. silent ischemia
  2. nocturnal angina
  3. angina decubitus
  4. prinzmetal’s (variant) angina
  5. microvascular angina
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15
Q

What is silent ischemia?

A
  • Ischemia that occurs in the absence of any subjective symptoms
  • Associated with diabetic neuropathy
  • Confirmed by ECG changes
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16
Q

What is nocturnal angina?

A

Occurs only at night but not necessarily during sleep

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17
Q

What is angina decubitus?

A
  • Chest pain that occurs only while lying down
  • Relieved by standing or sitting
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18
Q

What is prinzmetal’s (variant) angina?

A
  • Occurs at rest usually in response to spasm of major coronary artery
  • rare
  • Calcium channel blockers and/or nitrates are used to control the angina (ie. Verapamil, diltiazem)
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19
Q

What is microvascular angina?

A
  • ** Coronary MVD is a new concept and may be a cause of heart disease in women. **
  • May occur in the absence of significant coronary atherosclerosis or coronary spasm
  • Pain is related to myocardial ischemia associated with abnormalities of the coronary microcirculation
20
Q

What is the diagnosis test for stable angina?

A
  • ECG, stress test, echocardiography, EBCT, PET scan, coronary angiography
21
Q

What is the treatment of stable angina?

A
  • drug therapy
  • coronary revascularization: PCI or CABG
22
Q

What is the drug therapy for chronic stable angina?

A
  1. Short-Acting Nitrates: First-line therapy for the treatment of angina. Dilating peripheral blood vessels, coronary arteries, and collateral vessels.
  2. Long-Acting Nitrates: used to reduce the incidence of anginal attacks.
  3. β-Adrenergic blockers: Preferred drugs for the management of chronic stable angina
    4.Calcium channel blockers: used for prinzmetals angina
  4. Angiotensin-converting enzyme inhibitors: Patients with chronic stable angina who are considered at high risk for a cardiac event.
23
Q

What is pt teaching for chronic stable angina?

A
  • Lifestyle changes and reduction of risk factors
  • Explore, recognize, and adapt behaviours to avoid to reduce the incidence of episodes of ischemia
  • Teaching regarding disease process
  • Medications (Nitro)
  • Returning to activities
  • Stress reduction
24
Q

What is acute coronary syndrome(ACS)?

A

-Develops when myocardial ischemia is prolonged and not immediately reversible.
- includes unstable angina and myocardial infarction
- part of the myocardium is permanently destroyed

25
Q

What is the etiology and pathophysiology of acute coronary syndrome(ACS)?

A
  1. deterioration of once stable plaque
  2. rupture
  3. platelet aggregation
  4. thrombus
26
Q

What is unstable angina?

A
  • Chest pain that is new in onset, occurs at rest, or has a worsening pattern.
  • Unpredictable and represents a medical emergency
27
Q

What is myocardial infarction? (MI)

A

Result of sustained ischemia (>20 minutes), causing irreversible myocardial cell death (necrosis)
- involve the left ventricle

28
Q

What is the S&S of MI?

A
  • pain
  • heaviness, constriction, tightness, burning, pressure, or crushing
    -severe, immobilizing chest pain not relieved by rest, position change, or nitrate administration
  • SOB, crackles, JVD, increased BP, N&V, decreased urine output, cool, clammy skim, anxiety
29
Q

What is the complications of MI?

A
  • Dysrhythmias
  • heart failure
  • cardiogenic shock
  • papillary muscle dysfunction
  • ventricular aneurysm
  • pericarditis
  • Dressler syndrome
30
Q

What is the diagnostic studies for Angina and MI?

A

electrocardiographic findings
- changes in QRS complex, ST segment, and T wave can rule put or confirm UA or MI

31
Q

What are the three serum cardiac markers for testing for angina and MI?

A
  1. CK-MB
  2. Troponin
  3. Myoglobin
32
Q

What is the treatment of acute MI?

A

MONA
M-morphine
O-oxygen
N-Nitrate
A- Aspirin

33
Q

What is a percutaneous coronary intervention (PCI)?

A
  • ballon angioplasty
  • stent
  • Emergent PCI is the first line of treatment for pt confirmed with MI
34
Q

What is coronary artery bypass graft (CABG)?

A
  • The chest is opened, heart is stopped, blood is rerouted through a lung-heart machine.
  • Blood vessel grafts are taken from arteries or veins in the chest wall or other areas of the body and transplanted in front of and beyond the blocked arteries.
  • Patients may require one, two, or three grafts depending on the number of coronary arteries that are blocked.
35
Q

Who is recommended for CABG surgery?

A
  • who do not achieve satisfactory improvement with medical management
  • who have left main coronary artery or three-vessel disease
  • who are not candidates for PCI (e.g., lesions are long or difficult to access)
  • in whom PCI has failed and chest pain is ongoing
36
Q

What is the complications of CABG?

A
  • Bleeding and anemia from damage to RBCs and platelets
  • Fluid and electrolyte imbalances
  • Hypothermia as blood is cooled as it passes through the bypass machine
  • Infection
37
Q

What is sudden cardiac death(SCD)?

A

death due to a cardiovascular cause that occurs within one hour of the onset of symptoms. A sudden cardiac arrest occurs when the heart stops beating or is not beating sufficiently to maintain perfusion and life

38
Q

What is the 5 H’s of cardiac arrest?

A
  1. hypovolemia
  2. hypoxia
  3. hydrogen ion (acidosis)
  4. hyper/hypo-kalemia
  5. hypothermia
39
Q

What is the 5 T’s of cardiac arrest?

A
  1. toxins
  2. tamponade
  3. tension pneumothorax
  4. thrombosis- coronary
  5. thrombosis- pulmonary
40
Q

What lab value do you watch for someone who is having an MI?

A

troponin, results come faster
- test again in 6 hours

41
Q

If you are walking a pt with angina and they suddenly get SOB and chest pain. What do you do?

A

sit them down right where they are

42
Q

Do female pts experience more typical or atypical symptoms of chest pain? Why?

A

atypical, they have smaller arteries

43
Q

Someone has a heart attack, what would you do?

A

call a code blue
- doctors will eventually put in an angiogram and a stent

44
Q

What is some post op considerations for someone with an angiogram?

A
  • risk for bleeding, look for pulse below the site
45
Q

What is ischemia of the heart muscle??

A

no oxygen to the heart = dying heart muscle

Nursing Theory IV A- Cindy'S Class (17 decks)

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