CVS

Question 1

What causes coronary artery disease?

Answer 1

Atherosclerosis: build up of fatty plaque on the walls of the coronary arteries
Blood Clot: can form around a plaque, blocking the flow of blood to the heart
Coronary Artery Spasm: temporary narrowing or constriction of the artery, which can reduce blood flow

Question 2

List the risk factors of CAD

Answer 2

smoking
high BP
diabetes
obesity
stress
old age
hypertension
hyperlipidemia
family Hx of heart disease
unhealthy diet
male

Question 3

How can I diagnose a CAD?

Answer 3

1) electrocardiogram
2) stress test
3) echocardiogram
4) angiography
5) blood tests: cardiac enzymes eg: troponin elevated

Question 4

What are the symptoms of CAD?

Answer 4

angina, SOB, fatigue, dizziness, heart palpitations

Question 5

What are the immediate interventions for CAD?

Answer 5

Morphine: opioid pain reliever

Oxygen: increase O2 supply to the heart

Nitrates (1): vasodilator to reduce workload and improve blood flow

Aspirin (1): antiplatelet to prevent further clotting

Question 6

What is a PCI used for?

Answer 6

mostly used in STEMI patients (best within 90 mins from onset, less effective after 12 hours)
It is a catheter inserted via the radial/femoral artery to open narrowed coronary arteries to improve blood flow to the heart muscle

Question 7

What is the clinical presentation of stable angina? (OPQRST)

Answer 7

O: during physical/emotional exertion
P: relieved by rest/vasodilators
Q: crushing/squeezing/pressure
R: radiates to shoulders, jaw, back, neck, arms
S: deep, hard to locate, substernal
T: 15s - 15min

Question 8

What is the clinical presentation of unstable angina? (OPQRST)

Answer 8

O: sudden/at rest
P: not relieved
Q: severe crushing/squeezing/pressure
R: radiates to shoulders, jaw, back, neck, arms
S: deep, hard to locate, substernal
T: lasts >20 min

Question 9

What is a non-invasive way to assess cardiac function?

Answer 9

Apical pulse
(count for 1 full minute)
normal: 60-100bpm

Question 10

What does the apical radial pulse indicate?

Answer 10

Deficit: difference > 2
It indicates that there is impaired cardiac perfusion
-> it can be caused by atrial fibrillation because each ventricular contraction may not be sufficiently strong to transmit an arterial pulse wave through the peripheral artery

Question 11

Name the 3 checks

Answer 11

1) when retrieving meds
2) when preparing meds
3) when administering meds

Question 12

Name the 10 rights

Answer 12

1) patient
1) medication
dose
time
route
education
to refuse
assessment
documentation
evaluation