Done Coronary Artery Disease (10) Flashcards
What is coronary artery disease?
Includes Angina and MI
Conditions that affect the arteries that provide blood, oxygen, and nutrients to the myocardium.
When the blood flow is partially or completely blocked, ischemia and/or infarction may occur.
Most common cause is atherosclerosis (blocked artery) (cholesterol and lipid levels are high)
What is the difference between angina and myocardial infarction?
Angina is just ischemia
MI is Ischemia which has led to tissue damage or infarction
What is angina?
A clinical syndrome characterized by episodes of pain or feeling of pressure in the anterior chest.
Cause is insufficient coronary blood flow, resulting in inadequate oxygen supply to the myocardium.
This episode is temporary and occurs with an increased workload on the heart.
What is the physiologic rationale for the pain associated with angina.
Eating a heavy meal increases the blood flow to the mesenteric area for digestion, thus reducing the available blood supply to the heart.
Stress or any emotion-provoking situation causing the release of adrenaline and increased blood pressure may accelerate the heart rate, increasing myocardial workload
What are the waist circumference risk factors?
BMI?
Waist for men?
women?
BMI -> 30
Waist circumference greater than 40 for men and 35 for women
Risk factors for CAD/angina.
Increasing age
Genetic predisposition
Lipid levels
Elevated blood pressure levels
Physical Inactivity
Tobacco use
Factors that contribute to anginal pain…..why do they contribute to anginal pain?
Physical exertion can precipitate an attack by increasing oxygen demands.
Exposure to cold can cause
vasoconstriction and elevated BP with increased oxygen demand
Describe anginal pain in the older adult. Why is the pain different?
How is pain manifested in older adult?
The older adult may not exhibit the typical pain profile because of changes in neuroreceptors.
Pain is often manifested in the older adult as weakness or fainting.
Can also experience disorientation or confusion due to poor cardiac output
Digoxin
What is the intended action?
Side effects?
heart failure
Flushing
Dizziness / OH
Headache
Tachycardia
How to administer digoxin
Monitor apical pulse for one full minute before administration.
Withhold if pulse is less the 60
What to do if blood pressure drops with digoxin?
If blood pressure is less than 100 systolic or 25 lower than the previous reading.
lower the head of the bed and notify a health care professional
lowering promotes blood flow
Storage of nitro
How is it kept?
It is not stored in?
Inactivated by?
If fresh?
Supply should be renewed?
The client should carry the medication with them at all times.
kept in a securely capped dark glass bottle.
It is NOT stored in metal or plastic containers.
NTG is inactivated by heat, moisture, light and time.
If fresh, the client will feel a burning/tingling sensation under the tongue and a feeling of fullness or throbbing in the head.
The NTG supply should be renewed every 6 months (can lose potency)- NEED TO BE REPLACED
Administration of nitro topical ointment.
Dosed by?
Placed where?
once absorbed?
Why should it be wiped off?
dosed by the inch
Placed on the upper body or arm
Flat muscular area that is free from hair and scars
Once absorbed it has a duration of action for 3-6 hours
Should be wiped off to allow for a 10-14-hour nitrate free interval. To prevent nitrate tolerance
Administration of nitro spray.
Where should u spray it?
Can be taken?
NTG spray is available and absorbed quicker.
The spray should be directed on the tongue and not inhaled.
Spray can be taken prophylactically before beginning an activity.
