Exam 2, Week 5: Coronary Artery Disease Flashcards
CAD is a blockage of one or more arteries that supply the heart with blood. The 2 most common forms of CAD are Arteriosclerosis, and Atherosclerosis.
“blank”-sclerosis is the thickening/Hardening of the “blank” walls.
Arteriosclerosis is the thickening/hardening of the arterial walls.
This is evident in the name. Sclerosis is “hardening”, and “Arterio-“ refers to the arteries. So, the translation is “Arterial Hardening.”
Now you just have to think: “Well, what specifically is hardening? Oh, the walls of the artery!”
The CAD Atherosclerosis is a little more difficult to define just by looking at the word, but we know that involves hardening because of “sclerosis.”
“Athero-“ is Greek, and it means “Paste.”
So, Atherosclerosis means “Paste Hardening.”
Since Atherosclerosis means “Paste Hardening”, and it involves the arterial blood vessels, what can we assume “Paste Hardening” is referring to, and what can we infer about what Atherosclerosis is?
Paste hardening refers to the plaque that is being built up in the inner most layer of the arteries, called the Intima layer.
This plaque is made up of Lipids, Calcium (because remember, Ca+ is used in heart function), and Carbs.
So, Atherosclerosis is a CAD that consists of the hardening of the arteries due do plaque buildup.
A patient has died due to an embolism in the brain. When assessing for how this may have happened, traces of plaque were found in the brain. How could this have happened?
Atherosclerosis in arteries led to a great deal of plaque buildup. The buildup of unstable plaque that accumulated in the Intima layer of the artery eventually ruptured and traveled to the brain in the form of a blood clot, causing an embolism, and death.
Collateral circulation occurs when the vessels in the body become TOO clogged because of plaque, and then do what as a response?
Create new blood vessel pathways.
What are some modifiable risk factors that you would encourage in a patient to fight against arteriosclerosis and atherosclerosis?
What are some non-modifiable risk factors?
-Reduce Smoking (biggest)
-Reduce alcohol consumption
-Diabetes
-Hypertension
-Hyperlipidemia
-Obesity
Non-modifiable:
-Age
-Race
-Sex
-Family history
The CAD disease known as Atherosclerosis, aka a thickening of the arterial walls due to plaque formation, can lead to a further illness that affects the outer arteries of the body.
With this information, what is the name of the disease caused by the CAD disease of Atherosclerosis? Think of it as a series of events:
Atherosclerosis starts with the heart, because it is a CAD (coronary artery disease). Well, where do arteries send blood from the heart to? What is another word for these area’s?
Peripheral Artery Disease is the blockage of peripheral arteries due to plaque.
The areas are on the “Peripheral”, or the “outside.”
PAD, aka Peripheral Artery Disease is caused by Atherosclerosis. What does the name tell you about what areas of the body are affected by this issue?
Peripheral means outside, and the areas in the peripheral are the arm and legs. BUT PAD mainly effects the LEGS.
So, your LEGS are mostly affected by PAD because your legs are on the PERIPHERY of your body.
What would be some modifiable risk-factors for a patient developing PAD?
Remember, PAD is caused by Atherosclerosis, so what would this tell you about the risk-factors?
-Decrease Smoking (biggest)
-Decrease alcohol levels
-Diabetes
-Hypertension
-Hyperlipidemia
-Obesity
If someone has, for example: “Lower Extremity Occlusion”, the word “Occlusion” means a blockage of a vessel or artery in the lower extremities.
To occlude something is to block it from view or obscure it.
What might be some characteristics of a lower extremity occlusion? (6 P’s)
Pain
Pallor
Pulse (deficit or missing)
Paresthesia (Pins N” Needles)
-Poikilothermia (“Cold-Blooded”)
Paralysis (Can’t feel the limb)
What physical action can be used to treat for PAD to allow for continued blood flow to the peripheral extremities?
Dangling your feet
A patient complains of pain in his legs when walking, but then the pain goes away when he sits or stands still. What is the patient experiencing that is the most common complaint associated with PAD?
Intermittent claudication.
A nurses role for a patient with Peripheral Artery Disease (PAD) is to assess and educate.
What would the nurse asses in a patient to check for signs of PAD?
What would the nurse educate the patient on?
-Capillary refill
-Pallor
-Coolness and temp of their limbs (Poikilothermia)
-Paralysis
-Pain
-Pins N’ Needles (Paresthesia)
-Pulse weakness or absence
-Educate changes in lifestyle, like diet, exercise, smoking habits, and alcohol reduction. As well as taking certain medications if prescribed.
Aortoiliac disease is another form of Peripheral Artery Disease.
Remember, it’s another form of PAD, which is a type of CAD, which means blockage. So, Aortoiliac Disease is a blockage of the:
a.) Aortic arch
b.) Abdominal Aorta
c.) Iliac Aorta
d.) Pulmonary Aorta
b.) Blockage of the Abdominal Aorta
Aortoiliac disease (a PAD) is a blockage of the “X” aorta as it transitions to the:
a.) Aortic arteries
b.) Peripheral arteries
c.) Iliac arteries
d.) Iliac aorta
c.) iliac arteries
Aortoiliac disease, a Peripheral Artery Disease (PAD) is a “blank” of the “blank” aorta as it transitions to the “blank” arteries.
Aortoiliac disease is a blockage of the abdominal aorta as it transitions to the Iliac arteries.
Aortoiliac disease is a PAD that can be characterized by butt or lower back pain when walking (claudication), as well as impotence in men.
What would be the nurse’s role in care for a patient with Aortoiliac disease?
tip: It’s the same as you would in a surgery.
-You would want to do an abdominal assessment on an Aortoiliac diseased patient
-Check the pulses
-NPO orders
-Give ice chips
-Maintain Fluids
What assessment method would you perform on a patient with Aortoiliac disease who underwent surgery to treat it?
Why?
What should you monitor post-surgery?
An Abdominal assessment
-A patient could have a paralytic ileus
-If the patient underwent surgery their bowels could have been repositioned.
-Post surgery bowel sounds may not return for 3 days, so check for those.
-Check position and function of possible NG tubes.
Angiography is a good diagnostic test to watch blood flow in a patient. Do you remember what Angiography uses to watch blood flow in a patient?
a.) CT-scan
b.) Radiopaque dye
c.) Incentive spirometry
d.) Iodin Vapor
b.) Radiopaque dye is used in Angiography. Angiography uses “Fluoroscopy” (remember?), which is the use of dye to watch live, x-ray images of bodily organs/functions.
An Angiography would use Radiopaque dye injected into the arteries to watch blood flow.
