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IM3 > exam 4 CAD > Flashcards

exam 4 CAD Flashcards

1
Q

the filling and stretching of the ventricles myocardium right before contraction

A

preload

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2
Q

the amount of resistance to the ejection of blood from the ventricle

A

afterload

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3
Q

CAD is caused by accumulation of lipid or fatty substances in vessel walls

A

atherosclerosis

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4
Q

what are risk factors for CAD that you cannot change

A

age
gender
family history
ethnicity

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5
Q

what are risk factors about CAD that you can CHANGE

A
  • high cholesterol
  • smoking
  • hypertension
  • hyperglycemia
  • obesity
  • physical inactivity
  • stress
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6
Q

this is the number 1 killer in women

A

CAD

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7
Q

when tissues are not getting enough oxygen

A

ischemia

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8
Q

myocardial ischemia can be caused by what? 3 things

A
  • atherosclerosis
  • thrombus formation
  • vasoconstriction
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9
Q

Modifiable risk factors for coronary artery disease include which of the following?
Select all that Apply.

A. High cholesterol
B. Hyperglycemia
C. Ethnicity
D. Physical inactivity
E. Smoking

A

AEBD

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10
Q

Chest pain is caused by

A

myocardial ischemia

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11
Q

what are some things that can cause angina

A

physical exerction
exposure to cold
eating a heavy meal

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12
Q

this angina is predictable on exertion

A

stable

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13
Q

this angina is unpredictable caused by vasospasm

A

Prinzmetal

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14
Q

this angina has EKG changes but no reported symptoms

A

silent ischemia

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15
Q

this angina occurs at rest and increases severity

A

unstable

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16
Q

people who have angina will carry

A

nitroglycerin

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17
Q

angina is treated with medication that relaxes the muscle wall

A

CCB

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18
Q

a patient who has diabetes or is older may not feel what occuring?

A

chest pain

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19
Q

women who have angina may experience?

A

tiredness and weakness

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20
Q

elderly with chest pain will have

A

dyspnea

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21
Q

ST depression

A

ischemia

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22
Q

St elevation is

A

infarction

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23
Q

what is another term for unstable angina

A

acute coronary syndrome

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24
Q

when we are looking at the cholesterol panel what kind of results do we want?

A

high HDL, low LDL, low triglycerides, low cholesterol

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25
Q

what are some drugs we might give to a patient who has high cholesterol?

A

atorvastatin, Niacin, and vibrates (gemfibrozil)

26
Q

a patient is taking atorvastatin and starts to experience leg cramps. what would you advise them to do?

A

stop taking the medication

27
Q

what labs do we need to watch for with lipid lowering drugs

A

liver enzyme because these drugs are excreted in the liver

28
Q

fix this slide increase –

A

HDL

29
Q

Which of the following laboratory values needs to be closely monitored in a patient taking atorvastatin?

Liver function tests
Renal panel
White blood cell count
Troponin

A

A

30
Q

how can we treat a patient with angina?

A

decrease BP, HR, assist contractility, decrease left ventricular volume

31
Q

you patient starts complaining of chest pain what is your main priority

A

oxygen

32
Q

what are the nursing interventions for chest pain?

A
  • oxygen
  • pain assessment (ask when pain started)
  • VS
  • monitor resp status
  • 12 lead EKG
  • nitroglycerin
33
Q

what medication do we need to educate a client on nitro to not mix

A

erectile dysfunction meds

34
Q

Side effects
flushing – vasodilatoing
HA- blood rushing
↓ BP
tachycardia

what does these go to?

A

nitrites

35
Q

beta blockers reduce

A

HR, BP, and contractility

36
Q

Monitor heart rate (bradycardia)

Check blood pressure

Monitor for bronchospasm

Monitor glucose levels (hypoglycemia)

Never stop abruptly

what medication goes with these?

A

beta blockers

37
Q

A patient with a new prescription for metoprolol is told it should never be stopped abruptly. Why?

Stopping a beta blocker abruptly can cause hypoglycemia.

Stopping a beta blocker abruptly can cause rebound hypertension.

Stopping an ace inhibitor abruptly can cause an irritating cough.

Stopping a calcium channel blocker abruptly can cause rapid decrease in heart rate.

A

B

38
Q

Nitroglycerin primarily dilates veins but at higher doses dilates arteries as well?
true or false

A

true

39
Q

do not take this medication with grapefruit juice

A

beta blocker

40
Q

this medication is good for coronary vasospasm

A

beta blocker

41
Q

beta blocker is give to give with this kind of chest pain

A

prinzmetal

42
Q

patients with angina need to carry what at all times

A

nitro

43
Q

Prinzmetal angina is predictable pain that is relieved by rest.

True
False

A

false- unpredictable

44
Q

Myocardial cells begin to necrose as the blood flow is interrupted.

A

myocardial infarction

45
Q

Myocardial tissue abruptly deprived of oxygen

A

myocardial infarction

46
Q

Signs and symptoms:

Pain- jaw, back, mid back/shoulder pain, heartburn (epigastric)
SOB
Nausea
Sweating
Pale coolskin
Anxiety

A

myocardial infarction

47
Q

how much urine output do we want a patient to have?

A

30ml/hr

48
Q

a patient will have a decrease urinary output in what condition?

A

myocardial infarction

49
Q

a patient needs to be on what with myocardial infarction

A

best rest and stool softeners

50
Q

what are the medications we give to a patient with a MI?

A

MONA
Morphine-
↓preload = ↓workload on heart
Oxygen
Nitrates -vasodilation
Aspirin –antiplatelet

51
Q

what are the goals for cardiac rehab?

A

Goals​
Extend & improve quality of life​

Limit progression of atherosclerosis​

Return client to work and pre-illness lifestyle​

Enhance psychosocial & vocational status​

Prevent another cardiac event​

52
Q

Which of the following is not included in thecharacteristic assessment of chest pain?

A. When did the pain begin?
B. Where is the pain?
C. What type of pain is it? Stabbing, crushing,etc
D. How quick is intervention taken (i.e.nitro given, O₂applied?)

A

D

53
Q

what are the surgical interventions for CAD

A

Cardiac Catheterization & CoronaryAngiography (CCCA)​

PercutaneousCoronary Interventions (PCI)​

Coronary Artery Bypass (CABG/ACBP)​

54
Q

a patient is going to have a cardiac Catheterization &Coronary Angiography (CCCA) what do we need to teach for post op

A

8-12 hours and prepare client for expectations of procedure

55
Q

what allergy do we need to ask for before a surgical procedure?

A

shellfish

56
Q

Catheterization &Coronary Angiography (CCCA) looks for

A

blockages

57
Q

post op procedure nursing interventions?

A

-VS every 15 mins for 1 hour
- check surgical site every time in the room
- assess for hematomas
- bed rest for 2/6 hours

58
Q

The patient returns to the unit shortly aftercardiac catheterization. What importantteaching should occur during this time ofthe recovery?Select all that apply.

Drink a lot of fluids

Call the nurse if feel a pop or dampness at thecatheter insertion site

Notify the nurse if chest pain occurs.

Keep affected extremity straight

Ambulate to the restroom if needed

A

all but C

59
Q

Surgery in which a blood vessel from another part of the body is grafted to the occluded coronary artery so that blood can flow beyond the occlusion.”

A

coronary artery bypass

60
Q

Which urinary output demonstrates to the nurse renal perfusion is being maintained following cardiac surgery?

10 ml/hr
15 ml/hr
20 ml/hr
30 ml/hr

A

30ml/hr

61
Q

keep

A

going :)

IM3 (8 decks)

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