LAB - 7.2 - CAD & Antianginal Drugs

Question 1

is characterized by narrowing or occlusion of a coronary artery.

Answer 1

Coronary Artery Disease (CAD)

Question 2

The narrowing deprived cells of oxygen and nutrients, also known as

Answer 2

myocardial ischemia.

Question 3

If ischemia develops over a long period of time, the heart may compensate for its inadequate blood supply, and the client may experience no symptoms.

Answer 3

NA

Question 4

As CAD progresses, the myocardium does not receive enough oxygen to meet the metabolic demands of the heart, and symptoms of angina begin to appear.

Answer 4

NA

Question 5

Persistent myocardial ischemia may lead to

Answer 5

heart attack (MI)

Question 6

The most common etiology of coronary artery disease (CAD) in adults is ___, the presence of plaque – a fatty, fibrous material within the walls of the coronary arteries.

Answer 6

atherosclerosis

Question 7

Plaque develops progressively over time, producing varying degrees of intravascular narrowing, and a situation that results in partial or total blockage of the vessel

Answer 7

NA

Question 8

Lat: “strangling of the heart”

Answer 8

Angina Pectoris

Question 9

Chest pain from reduced bloodflow to the heart (myocardial ischemia)

Answer 9

Angina Pectoris

Question 10

Squeezing or heaviness in the chest that spreads to the head, neck, arms, chest, abdomen

Answer 10

Angina Pectoris

Question 11

Not the same as a heart attack

Answer 11

Angina Pectoris

Question 12

Caused by the narrowing of one or more arteries of the heart (due to blockage, vasospasms, anemia)

Answer 12

Angina Pectoris

Question 13

Types of Angina:

Answer 13

Stable angina
Unstable Angina
Variant Angina

Question 14

most common form of Angina
Caused by a fixed obstruction of plaque
Predictable, consistent pain patterns

Answer 14

Stable angina

Question 15

type of angina that is unpredictable, pain patterns change
More severe and lasts longer
Does not respond to rest or medications
A medical emergency as it often preceds a heart attack

Answer 15

Unstable Angina

Question 16

types of unstable angina

Answer 16

Obstructive angina
Microvascular Angina

Question 17

this type of angina is more common in women

Answer 17

Microvascular Angina

Question 18

this type of angina can occur at rest
Occurs mostly at night
Severe, but responds well to medications
Caused by vasospasms

Answer 18

Variant Angina

Question 19

These drugs can work to improve blood delivery to the heart muscle

Answer 19

Antianginal Drugs

Question 20

Antianginal Drugs can work to improve blood delivery to the heart muscle in one of 2 ways:

Answer 20

By dilating blood vessels ( increasing the supply of oxygen)

By decreasing the work of the heart (decreasing the demand for oxygen)

Question 21

Anti-Angina Drugs come in many different forms:

Answer 21

tablets and capsules that are swallowed;

tablets that are held under the tongue, inside the lip, or in the cheek until they dissolve;

stick-on patches; and sprays

Question 22

are drugs that act directly on smooth muscle to cause relaxation and to depress muscle tone. Because the action is direct, these drugs do not influence any nerve or other activity, and the response is usually quite fast.

Answer 22

Nitrates

Question 23

Commonly used Anti-Angina Drugs:

Answer 23

Isosorbide dinitrate (Isordil)

Isosorbide mononitrate (Imdur)

Nitroglycerin (Nitrostat, Nitro-Bid)

Question 24

Adverse Effects of Anti-Angina Drugs

Answer 24

CNS: Headache, dizziness, weakness
GI: Nausea, vomiting, incontinence
Cardiovascular: Hypotension which can be severe and must be monitored; reflex tachycardia that occurs when blood pressure falls; syncope and angina which could be exacerbated by the hypotension and changes in cardiac output

Question 25

The usual protocol for administering nitroglycerin tablets for chest pain is to administer ___ tablet every __ minutes (STAT or PRN?) for chest pain for a total dose of ___ tablets. Onset of action is within minutes while duration of action is ___ minutes.

Answer 25

one
5
as needed
three

1-3
30-60

Question 26

Nursing Interventions or Anti-Angina Medications

Answer 26

Give sublingual preparations under the tongue or the buccal pouch, and encourage the patient not to swallow.

Offer sips of water before giving sublingual nitroglycerin because dryness may inhibit drug absorption

Ask the patient if the tablet “fizzles” or burns, which indicates potency.

Always check on the expiration date and protect the medication from heat and light.

Instruct the patient that a sublingual dose may be repeated in 5 minutes if relief is not felt, for a total of 3 doses; if pain persists, the patient should go to an emergency room to ensure proper medical support if an MI occur.

Question 27

Education for Anti-Agina Transdermal Patch

Answer 27

Wash hands thoroughly before and after applying.

Apply the patch to the chest, inner side of the upper arm, or shoulder.

Clean and dry the skin before applying the patch. If necessary, hair may be removed by clipping.

To avoid skin irritation, change the treatment site daily. Do not apply to irritated or damaged skin

If the patch becomes loose, remove it and apply a new patch at a different site.

After you remove the used patch, fold the sticky side together and throw away.

This patch should only be worn for up to 12 to 14 hours a day, or as directed by your doctor so that the client will have a 10 to 12 hour “nitrate-free” period each day. This is referred to as a pharmacological vacation away from the medication. This will prevent client tolerance to nitrates.