Med Nursing 2

Question 1

Coronary Artery Disease

Answer 1

Caused by the buildup of plaque in the wall of the coronary arteries

The major blood vessels that supply the heart (coronary arteries) struggle to send enough blood, oxygen and nutrients to the heart muscle. Cholesterol deposits (plaques) in the heart arteries and inflammation are usually the cause of coronary artery disease

Question 2

myocardial ischemia

Answer 2

caused from an increased demand for oxygen or a decreased supply of oxygen

Question 3

Chronic Stable Angina

Answer 3

• Occurs intermittently over a long period with the same pattern of onset, duration, and intensity of symptoms
• Rarely sharp or stabbing
• Pain usually lasts 3-5 minutes
• Drug therapy: goal: ↓ O2 demand and/or ↑ O2 supply
• If Ischemia continues and is not reversed, acute coronary syndrome (ACS) develops

Question 4

Myocardial Infarction

Answer 4

“heart attack,” is caused by decreased or complete cessation of blood flow to a portion of the myocardium

The symptoms of MI include chest pain, which travels from left arm to neck, shortness of breath, sweating, nausea, vomiting, abnormal heart beating, anxiety, fatigue, weakness, stress

Question 4

Acute Coronary Syndrome

Answer 4

• ACS encompasses the spectrum of
  unstable angina
• non–ST-segment–elevation myocardial infarction (NSTEMI)
• ST-segment–elevation myocardial infarction (STEMI)
• Deterioration of once-stable plaque –> Rupture –> Platelet aggregation –> Thrombus

Question 5

Unstable Angina

Answer 5

• Chest pain that is new in onset, occurs at rest, or has a worsening pattern.
• Unstable angina is unpredictable and represents an emergency.

Question 6

Automaticity

Answer 6

ability ad initiation of an impulse

Question 6

Atrial Fibrillation

Answer 6

• Total disorganization of atrial electrical activity due to multiple ectopic foci, resulting in loss of effective atrial contraction
• Most common dysrhythmia
• Can result in decrease in CO due to ineffective atrial contractions (loss of atrial kick) and rapid ventricular response
• Thrombi may form in the atria as a result of blood stasis.

Question 7

Contractility

Answer 7

the way the heart responds to the impulse by contracting

Question 8

Conductivity

Answer 8

how the impulse is transmitted

Question 9

Excitability

Answer 9

the way it’s electrically stimulated

Question 9

Sinus Bradycardia

Answer 9

• Slow but regular heart rate because sinus node discharges at rate <60 beats per minutes
• Can be normal, especially in athletes

Question 10

Sinus Tachycardia

Answer 10

Fast but regular heart rate because sinus node discharges at rate >100 beats per minutes

Question 10

Ventricular Tachycardia

Answer 10

• Ventricular rate 100 to 250 beats per minute
• Associated with MI, CAD, electrolyte imbalance, CNS disorders, etc
• Life threatening

Question 11

Atrial flutter

Answer 11

• Atria of heart contracting rapidly in characteristic flutter waves
• Atria rate is 250 -350 beats/minute. * The ventricular rate varies according to the conduction rate.
• High ventricular rates (>100) and loss of the atrial “kick” can decrease CO and precipitate HF, angina
• Risk for stroke due to risk of thrombus formation in the atria

Question 11

Stroke

Answer 11

Stroke occurs when ischemia or hemorrhage into the brain results in death of brain cells.

Question 12

Ventricular Fibrillation

Answer 12

• Disorganized ventricle electrical activity without coordination and without effective contractions ineffective “quivering’ of ventricles
• Occurs in acute MI, CAD, cardiomyopathy
• Requires CPR, ACLS, defibrillation
• If untreated leads to death

Question 13

Ischemic stroke

Answer 13

inadequate blood flow to the brain from partial or complete occlusion of an artery.

Question 14

Asystole

Answer 14

Absence of contractions of the heart
Flat line in an EKG

Question 15

2 types of Ischemic stroke

Answer 15

Thrombolytic stroke + Embolic stroke

Question 16

Hemorrhagic stroke

Answer 16

a burst blood vessel may allow blood to seep into and damage brain tissues until clotting shuts off the leak

Question 16

Thrombolytic stroke

Answer 16

• the process of clot formation results in a narrowing of the lumen, which blocks the passage of blood through the artery
• Thrombosis occurs in relation to injury to a blood vessel wall and formation of a blood clot.
• Result of thrombosis or narrowing of the blood vessel

Question 17

Embolic stroke

Answer 17

• an embolus is a blood clot or other debris circulating in the blood. When it reaches an artery in the brain that is too narrow to pass through it lodges there and blocks the flow of blood
• Occurs when an embolus lodges in and occludes a cerebral artery
• Results in infarction and edema of the area supplied by the involved vessel

Question 17

Transient ischemic attack

Answer 17

Transient episode of neurological dysfunction caused by focal brain, spinal cord, or retinal ischemia, without acute infarction of the brain
Symptoms last <1 hour.
a precursor to ischemic stroke