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MI/Angina/CAD Flashcards

1
Q

What does ‘Cath Lab’ refer to?

A

A specialized medical facility for cardiovascular procedures

Includes angioplasty, angiogram, and CABG.

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2
Q

What is a normal creatinine level?

A

0.9 - 1.2

Creatinine levels above 1.3 require reporting.

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3
Q

What should be done if a patient’s creatinine is over 1.3?

A

REPORT immediately

Also check urine output; below 30 ml/hr is concerning.

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4
Q

How long before and after a procedure should Metformin be stopped?

A

48 hours

This is to prevent complications related to renal function.

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5
Q

What does a non-palpable pedal pulse indicate?

A

Call healthcare provider (HCP)

Indicates possible perfusion issues.

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6
Q

What is the goal of stable angina management?

A

No chest pain during daily activities

Activities include combing hair, dressing, etc.

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7
Q

What is the maximum number of nitroglycerin doses a patient can take for chest pain?

A

3 doses

Taken 5 minutes apart; call 911 if pain persists.

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8
Q

How should nitroglycerin be administered?

A

Sublingually (SL)

Do not swallow; place under the tongue.

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9
Q

What is a common adverse effect of nitroglycerin?

A

Headache (HA)

It is considered a normal side effect.

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10
Q

What are the signs of cardiogenic shock after a myocardial infarction (MI)?

A

Severe hypotension

Requires immediate medical attention.

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11
Q

What is a contraindication for using isosorbide?

A

Sildenafil (‘-afil’ drugs)

Using them together can be fatal.

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12
Q

What should be monitored for chronic heart failure?

A

Rapid weight gain, worsening crackles, sudden edema

Indicates fluid overload.

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13
Q

What is the proper storage for nitroglycerin?

A

Avoid light and heat

Do not store in pill boxes or cars; use a purse.

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14
Q

What should a patient do if a nitro patch falls off?

A

Take nitro (pill/spray)

New patch can take 40-60 minutes to work.

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15
Q

What is the administration frequency for a nitro patch?

A

Once daily

Do not use more than one patch at a time.

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16
Q

What areas should be avoided for nitro patch application?

A

Hairy, scarred, burned, calloused, broken skin

Must be a clean, dry, shaven area.

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17
Q

What is a key point about applying a nitro patch?

A

Rotate locations daily

Teach patients to wash hands after application.

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18
Q

What type of angina is characterized as ‘unpredictable’?

A

Unstable angina

It is unrelieved with rest.

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19
Q

What is a common side effect of hypotension when using nitroglycerin?

A

Need for slow position changes

This helps prevent dizziness or fainting.

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20
Q

What are Antiplatelets and their potency compared to anticoagulants?

A

Antiplatelets are less potent than anticoagulants

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21
Q

What is the normal platelet count range?

A

150-400k

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22
Q

What are the risks associated with a platelet count less than 50k?

A

RISKY

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23
Q

What is the INR range for Warfarin?

A

2.5-3.5

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24
Q

What is the antidote for Warfarin?

A

Vitamin K

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25
Q

What does aPTT stand for in relation to Heparin?

A

Activated Partial Thromboplastin Time

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26
Q

What is the aPTT range for Heparin?

A

46-70

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27
Q

What is the antidote for Heparin?

A

Protamine Sulfate

28
Q

List some conditions that increase bleed risk.

A
  • Peptic ulcers
  • Active bleeds
  • Use of NSAIDs
  • Use of certain vitamins (Echinacea, Garlic, etc.)
29
Q

What should be avoided before a CATH LAB or surgery?

A

NPO 6 - 12 hours

30
Q

What indicates a Myocardial Infarction?

A

(+) Positive Troponin

31
Q

What is the priority treatment for a clot in a heart attack?

A

Remove the clot

32
Q

What are the types of clot busters?

A
  • Thrombolytics
  • Fibrinolytics
33
Q

What is the duration of t-PA (Alteplase, Streptokinase) effect?

34
Q

What should be avoided after a CABG procedure?

A
  • Heavy lifting
  • Baths
35
Q

What are the contraindications for thrombolytics?

A
  • Active bleeds
  • Peptic ulcers
  • History of arteriovenous malformations
  • Intracranial hemorrhage
  • Hypertension (over 180/110)
36
Q

What should be done if a stress test is stopped?

A

Chest pain or ST elevation

37
Q

What should be avoided 24-48 hours before a chemical stress test?

A
  • Cigarettes
  • Caffeine
  • Certain medications (Nitro, Beta Blockers)
38
Q

What is the NPO requirement before and after a stress test?

39
Q

What does a positive Troponin test indicate?

A

Heart Attack (MI)

40
Q

What is the significance of ST elevation in a stress test?

A

Indicates potential heart issues

41
Q

What is Myocardial Infarction (MI)?

A

Necrosis of heart muscles due to lack of oxygen from coronary artery blockage

MI is often referred to as a heart attack.

42
Q

What are common signs and symptoms of a Myocardial Infarction?

A
  • Pain (jaw, back, mid back/shoulder, heartburn, substernal)
  • Shortness of breath (dyspnea)
  • Nausea/Vomiting
  • Sweating (diaphoresis)
  • Pale cool skin (dusky)
  • Anxiety

Key words include sudden, crushing, and radiating pain.

43
Q

List the risk factors associated with Myocardial Infarction.

A
  • Stress
  • Smoking
  • Obesity (BMI over 25)
  • Diabetes & Hypertension (over 140/90)
  • High cholesterol diet (animal fats)
  • Age (over 50) and African American males
  • Men more than women

SODDA is a mnemonic for these risk factors.

44
Q

What does CAM stand for in the context of MI progression?

A
  • C - Coronary artery disease (CAD)
  • A - Acute coronary syndrome (ACS)
  • M - Myocardial Infarction (MI)

Angina can be stable (relieved with rest) or unstable (unrelieved).

45
Q

What is the first diagnostic test for Myocardial Infarction?

A

EKG (electrocardiogram)

Look for ST elevation or ST depression indicating blockage.

46
Q

What lab value is a key indicator of a Myocardial Infarction?

A

Troponin (over 0.5 ng/mL)

It is the only indicator of MI among trauma labs.

47
Q

Fill in the blank: The recommended diet for MI patients should be low in _______.

A

sodium and fluids (2g/2L per day)

This helps prevent heart failure.

48
Q

What are the pharmacological treatments during chest pain?

A
  • Oxygen
  • Aspirin
  • Nitroglycerin (under tongue, max 3)
  • Morphine (for pain)

These treatments aim to relieve pain and improve oxygenation.

49
Q

What is the purpose of Heparin in MI treatment?

A

Prevents clot growth (does not dissolve clots)

Use PTT (46-70) to monitor and Protamine Sulfate as the antidote.

50
Q

What are the cautionary measures for administering Beta Blockers?

A
  • Bad for heart failure patients
  • Bradycardia (HR 60 or less)
  • Low BP
  • Breathing problems (asthma, COPD)
  • Blood sugar masking (diabetics)

Beta blockers lower blood pressure and heart rate.

51
Q

True or False: Calcium Channel Blockers are safe for patients with low HR and BP.

A

False

They should be avoided in such cases.

52
Q

What are the signs of elevated potassium in MI patients?

A

Muscle cramps, spasms, peaked T waves, ST changes

Elevated potassium can lead to heart complications.

53
Q

What is the first choice medication upon discharge for MI patients?

A

ACE inhibitors (-pril)

Lisinopril is a common example.

54
Q

Fill in the blank: Patients should avoid _______ while taking Statins.

A

grapefruit

Grapefruit can increase the risk of side effects.

55
Q

What does the acronym DURING stand for in the context of chest pain management?

A

D-U-A-N-M: O-Oxygen, A-Asa, N-Nitro, M-Morphine

This acronym helps remember the immediate steps to take during chest pain.

56
Q

What is the role of Heparin in clot stabilization after a myocardial infarction (MI)?

A

Prevents clot growth; does not dissolve clots

t-PA is used to dissolve clots, whereas Heparin prevents further growth.

57
Q

What is the therapeutic range for PTT when administering Heparin?

A

46 - 70 seconds

The maximum is noted as ‘3 x MAX’.

58
Q

What is the antidote for Heparin?

A

Protamine Sulfate

This is used to reverse the effects of Heparin.

59
Q

What class of medications do Beta Blockers belong to and what is their primary effect?

A

Beta Blockers (-lol); they block both BP and HR

Atenolol is a common example.

60
Q

What are the cautionary considerations for using Beta Blockers?

A

Heart Failure, Bradycardia, Breathing Problems, Blood Sugar Masking

Each ‘B’ represents a different caution associated with Beta Blockers.

61
Q

What is the function of Calcium Channel Blockers?

A

Calm BP & HR

Examples include Nifedipine, Diltiazem, and Verapamil.

62
Q

What should be avoided when using Nitroglycerin?

A

Viagra (-afil)

The combination can lead to severe hypotension and death.

63
Q

What are the first and second choices for antihypertensive medications after MI?

A

1st: Ace (-pril); 2nd: ARBs (-sartan)

Lisinopril and Losartan are examples.

64
Q

What are the main precautions to take when administering Ace inhibitors?

A

Avoid pregnancy, angioedema, cough, elevated creatinine, elevated K+

These precautions help mitigate risks associated with Ace inhibitors.

65
Q

What is the normal range for creatinine levels?

A

0.9 - 1.2

Elevated levels may indicate kidney issues.

66
Q

Fill in the blank: High potassium levels can lead to ______.

A

High Pump

This refers to the increased cardiac workload associated with elevated potassium.

67
Q

What should be monitored for in patients with elevated potassium levels?

A

Muscle cramps, spasms, peaked T waves, ST changes

These signs indicate potential cardiac complications.

Med Surg 2 (15 decks)

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