Mid Sem Flashcards
1
Q
ACS Pathophysiology
A
- Clinical presentations from unstable angina without myocyte death through to myocardial infarction with or without ST elevation
- Similar pain to angina pectoris but more severe and persistent and not relieved by medication or rest
- Cause cardiovascular changes such as BP decrease, inflammation, pulmonary oedema and hypoxaemia
- Stable angina is an attack that it triggered by something, often overexertion, and subsides with rest
- Unstable angina is not triggered by anything, does not subside with rest, prone to rupture and form thrombi
- MI is prolonged vessel obstruction, more than 20 minutes leads to irreversible damage to the myocytes
- Acute MI is subdivided to Non-STEMI and STEMI
2
Q
ACS Treatment
A
- Acute MI is immediately treated with aspirin and clopidrogel as anti-platelet medication
- IV fentanyl as analgesia
- Oxygen is required to improve oxygen delivery
- Glyceryl trinitrate: Coronary vasodilation, reduce stoke volume, reduce oxygen demand, improve pain
- STEMI and non-STEMI managed with thrombolytics and percutaneous coronary intervention
3
Q
ACS Nursing management
A
- ECG skills
- Cannula management
- Central lines
- Catheters
- Wound care and dressing
- Analgesia
- Obs
- Patient education
4
Q
Heart failure Pathophysiology
A
- A syndrome encompassing different types of cardiac dysfunction caused by inadequate perfusion of tissues
- Mostly caused by left ventricle dysfunction
- Left heart failure divides to systolic and diastolic heart failure
- Systolic heart failure is an inability of the heart to EFFECTIVELY CONTRACT, leading to an inability of the heart to generate adequate cardiac output to perfuse vital tissues
- Systolic heart failure leads to stroke volume falling, dilation of heart, ventricular end-diastolic volume increasing
- Diastolic heart failure is a result of DECREASED COMPLIANCE OF THE VENTRICLE and ABNORMAL DIASTOLIC RELAXATION - Stiffened and not stretchable to adequately fill the heart
- Right heart failure is a result of left heart failure when an increase in left ventricular filling pressure is reflected back into pulmonary circulation
5
Q
Heart failure Treatment
A
- Vasodilators!!!!!!!
- Digoxin, ACEI, ARBs, Aldosterone antagonists, b-blockers, diuretics
6
Q
Heart failure nursing management
A
- A-E
- Monitoring of vitals
- ECGs
- Patient education
- Medication administration
7
Q
COPD Pathophysiology
A
- A progressive, chronic, irreversible disease characterised by the IRREVERSIBLE obstruction of the airway. It is caused by noxious gas and particles
- Airflow limitation is mostly irreversible
- Pathophysiologically characterised by chronic bronchitis (airway inflammation and remodelling) and emphysema (destruction of alveolar tissue and decrease in elastic recoil), commonly the coexistence of both
- Goals of COPD are reducing the risk of exacerbations and reducing symptoms long term
8
Q
COPD treatment
A
- Long term management is oxygen therapy
- Short term management is short-acting bronchodilators (salbutamol), inhaled glucocorticoids (potent anti-inflammatory actions reduce hyperactivity of the airways, e.g. Budesonide) and pulmonary rehabilitation
9
Q
COPD Nursing management
A
- Maintaining patent airway
- Promoting oxygen therapy
- Respiratory assessments
- Patient education
- Medication administration
10
Q
Asthma Pathophysiology
A
- Asthma is a hypersensitivity reaction leading to inflammation
- 3 principle characteristics; Airway oedema (inflammation), airway hyper-responsiveness and mucus hypersecretion
- Physiological changes are episodic and usually reversible
- Asthma, when well controlled, means that pulmonary function tests usually lie within normal levels, however at risk for acute exacerbations
- Acute exacerbations are caused by triggers; allergens, infections, smoke, occupational exposures
11
Q
Asthma treatment
A
- Long term management is aimed at maintaining asthma control and lung function and reducing risk of exacerbations
- This includes inhaled corticosteroids to treat the inflammation and overall asthma control and bronchodilators
- Short term management is rapid bronchodilation during exacerbations, maintaining a patent airway and administration of oxygen
- Three types of sympathomimetic rapid-acting bronchodilators; short-acting b2 receptor agonists (salbutamol), long-acting b2 receptor agonists (salmeterol) and non-selective adrenergic agonists (ephedrine)
12
Q
Asthma nursing management
A
- Maintenance of a patent airway
- Oxygen therapy
- Monitoring for changes in symptoms or lung function
- Respiratory assessments
- Medication administration
- Patient education
13
Q
Hypertension Pathophysiology
A
- Consistent elevation of systemic arterial blood pressure
- Results from a sustained increase in peripheral resistance and an increase in circulating blood volume
- Combined systolic and diastolic hypertension or isolated systolic hypertension
- Hypertension is split into primary and secondary hypertension
- Primary hypertension has no known cause
- In primary hypertension, inflammation influences the initiation and progression of atherosclerosis, which can be triggered by endothelial dysfunction or insulin resistance, increasing peripheral resistance, leading to hypertension
- Secondary hypertension is caused by an underlying disease/issue
- Secondary hypertension is caused by kidney disease, hormonal imbalances or drugs, if the cause is removed before permanent structural changes then BP return to normal
14
Q
Hypertension treatment
A
- Commencement of anti hypertensive drugs should depend on severity of disease
- 4 classes of anti hypertensive drugs:
- Vasodilators - Ca channel blockers, arteriolar dilators
- Sympathetic inhibitors - B-andrenoceptor antagonists, a-andrenoceptor antagonists
- Renin-angiotensin system blockers - ACEI, angiotensin-receptor antagonists
- Diuretics
15
Q
Hypertension nursing management
A
- Patient education
- Monitoring of blood pressure
- Administer anti hypertensive medication
- Improve tolerance to activity
- Manage pain
- Promote lifestyle and dietary modifications
