Nursing management of coronary vascular disorder Flashcards
Atherosclerosis definition
abnormal accumulation of lipid deposits and fibrous tissue with in arterial lumens (
- narrowing of coronary vessels , causing reduced blood flow to the myocardium
What are the plaques made of in atherosclerosis?
platelets and cholesterol
causes of atherosclerosis
diet high in fatty processed foods/ triglycerides
HTN
Smoking
What do the symptoms of atherosclerosis depend on?
based on where the “clogs” are (the bigger the clog the worse the symptoms)
- heart= MI
- brain= stroke
What is the most common clinical manifestation of atherosclerosis?
angina pectoris
what are symptoms of atherosclerosis ?
Epigastric distress
Pain that radiates to jaw or left arm
SOB
WOMEN ATYPICAL
MI
HF
sudden cardiac death
Ischemia vs infarction
ischemia= decreased blood and oxygen
Infarction= cell death and tissue scaring
Metabolic syndrome
Enlarged waist circumference (fat around stomach= fat around organs :( )
Elevated triglycerides
Reduced HDL
HTN
hs-CRP (inflammatory marker)
risk factors for CAD (coronary artery disease)
MODIFIABLE: cholesterol, tobacco, HTN, obesity, physical activity
NONMODIFIABLE: family history, age, race, gender (men)
What is metabolic syndrome associated with?
CAD
Prevention of CAD
control cholesterol
dietary measures
physical activity
meds
tobaccos cessation
HTN management
control diabetes
How do we want to start to treat CAD?
try with diet and life style changes alone initially, as meds have negative side effects (Myalgia)
Statins
commonly prescribed for CAD to control cholesterol
- Myalgia side effects
- monitor liver function
administer in EVENING (body produces most cholesterol @ night)
angina pectoris
syndrome characterized by episodes or paroxysmal pain or pressure in the anterior chest caused by insufficient coronary blood floe
Gerontologic angina considerations
silent CAD
pharmacologic stress testing
use meds cautiously
symptoms are more like weakness/ baseline deviation
treatment of angina pectoris
Goal is to decrease myocardial oxygen demand and increase oxygen supply (REST)
- meds
- oxygen
- reduce/ control risk factors
- reperfusion therapy
meds for angina
MONA (morphine, oxygen, nitro, aspirin)
Beta blockers
Anti-platelet/ anti-coag
Heparin IV
why give morphine for angina?
treat pain and anxiety
Vasodilate and decrease preload/BP
Why give oxygen for angina?
decreased the bodies work to get O2
why give Nitroglycerine for angina?
opens arteries and veins, decreases chest pain
why give Aspirin for angina?
blood thinner, inhibits platelet aggregation so prevents further clotting
why give beta blockers for angina?
decreases HR and workload of the heart
- allows the heart to rebound and heal
why give IV Heparin for angina ?
Blood thinner allows reperfusion and prevent clot/ clog growth
Acute coronary syndrome (ACS)/ Myocardial Infarction (MI) description
Emergent!
Acute onset of myocardial ischemia resulting in myocardial death
