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Nursing III > Obstruction to Circulation > Flashcards

Obstruction to Circulation Flashcards

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1
Q

CAD

A

Coronary Artery disease

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2
Q

Arteriosclerosis is what?

A

calcification of the walls of the arteries. Walls become rough & vessels become narrow, decreasing blood volume, causing pain, ischemia & impaired tissue function

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3
Q

Medications for the treatment of CAD

A

Aspirin, beta blockers, Ace Inhibitors, Lipid management

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4
Q

What are Statins used for & their action?

A

Used for Lipid management to prevent 1st &2nd MI in pts with CAD, DM or hyperlipidemia. They increase HDL, decrease LDL, decrease TG, decrease total elevation in cholesterol

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5
Q

What are Bile Acid Sequestrants used for & their action?

A

Used for Lipid management. They decrease LDL Usually given when Statins are not sufficient to lower high cholesterol

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6
Q

What are Nicotinic acids used for & their action?

A

Used for Lipid management. They decrease VLDL

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7
Q

What are Fibrates used for & their action?

A

Used for Lipid management. They decrease HDL & increase TG

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8
Q

What are Cholesterol absorption inhibitors used for & their action?

A

Used for Lipid management. They decrease LDL & total

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9
Q

Side effects of Statins

A

GI, hepatotoxicity, osteoproosis, personality changes, muscle pain, increase risk of rhabdomyolysis

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10
Q

rhbdomyolysis

A

breakdown of muscles.

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11
Q

Bile Acid Sequesterants side effcts

A

GI, osteoporosis. They can actually increase Triglyceride levels

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12
Q

Nicotinic acid side effects

A

Flushing, rashes & itching which last about 30 mins. Take aspirin to take care of flushing or take at night

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13
Q

Fibrates side effects

A

GI, Hepatic, Cholelithiasis (formation of gall stones), muscle pain, rhabdomyolysis, SHORT TERM USE ONLY

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14
Q

Cholesterol absorption inhibitors example

A

Zetia

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15
Q

Psyllium fiber is found in what & what does it do?

A

Found in Metamucil, it helps reduce cholesterol

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16
Q

Antihypertensive medication

A

ACE inhibitors, Beta Blockers, Calcium Channel Blockers

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17
Q

Antiplatlet Medications

A

Aspirin, Clopidogrel (Plavix)

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18
Q

What kinds of things cause chest pain?

A

Rib & muscle inflammation, Pneumonia, Heart Attack, Angina, Galbladder inflammation, Gastroesophageal Reflux Disease

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19
Q

Unstable Angina, Angina + recurrent attacks at rest are both considered?

A

Acute Coronary Syndrome

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20
Q

Prodromal symptoms that appear a month before an episode of Acute Coronary Syndrome (ACS)

A

Fatigue, SOB, Sleep disturbances, Anxiety, Fleeting chest discomfort. Share these symptoms with people at risk for ACS

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21
Q

What can cause Angina?

A

Spasm, obstruction or both of the heart, Inflammation, infection of arteries, Injury

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22
Q

What is the most common cause of Angina?

A

Coronary Artery Disease

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23
Q

Progressive Angina leads to what?

A

heart attack because plague ruptures & clots attach which leads to hart attack.

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24
Q

Stable Angina is reversed by?

A

Diet and exercise

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25
Q

Why do you get pain with Angina?

A

because the heart is deprived of O2

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26
Q

What is the difference between unstable/stable angina?

A

Stable angina: person experiences pain while exercising, stress, heavy meal & pain lasts about 15 mins. Unstable Anginia: Pain can occur at rest, Nitro doesnt relieve pain, pain is more severe

27
Q

Stable Angina Location, Duration, Radiation, & Character

A

Substernal, less than 15 secs, radiates to jaw, neck, arms & feels like pressure, squeezing, heaviness or burning

28
Q

Stable Angina associated symptoms

A

SOB, dizziness, sweating, nausea, Rapid hr, fainting

29
Q

How do you alleviate stable angina?

A

Rest, Nitroglycerian. If hospitalized after Nitro didn’t work you would get treated with Morphine & O2

30
Q

What vital sign is important to check before giving Nitro & why

A

BP because Nitro lowers BP. Hold Nitro is BP is <90/60

31
Q

Preload

A

stretching of the muscle fibers in the ventricles

32
Q

Afterload

A

Amount of pressure the left ventricle must work to pump blood into circulation

33
Q

How does Nitro work?

A

it relaxes the walls of arteries & veins allowing them to dilate & improve oxygen flow

34
Q

How does Nitro effect preload & afterload?

A

it lowers it

35
Q

Nitro oral capsule or tablet & patch are used for prevention or occurring angina?

A

Prevention

36
Q

Sublingual or oral spray is used for prevention or occurring angina?

A

occurring

37
Q

Where do you put a Nitro patch?

A

Above elbows& above the knees

38
Q

Side effects of nitro & what can you do about the side effects

A

Dizzeness/light-headedness, flushed skin, headache. Take a Tylenol before they take Nitro to help with headache

39
Q

Can Nitro tolerance develop? If so, what do you do about it?

A

Yes. Put patch on for 12 hours then take off for 12 hrs & repeat

40
Q

Whats important to know about Nitro tablets?

A

they lose their effectiveness when exposed to light, air, heat.

41
Q

Why are headaches a side of Nitro?

A

because Nitro causes vasodilation

42
Q

What drugs shouldnt you take with Nitro & why?

A

Do not take Nitro with 1.)BP drugs (Beta blockers, Calcium channel blockers), 2.) Nitro causes a severe drop in BP when taken with Viagra, 3.)Aspirin increases Nitro effect, 4.)Alcohol can cause a swift decrease in blood pressure causing dizziness & fainting.

43
Q

What do Beta Blockers do to the body?

A

decrease: HR, BP, force of contraction, O2 consumption, afterload

44
Q

“BETA BLOCKER” side effects

A

Bradycardia, Exacerbates heart failure, Tired, Appetite loss ; Bad dreams, Low state-depression, Only occasionally able to preform, Contractility decreased, knowledge deficit, Exacerbates asthma, Really nauseated

45
Q

Can you stop beta Blockers abruptly? when should you hold med & call Dr?

A

No; if HR <60

46
Q

Atenolol (Tenormin), Metoprolol (Toprol, Lopressor), Nadolol (Corgard) are examples of?

A

Beta Blockers

47
Q

What people should not take beta blockers?

A

people with asthma, PVD, Sinus bradycardia

48
Q

Calcium Channel Blockers do what to the body?

A

decreases preload & afterload, O2 consumption, BP, electrical excitation & contractility

49
Q

What do Calcium Channel Blockers do to coronary arteries & peripheral arteries?

A

dilates them

50
Q

Adverse effects of CCB

A

Abrupt N/V, bradycardia, Constipation, Dizziness, EDEMA, Falling sperm count (doesnt stop them from being able to perform but it stops them from having kids), Gingival Overgrowth

51
Q

Amlodipine (Norvasc), Dilitizem (Cardizem), Felopine (Plendil), Nifedipine (Procardia, Adalat) are examples of what medication?

A

Calcium Channel Blockers

52
Q

What is a Atherectomy?

A

Procedure where plague is chipped away from artery from a rotating shaver that is inserted into artery

53
Q

Which meds are used with chronic angina?

A

Beta blockers, CCB

54
Q

Duration of a heart attack

A

longer than 15 mins

55
Q

Heart attack character

A

Deep, dull, squeezing, crushing

56
Q

Women can experience symptoms of a heart attack __ month before actually having a heart attack

A

1 or more months

57
Q

Most common s/s of heart attack

A

unusual fatigue, sleep disturbance, shortness of breath

58
Q

What do you do for the 1st 12-24hr with a patient that had an MI?

A

BR, no caffeine, O2, Stool softeners, avoid Valsalva maneuver (breathing out of nose) because it drops BP

59
Q

What do you do between 24-48 hrs after a patient has had an MI?

A

gradual increase activity, no smoking, cardiac diet

60
Q

How long before scar tissue starts to form after a heart attack?

A

10-14 days

61
Q

When does collateral circulation start to form in heart after heart attack?

A

2-4 weeks, damaged area is still weak

62
Q

When does scar tissue replace necrotic tissue after a heart attack?

A

6-8 weeks

63
Q

Mevacor, Zocor, Pravachol, Lipitor, Lescol, Crestor are exmples of?

A

Statins

64
Q

Nursing implications for Statins?

A

decreases the absorption of vit ADEK, increase bleeding time if on Coumadin, RUQ pain=discontinue, Report muscle aches

Nursing III (25 decks)

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