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Occlusive Cardiovascular Disorder Flashcards

Occlusive Cardiovascular disorder

1
Q

Artery/arteriole intimal lining loses elasticity & weakens.

  • weakening secondary to high pressure
  • part of the aging process
A

Arteriosclerosis

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2
Q

Type of arteriosclerosis
Formation of plaque w/in arterial walls
Begins in childhood
Often asymptomatic-noted when TIA, stroke, ischemia cardiac events occurs

A

Atherosclerosis (plaque formation)

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3
Q

PATHOLOGY: multistep process for atherosclerosis

A
  1. 1st injury to endothelial cells>inflammation & immune reactions
  2. Growth of smooth muscle cells >secrete collagen & Fibrous proteins
  3. Lipids, proteins & clotting factors accumulate = scar tissue builds up
  4. Scar tissue replaces some of the injured wall
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4
Q

PATHOLOGY: cont’ (complications) of Atherosclerosis.

A

Smooth muscle cells, fibrous proteins develop into plaque

PLAQUE: irregular edges allow blood cells & material to adhere to wall

*Plaque may calcify, harden, break off to form thrombus/occlusion

Causes* partial/total occlusion/ narrowing of the affected artery.

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5
Q

Obstructed blood flow through the coronary arteries to the myocardium.

Primary cause: atherosclerosis

A

(CAD) Coronary artery disease

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6
Q

CAD therapeutic interventions

A

CAD PREVENTIONS:
- Control risk factors: related to lifestyle & environment

* low cholesterol diet
* lipid lowering agents 
* smoking cessation
* Control hypertension & DM
* low dose ASA or anticoagulants
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7
Q

CAD: therapeutic interventions cont’

Percutaneous transluminal coronary angioplasty (PTCA)

A

Cardiac catheterization lab

Catheter with balloon tip inserted & advanced to heart

Then balloon is inflated into sclerotic artery to compress plaque.

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8
Q

Cut and remove plaque, coronary artery stents- angioplasty metal mesh tube implanted at site of blockage.

A

Coronary atherectomy

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9
Q

Vessel from leg or chest used to reroute blood around occluded artery

A

Coronary artery bypass graft (CABG)

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10
Q

Which lab value may determine the degree of damage to the heart?

A. BUN. B. CK-MB

C. Creatinine. D. ABG

A

B. CK- MB

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11
Q

Primary symptom of CAD & MI

-Symptoms of ischemia - increase workload on the ❤️

CAD» unable to dilate & increase blood flow & O2- myocardial ischemia & chest pains

*Usually stops with rest - no cardiac damage

A

Angina Pectoris

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12
Q

Angina Pectoris S/S are …?

A

Pain- heaviness, tightness, viselike, crushing, squeezing

Center of the chest, may radiate
Usually occurs in the am, or anything that increases the workload on the heart

Pale. Diaphoretic. Dyspneic.

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13
Q

Type of Angina: Arteries can’t increase blood flow to heart during increased activity

Usually stops with rest a/o vasodilator

A

STABLE ANGINA

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14
Q

Type of Angina: longer duration, can occur at rest, same time each day and coronary artery spasm cause no damages.

A

VARIANT ANGINA (Prinzmetal’s angina)

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15
Q

Type of Angina: worsening CAD, rest don’t relieve it, can occur at rest, increasing frequency, risk for cardiac damage and/ or death

A

UNSTABLE ANGINA

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16
Q

S/S Unstable angina

A

Traditional- chest pain, jaw pain, heartburn

Female: may have above or atypical - fatigue,nausea, breathlessness.

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17
Q

Myocardial ischemia without chest pain

Prognosis same

More often in Elderly, HTN, DM.

A

SILENT ISCHEMIA

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18
Q

ANGINA PECTORIS: THERAPEUTIC INTERVENTIONS?

A

Weight reduction > decrease workload on the heart.

Diet to low sodium, advoid saturated fats and advoid or low fatty dairy

Stress reduction

Medications: vasodilators, calcium channel blockers,> decrease O2 demand (pines) beta blockers> decrease HR & force of contractions.

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19
Q

ANGINA PECTORIS TREATMENT:. Medications ?

A

• Vasodilators Nitroglycerin (NTG)
- take 1 SL q5mins x 3 for total time of 15mims, until chest pain relieved of not call “911”
medical emergency 🔔

  • Calcium channel blockers: verapamil, nifedipine
  • Beta blocked: propranolol, metoprolol, atenolol.
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20
Q

Death of heart muscle

  • Affects myocardial cells are permanently destroyed
  • . May affect conduction, blood flow & function
A

Definition of a (MI) Myocardial Infraction

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21
Q

Coronary artery blockage

Decreased cardiac blood supply

Cardiac damage

A

Pathology of Myocardial Infraction

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22
Q

S/S of a MI?

A
  • Crushing, viselike pain- radiates to arm, shoulders, neck, and jaw
  • SOB
  • Restlessness
  • Dizziness/syncope
  • Nausea
  • Diaphoresis
22
Q

S/S of a MI?

A
  • Crushing, viselike pain- radiates to arm, shoulders, neck, and jaw
  • SOB
  • Restlessness
  • Dizziness/syncope
  • Nausea
  • Diaphoresis
23
Q

Atypical S/S Myocardial Infraction are what?

A
  • Women/ older adults
  • absence of classic pain
  • Epigastric or abnormal pain
  • Chest cramping
    • fatigue/anxiety
  • Dyspnea
  • restlessness
  • falling
24
WOMEN & MI ?
* Leading cause of death African american @higher risk Higher mortality rate, more complications than men Prodromal symptoms month prior to MI - usually fatigue,sleep disturbances & dyspnea Usually delay treatment - less aggressive treatment given
25
Older adults & MI?
Reports SOB, fatigue,fast/slow heartbeats, chest discomfort Silent MI- collateral circulation.
26
What are the biomarkers for MI?
Troponin ,CK CK3 & CK- MB Magnesium level- PT/PTT prior to anticoagulation medication (check clotting times to prevent risk of bleeding.)
27
Nursing interventions for MI?
``` Bestest/bedside commode Glucose control Daily weight Low sodium clear liquids Diet: NO CAFFEINE, fluid restriction, weight loss & NO SMOKING 🚬 ```
28
Venous or arterial are affected | Common among older adults & w/ DM
PERIPHERAL VASCULAR DISEASE
29
Chronic, progressive arterial narrowing (arterials affected) Reduced blood supply Ischemia develops
PERIPHERAL ARTERIAL DISEASE
30
S/S OF PAD?
``` Intermittent claudication Cool skin Reddish-purple when dependent ** Pale when elevated (don't elevate extremities) Diminished/ absent pulses ``` Artery has no pulse -assess cap refill no more 5 sec, ck for 6 P's Nerve not getting blood supply-tingling & numbness
31
Diagnostic test for PAD ?
* Ankle- brachial index - compare pulse in extremities * Doppler US * MRI
32
Risk factors for PAD?
* DM * HTN * Smoking 🚬 * Obesity
33
Nursing interventions & theraputic interventions for PAD?
Diet: low fat, low cholesterol, low calorie Medications: Lipid lowering agents, Pentoxyfyline (trental), Thombolytics.
34
Invasive treatments/ theraputic interventions (surgery) for PAD?
Percutaneous transluminal angioplasty (PTA) Atherectomy Stents Aortic-femoral bypass
35
Vasoconstriction with cold/stress- causes ischemia Mainly affects hands but also ears,feet & nose Phases: blanching, pain, reddening- restricted flow/spasming arterials
*RAYNAUD'S DISEASE
36
Theraputic interventions for raynaud's disease?
Keep warm, advoid vasoconstriction & vasodilators
37
Recurring inflammation of the small & medium arterials and veins of LE. - occlusion of vessels secondary to thrombus formation- vasospasms, ischemia, gangrene Cause, possible smoking/autoimmune response to tobacco.
thromboangitis obliterans : BUERGER'S DISEASE
38
S/S of BUERGER'S disease are?
Intermittent claudication. 6 P's Lower extremities red or CYANOTIC in dependent position.
39
Theraputic interventions for BUERGER'S Disease?
Smoking cessation Calcium channel blockers Skin assessment-edvidence of breakdown
40
Defined: bulging, ballooning or dilation at the weakened point of an artery Cause is unknown Abdominal aorta most common (see pulse in ABD.)
ANEURYSM
41
What are the types of Aneurysm
1. Fusiform - bulging 2. Saccular- ballooning 3. Dissecting- ballooning/ bulging from the side
42
Theraputic interventions nursing for aneurysm?
Control hypertension & bypass graft Diagnostic test: Ct scan, abdominal US, Aortography
43
Elongated, tortuous, dilated veins Unknown cause - familial CONTRIBUTING FACTORS: prolonged standing, pregnancy, family history & obesity.
* VARICOSE VEINS
44
S/S of VARICOSE VEINS?
Disfigurement of lower extremity (bulging) Edema Dill pain Ulceration
45
Theraputic interventions for venous stasis ulcer
``` Goal: decrease edema/ heal ulcerations Compression wraps(upwards, most distal 1st) Bestest with elevation of LE Advoid prolonged sitting and standing Walk Skin ulcers- imma boot, skin grafts ```
46
Nursing interventions for venous stasis ulcers ?
``` Wound care, emotional support Education: -elevate legs, - protect legs from injury - don't cross legs/wear tight clothing - advoid heating devices (vasodilation) - apply compression from foot upward ```
47
Vascular surgery: nursing pre-op are?
Baseline assessment Pain control needs Lab results reviewed
48
Vascular surgery complications are ?
``` Bleeding hemorrhaging Reocclusion Hematoma Neurological dysfunction Volume deficit ```
49
Bacteria infection of lymphatic channels- staphylococcus and streptococcus May occur in arms and legs Pain,red,streak,chills & fever May cause sepsis/death , Is what? What is the treatment for this?
LYMPHANGITIS treatments are ... Antibiotics, heat, elevation, pneumatic pressure devices for lymphedema -monitor site
50
In assisting w/ community education on prevention of PAD,the nurse is careful to include which of the following major risk factors? (Choose all that apply) A. Dysrhythmia B. DM. E. Hypertension C. Exposure to cold weather D. Cigarette smoking 🚬
B.DM. D. SMOKING 🚬 E. HYPERTENSION
51
The nurse is caring for a PT whose Troponin level 🎚️ s elevated. Which nursing action would be appropriate? A. OOB as desired B. Ambulate BID C. Maintain bedrest D. Ambulate daily
C. Maintain bedrest
52
The nurse is reinforcing teaching for managing the pain of PAD. Which PT statement indicates correct understanding of discharge instructions? A. " I will lie down frequently" B. " I will use a reclining chair" C." I will sit with my legs down" D. " I will do knee flexion exercises"
B. I will use a reclining chair and C. I will sit with my legs down

Cardiovascular (1 decks)

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