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Nursing 2300 (VIcky Hansen) > Unit 9 - CAD > Flashcards

Unit 9 - CAD Flashcards

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1
Q

coronary artery disease is cause by impaired blood flow to _____

A

myocardium

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2
Q

chest pain caused by reduced cardiac blood flow

A

angina pectoris

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3
Q

unstable cardiac ischemia

A

acute coronary syndrome (ACS)

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4
Q

necrosis/death of myocardial cells

A

acute myocardial infarction (AMI)

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5
Q

Pathophysiology/etiology of CAD:

  • blood flow in coronary arteries regulated by aortic pressure, heart rate, other factors
  • large arteries not connected: small arteries joined by _____ channels -> alternate routes for blood flow
A

collateral

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6
Q

most common cause of reduced coronary blood flow

A

atherosclerosis

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7
Q

high levels of low-density lipoprotein (LDLs) and toxins lead to arterial endothelial layer damage and plaque formation

A

atherosclerosis

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8
Q

complex lesions of lipids, fibrous tissue, collagen, calcium, cellular debris, capillaries - develop -> can rupture or ulcerate causing emboli or thrombus

A

atheromas

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9
Q

where does atherosclerosis develop

A

where arteries bifurcate or branch

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10
Q

ischemia develops when…

A

oxygen supply inadequate to meet metabolic needs

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11
Q

acute coronary syndrome

  • coronary blood flow _____ but not entirely occluded
  • rupture or erosion of _____ plaque (predominant cause)
  • coronary artery _____
  • progressive vessel _____
  • _____ of coronary artery
  • _____ myocardial oxygen demand and/or _____ supply
  • ECG changes: inversion of T-wave, possible elevation of _____ segment
A
  • coronary blood flow reduced but not entirely occluded
  • rupture or erosion of atherosclerotic plaque (predominant cause)
  • coronary artery spasm
  • progressive vessel obstruction
  • inflammation of coronary artery
  • increased myocardial oxygen demand and/or decreased supply
  • ECG changes: inversion of T-wave, possible elevation of ST segment
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12
Q

acute myocardial infarction (MI) occurs when blood flow to a portion of cardiac muscle is completely _____, resulting in a prolonged tissue _____ by damages area of the heart

A

blocked

ischemia

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13
Q

MI:

occlusion L anterior descending artery =

A

anterior MI

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14
Q

MI:

left circumflex artery =

A

lateral MI

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15
Q

MI can result from acute cocaine _____

A

toxicity

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16
Q

angina classes:

A

I
II
III
IV

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17
Q

Angina class:

does not occur with ordinary physical activity

A

Class I

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18
Q

Angina class:

prolonged walking or stair climbing

A

Class II

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19
Q

Angina class:

limits normal activities of daily living

A

Class III

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20
Q

Angina class:

angina with rest or activity

A

IV

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21
Q

substernal or epigastric chest pain =

A

acute coronary syndrome

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22
Q
  • continuous chest pain
  • onset sudden; not precipitated by activity
  • accompanied by nausea, vomiting, hypotension, bradycardia
A

acute myocardial infarction

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23
Q

Diagnostic Tests:

proteins released during a myocardial infarction that are sensitive indicators of _____ _____

A

myocardial damage

24
Q

Diagnostic Tests:

not specific to _____ muscle; use is limited

A

cardiac

25
Q

Diagnostic Tests:

elevated white blood cell count and erythrocyte sedimentation rate because of _____ _____ _____

A

myocardial cell inflammation

26
Q

Diagnostic Tests:

assess blood oxygen and _____-_____ balance

A

acid-base

27
Q 
Electrocardiogram:
changes seen in acute myocardial infarction
- T wave \_\_\_\_\_
- ST segment \_\_\_\_\_
- Formation of \_\_\_\_\_ wave
A
  • inversion
  • elevation
  • Q wave
28
Q

Echocardiogram:

evaluate cardiac wall motion and _____ _____ function

A

left ventricular

29
Q

Radionuclide imaging:

  • evaluates myocardial _____
  • cannot differentiate between _____ and _____ myocardial infarctions
A

perfusion

old and new

30
Q

Conservative management:

- reduce the risk of coronary artery disease (CAD) by _____ regardless of length of time smoking

A

50%

31
Q

Conservative management:
Diet

  • _____ saturated fat and cholesterol intake
  • _____ LDL level
  • _____ intake of soluble fiber
  • _____ alcohol intake
  • overweight or obese: encourage to _____ weight
A
  • reduce saturated fat and cholesterol intake
  • Lower LDL level
  • increase intake of soluble fiber
  • moderate alcohol intake
  • overweight or obese: encourage to lose weight
32
Q

drugs used to lower cholesterol: goal -> achieve LDL level < _____ mg/dL

A

130

33
Q

Drug of choice for CAD

A

nitrate (sublingual nitroglycerin)

34
Q

nitrate (sublingual nitroglycerin) acts within _____ minutes

A

1-2

35
Q

4 side effects of nitrate (sublingual nitroglycerin)

A

headache
nausea
dizziness
hypotension

36
Q

first-line drug to treat stable angina

A

beta-blockres

37
Q

beta-blockers are contraindicated in clients with _____ or severe _____

A

asthma

COPD

38
Q

T/F: beta-blockers may make prinzemtal angina worse

A

T

39
Q

Calcium-channel blockers are used for long-term _____

A

prophylaxis

40
Q

Calcium-channel blockers are used with caution in clients with _____, _____ _____, _____

A

dysrythmias, heart failure, hypotension

41
Q

_____ reduce risk of platelet aggregation and thrombus formation

A

aspirin

42
Q

_____ is essential initial treatment for myocardial infarction

A

aspirin

43
Q

Fibrinolytics:

  • _____ infarct size
  • _____ heart damage
  • _____ outcomes
A

limits
reduces
improves

44
Q

purpose of percutaneous coronary revascularization

A

restore blood flow to ischemic myocardium by compressing plaque

45
Q

_____ catheter shaves plaque off vessel walls, removes it

A

atherectomy

46
Q

_____ uses section of vein, artery to create connection (bypass) between aorta and coronary artery beyond the obstruction

A

CABG

47
Q

CABG

_____ clients -> totally relieves or significantly reduces angina

A

90%

48
Q

CABG

heart is stopped during surgery for _____ techniques; newer techniques do not require stoppage and are safer

A

older

49
Q

2 approaches to minimally invasive coronary artery surgery:

A
  • port-access coronary artery bypass

- minimally invasive direct coronary artery bypass

50
Q

laser drills tiny holes in myocardial muscle, provides blood flow to ischemic area

A

Transmyocardial laser revascularization:

51
Q
  • balloon inflates during diastole, deflates during systole
A

intra-aortic balloon pump

52
Q

_____ _____ device

  • takes partial or complete control of cardiac function
  • risk for infection high
A
  • ventricular assist device
53
Q

Diagnosis:
CAD
- imbalanced _____: more than body requirements
- ineffective _____ maintenance

A

nutrition

health

54
Q

Diagnosis:
Angina
- ineffective _____ perfusion: cardiac
- risk for _____ _____ regimen management

A

tissue

ineffective therapeutic

55
Q 
Diagnosis:
AMI
- \_\_\_\_\_ pain
- ineffective \_\_\_\_\_ perfusion
- \_\_\_\_\_ coping
- fear
A

acute
tissue
ineffective

56
Q

defined as an alteration in the structure and function of the right ventricle (RV) of the heart caused by a primary disorder of the respiratory system. Pulmonary hypertension is often the common link between lung dysfunction and the heart in _____ _____

A

cor pulmonale

Nursing 2300 (VIcky Hansen) (64 decks)

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