Week 3: Cardiac Flashcards
How is CAD developed?
There is a healthy artery. Then, Endothelial damage from factors like hypertension or diabetes allows fatty substances to build up in the arterial wall, forming plaques. If a plaque ruptures, it exposes underlying tissue, triggering a clot to form. This clot can block the artery, potentially leading to a heart attack.
What are the modifiable risk factors for CAD?
Lipid Levels: High cholesterol/triglycerides contribute to plaque formation.
Hypertension: High blood pressure damages blood vessels, increasing plaque risk.
Tobacco Use: Damages endothelium, increases blood clot risk.
Physical Inactivity: Leads to obesity, high cholesterol, hypertension.
Obesity: Increases CAD risk, part of metabolic syndrome.
Diabetes: Damages blood vessels, increases cardiovascular risk.
Metabolic Syndrome: Cluster of risk factors: obesity, high lipids, elevated glucose, hypertension.
Substance Abuse: Cocaine causes vasospasms, increasing CAD risk.
What are the non modifiable risk factors for CAD?
Age: Risk increases with age; older adults have more time for cardiovascular changes.
Gender: Men are more likely to develop CAD; women’s risk increases after menopause.
Ethnicity: Some ethnicities (e.g., African Americans) have higher CAD risk.
Family History: Genetic predisposition plays a significant role; heart disease can be inherited.
What is Angina?
The heart muscle isn’t getting sufficient oxygen, which causes chest pain
What is Unstable Angina?
Chest pain that occurs at rest or with minimal exertion, and is unpredictable and urgent
What are the S&S of Angina?
Chest pain, Jaw pain, Back pain, Indigestion like symptoms
How would a patient describe Angina?
Lots of pressure, Radiating pain, SOB, and sweating
What is the difference between angina and myocardial infarction (MI).
Angina:
- No permanent damage
- Reduced blood flow
- Short period of time, predictable
- Treatment with medication
Myocardial Infarction:
- Permeant damage
- Blood flow is blocked
- Prolonged period of time, unpredictable
- Emergency
What is the initial assessment for a patient experiencing a myocardial infarction?
ABCs
Airway: Ensure airway is clear; patient can respond verbally.
Breathing: Check chest rise/fall, assess respiratory rate/effort, observe skin colour.
Circulation: Check pulse, verify blood pressure, assess peripheral perfusion.
After ABCs what other assessments would you do for a patient experiencing a myocardial infarction?
Subjective Assessment
Medical History: Previous cardiac events, current medications, surgical history.
Symptom Evaluation: Fatigue, fluid retention, irregular heart rate, dyspnea, pain characteristics, dizziness.
Objective Assessment
Vital Signs: Blood pressure (both arms), pulse rate/rhythm, temperature.
Physical Examination: Patient positioning, comfort level, respiratory distress.
Peripheral Vascular Examination: Skin color, hair distribution, skin temperature, pulse checks (radial, dorsalis pedis, posterior tibialis).
Edema Assessment: Check for swelling, measure extent, assess from toes to thighs, evaluate sacral area if extensive.
Cardiac Auscultation: Listen to heart sounds, check apex and base, identify S1 and S2 sounds, note any abnormalities.
What are immediate nursing interventions for someone experiencing a myocardial infarction?
Oxygen Support: Assess oxygen saturation, provide supplemental oxygen if needed.
ECG Monitoring: Continuous cardiac monitoring, watch for arrhythmias, identify ST segment changes.
Pain Management: Assess pain characteristics, administer prescribed pain medications, monitor pain relief effectiveness.
Medication Administration: Anticoagulants, thrombolytics, antiplatelet drugs, beta-blockers, nitrates.
Psychological Support: Reduce patient anxiety, provide clear/calm communication, explain procedures.
What are some patient teaching that a nurse could provide after someone has experienced a myocardial infarction?
Lifestyle Modifications: Diet recommendations, exercise guidelines, stress management, medication adherence.
Risk Factor Management: Smoking cessation, weight management, cholesterol control.
What is the nursing management of cardiac patients in the emergency room (ER)?
Priorities: Rapid assessment, life-saving interventions, quick diagnostic procedures.
Nursing Interventions: ABCs (Airway, Breathing, Circulation), immediate ECG, rapid cardiac enzyme testing, pain management, oxygen support, prepare for urgent interventions.
Patient Condition: Acute, unstable, potential life-threatening situation, high-intensity monitoring.
What is the nursing management of cardiac patients in the Critical Care Unit (CCU)?
Priorities: Continuous cardiac monitoring, prevent further cardiac damage, advanced medical interventions.
Nursing Interventions: Continuous cardiac rhythm monitoring, invasive line management, hemodynamic monitoring, medication titration, potential mechanical ventilation, frequent neurological assessments.
Patient Condition: Critically unstable, high-risk complications, requires specialized equipment, potential post-surgical care.
What is the nursing management of cardiac patients in the Telemetry/Medical Unit?
Priorities: Gradual stabilization, rehabilitation, patient education, transition to home care.
Nursing Interventions: Continuous but less intensive monitoring, medication management, gradual activity progression, cardiac rehabilitation initiation, lifestyle modification counseling, discharge planning.
Patient Condition: Stabilizing, less acute risk, preparing for discharge, focus on long-term health management.
What are the danger signs of a cardiac pt?
Chest Pain Indicators: Retrosternal chest pain, radiating pain to shoulders, jaw, back, arms, unpredictable or persistent pain.
Respiratory Red Flags: Sudden dyspnea, difficulty breathing at rest, orthopnea, persistent coughing.
Circulatory Warning Signs: Irregular heart rate, palpitations, sudden weakness, dizziness, syncope.
What are diagnostic danger signs of a cardiac pt?
Elevated cardiac enzymes
ECG changes
ST segment elevation
Arrhythmias
What is the nurses role in cardiac arrest?
Immediate Recognition: Confirm unresponsiveness, absence of pulse, and abnormal breathing; activate emergency response.
Initial Response: Call code team, initiate cardiac arrest protocol, prepare for ACLS.
CPR: Start high-quality chest compressions (2-2.4 inches deep, 100-120/min), minimize interruptions.
Critical Interventions: Manage airway (intubation if needed), apply defibrillator for shockable rhythms, administer ACLS medications.
Monitoring: Continuous ECG, track vital signs, document interventions and times.
Post-Resuscitation Care: Stabilize airway and oxygenation, manage hemodynamics, assess neurological status to prevent complications.
