Week 8 Circulation & Perfusion II Flashcards
1
Q
Coronary Artery Disease - CAD
A
- Narrowing/obstruction of arteries
- Result of atherosclerosis process
- Build up of plaque in artery walls
- Impacting perfusion
- Damage to body systems
2
Q
CAD Causes
A
- Injury to artery walls
- Hypertension
- Diabetes
- Inflammation
- Cholesterol
3
Q
CAD Comorbidities
A
- Hypertension
- Dyslipidemia
- Diabetes
- High BMI
4
Q
CAD Risks
A
- Uncontrolled blood glucose
- High HbA1C
5
Q
Stenosis
A
- Might be enough flow during rest
- HR increases, not enough flow to tissue
- Starving tissues
6
Q
Angina
A
- Ischemia of partial thickness of myocardial muscle
- Chest pain brought on by myocardial ischemia
7
Q
Myocardial Infraction - MI
A
- Ischemia of full thickness of myocardial muscle
- Death of myocardia cells
- Result of prolonged ischemia
- EMERGENCY
8
Q
Angina Causes
A
- Stenosis
- Vasospasm
- Thickening of heart wall
9
Q
MI Causes
A
- Stenosis
- Plaque lodge
10
Q
MI STEMI
A
ST-elevation
11
Q
N-STEMI
A
Non-ST elevation
12
Q
Angina Tests
A
- Negative cardiac biomarkers
- Negative ECG
13
Q
MI Tests
A
- NonST - positive biomarkers, neg ECG
- STEMI - pos biomarkers & ECG
14
Q
Angina Diagnosis
A
ST depression on ECG
15
Q
MI Diagnosis
A
- NSTEMI - no change on ECG
- STEMI - ST elevation on ECG
16
Q
Troponin I
A
- Elevated with cardiac muscle damage
- Elevates 3-6hrs post MI
- Peak 12-16 hrs
- Remains high 5-9 days
17
Q
Angina Pharm Interventions
A
- Nitrates (short/long acting)
- Calcium channel blockers
- Beta blockers
- Antihyperlipidemic
- Anti-coagulants
18
Q
-ASE: Altplase, Reteplase, Aminolase
A
- Thrombolytics - clot busters
- Dissolve thrombus
- Bleeding risk
- IV admin
19
Q
MI Pharm Interventions
A
- Thrombolytics
- Nitrates
- Morphine
- Calcium channel blockers
- Beta blockers
- Antihyperlipidemic
- Ant-coagulants
20
Q
MI Pharm Interventions Target
A
- Vasodilation
- Clot busting
- Pain
- Reduce future complication risk
21
Q
Systolic Dysfunction
A
- Impaired myocardial contraction
- Contractility issue
- Ventricles lack strength
22
Q
Diastolic Dysfunction
A
- Impaired ventricular filling
- Compliance/pre-load issue
- Ventricles lacking elasticity
23
Q
Heart Failure Compensation
A
- Stimulate sympathetic NS
- Activate RAAS
- Vasoconstriction - blood shunted to vital organs
- Retain fluid - overload
- Dilate ventricles
24
Q
Heart Failure Causes
A
- Hypertension
- MI
- COPD
- Cardiomyopathy
- Valve issues
25
Left Sided HF
- Respiratory congestion
- Blood backs up in lungs
26
Left Sided HF S/S
- Dyspnea & SOB
- Nocturnal dyspnea
- Cough
- Crackles
- Orthopnea
- Decreased SpO2
- Extra beats or sounds
- Palpitations
- Dysrhythmias
- Increased HR
- Weak pulse
- Oliguria - FVO
- Dizzy, confused, restless
- Altered digestion
- Pale, cool
27
Right Sided HF
- Peripheral & visceral congestion
- Blood backs up in body
28
Right Sided HF S/S
- Liver dysfunction
- RUQ pain
- Hepatomegaly
- Jaundice
- Ascites
- Anorexia/nausea
- Splenomegaly
- Reduced RBC
- Jugular vein distension
- Unstable BP
29
B-Type Natriuretic Peptide BNP
Increase with heart failure
30
Echocardiogram
- Measures ejection fraction
- Normal 55-65%
- HFpEF >50% = preserved
- HFmEF 41-49% = mid range
- HFrEF <40% = reduced
31
HF Complications
- Cardiogenic shock
- Pulmonary edema
- Venous disorders
32
Pulmonary Edema
- Fluid in interstitial & alveoli
- Can be emergency
- Caused by L-side
33
Pulmonary Edema S&S
- Resp - SOB, tachypneic, low SpO2, cyanosis, pink sputum
- Cardiac- JVD, weak pulses, tachycardia
- Neuro (early) - restless, anxiety
- Neuro (late) - confusion, stupor
34
Cardiogenic Shock
- Compromised cardiac function
- Cannot maintain CO & tissue perfusion
35
Cardiogenic Shock S&S
- Increased HR
- Decreased BP
- Decreased urine output
- Pale, cool
- Confused, agitated
- Absence of bowel sounds
36
Venous Stasis Ulcers & Cellulitis
- Excavation of skin surface
- Necrotic tissue sloths off
- Inadequate perfusion result
37
Stage 1 HF
- Lifestyle modifications
- ACE inhibitor/ARB
38
Stage 2 HF
- Lifestyle modification
- ACE inhibitor/ARB & beta blocker
39
Stage 3 HF
- Lifestyle modification
- Surgical intervention
- ACE inhibitor/ARB & beta blocker & diuretic
40
Stage 4 HF
- Decision on level of care
- Palliative or heart transplant
41
HF Pharm Interventions Target
- Reduce cardiac workload
- Reduce symptoms
- Support cardiac function
42
HF Pharm Interventions
- ACE inhibitors or ARBs
- Beta blockers
- Diuretics
- Digoxin
43
Vascular Assist Device
- Implanted surgically
- Supports heart in maintaining flow
- Requires lifelong anticoagulants
44
Heart Transplant
- Lifelong meds for rejection
- Comorbidities need to be considered
- Lifestyle modifications
