Wk 4

Question 1

Coronary heart disease

Answer 1

Describes the effect ps of a reduction or complete obstruction of blood flow through coronary arteries due to narrowing from atherosclerosis and or thrombus
Slow and degenerative
Manifests as chest pain due to angina
Causes arrhythmia and heart failure

Question 2

Risk factors of CVD

Answer 2

Smoking 
hypertension
DM
Dyslipidemia 
Family hx
Age 45 male 55 female
Chronic kidney disease 
Obesity diet

Question 3

Angina pectoris

Answer 3

Syndrome of CHD characterised by crushing central chest pain
Pain from physical exertion and stress due to increased workload

Question 4

Different types of angina

Answer 4

Stable: predictable, not worse
Unstable: more pain, unpredictable,
Variant: spasm, may be no disease

Question 5

Diagnosis of angina

Answer 5

Typical: suc stern all chest discomfort, onset with exertion or emotional distress, relied with rest or nitroglycerin
Atypical: 2 of above criteria
Noncardiac chest pain: 1 criteria met

Question 6

Signs and symptoms of angina

Answer 6

Pain is progressive or very sudden 
Retro sternal pain
Radiating pain to left or right shoulder 
Occasional pain in neck and jaw
SOB
Increased Har

Question 7

Diagnosis of unstable angina

Answer 7

Typical angina: increased in severity or duration
Has onset at rest or at a low level of exertion
Unrelieved by nitroglycerin

Non typical angina: first episode with usual activity, prolonged pain at rest

Question 8

MI

Answer 8

Irreversible myocardial necrosis from an abrupt blockage and cessation of blood flow
Thrombosis, atherosclerotic plaque, coronary artery spasm
May develop cardiogenic shock

Question 9

Mi signs and symptoms

Answer 9

Severe crushing pain 
Pain in left arm, jaw and back
SOB pulmonary oedema
Cold clammy
Unconscious
Cardiac arrest

Question 10

Signs to help diagnose acute MI STzeMI/NSTEMI

Answer 10

Ischaemia symptoms that last longer than 30 mins
Diagnostic ECG changes
Serum cardiac marker troponin levels

Question 11

Avute MI

Answer 11

LAD: left ventricle and septum, high risk heart failure, shock, death
Circumflex: left ventricle, lateral and posterior wall, arrhythmia
RCA: inferior wall of left and right ventricle, AV node and SA node

Question 12

Cardiac arrhythmia

Answer 12

Group of conditions in which the heartbeat is irregular, too fast or too slow
Main types: extra beats, supraventricular tachycardia, ventricular arrhythmia, Brady arrhythmia
Dues to problems with electrical conduction system of heart

Question 13

Cardiac pacing: trancutaneous pacing

Answer 13

Temporary means of pacing a patients heart during medical emergency
Pulses of electric current through chest to contract the heart

Question 14

Hypotensive crisis

Answer 14

All tissues and organs require oxygen and glucose, low BP can be tolerated by some

Question 15

Common causes of chest pain:

Answer 15

Angina, 
mI
Gastric
Muscular skeletal
Aneurysm
Pleural

Question 16

Heart failure

Answer 16

Impairment of pumping ability of heart due to damage.
Increased workload due to hypertension, or malfunctioning heart valve - most common cause is hypertension due to atherosclerosis IHD

Question 17

Types of heart failur

Answer 17

Right side
Left side
CCF congestive cardiac failure can be both

Question 18

Hypertensive crisis

Answer 18

Systolic 180 diastolic 110 is hypertensive crisis
May have headaches and dizziness
Retinal damage, 
Breathlessness
Pulmonary oedema

Question 19

Nursing management of cardiac patient

Answer 19

ABCDE
Determin problem
Reduce myocardial workload 
Optimise CO
Detect complication and initiate Tx
Pain relief: where is it, what make it worse, what alleviates it, worse when you eat, what scale

Question 20

Cardiac lab tests

Answer 20

Enzymes are catalysts found in different cells of body
Troponin is highly cardiac specific protein in 2 forms
Trop I: within 4 hrs elevated for 2 weeks
Trop T: more sensitive shows small amounts of damage

Question 21

Acute management of ACS

Answer 21

ABCDE
MONA:
morphine: reduces pain and anxiety, careful with hypotension, hypovolemia, resp depression
oxygen: ACS patients often experience hypoxaemia, limits ischaemic myocardial damage
nitroglycerin: dilates coronary vessels, reduces systemic vascular resistance and preload,
aspirin: irreversible inhibition of platelet aggregation

Question 22

Nursing care of cardiac patients

Answer 22

Bed rest 
Light diet
Medication: anti-arrhythmia, pain, anti-coagulation 
Patient education
Rehab and continuing support
Inotropes
Pacing
Cardio version
Intra aortic balloon pump

Question 23

Inotropes

Answer 23

Alter stretch of cardiac and other smooth muscle fibres
Stimulates sympathetic nervous system and alters movement of ions
Alpha adrenergic receptors: vasoconstriction of smooth muscle
Beta receptors: vasodilation and heart rate and contractility increase

Question 24

Intra-aortic balloon pump

Answer 24

Designed to increase coronary blood flow and decrease after load

Question 25

Secondary prevention disease management

Answer 25

Blood pressure: beta blockers and ACE inhibitors,
Lipids: maximise use of statins
Diabetes: control blood sugar
Patient education: in hospital, discharge, outpatient, rehab
Smoking cessation: meds and counselling
Physical activity:
Diet

Question 26

Medication checklist for ACS

Answer 26

Anti platelet agent I.e. Aspirin
Lip lowering agent statin
Anti hypertensive: B blocker, ACE-I

Question 27

ACS includes

Answer 27

Unstable angina UA
NSTEMI
STEMI

Question 28

The cardio vascular system

Answer 28

Heart and pulmonary and systemic circulatory system
Main function: transport O2 to tissues from lungs
Transport CO2 from tissues to lungs
Nutrient, waste product transportation
Transport hormones
Transport and radiation of heat