Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
Ch 35 Mod IV
Ch 35 cardiac disorders ANGINA and AMI
| Question | Answer |
|---|---|
| CAD occurs when major coronary arteries supplying blood to (epicardium, endo, or myo) are partially or completely ____. | myocardium, blocked |
| Blockage of arteries are caused by what 3 things: | artery spasms, arteriosclerosis, athero |
| Arteriosclerosic and atherosclerosis may result in ____ or ____ of myocardial tissue: what conditions | ischemia, infarction |
| thickening, hardening, loss of elasticity of arterial walls | arterio |
| what causes the innermost layer of the artery to stiffen, thicken, and decrease in diameter for ASHD pts> | collagen and smooth tissues |
| Arteriosclerosis: what 3 things adhere(stick) to the damaged walls | lipids, cholesterol, calcium |
| arteriosclerosis causes 3 conditions, name them: remember acronym HIPA | Hypertension, Impaired tissue Perfusion, aneurysms |
| a form of arteriosclerosis, and is an ___disease that begins with___injury | atherosclerosis inflammatory; endothelial |
| what are seen in advanced stages of atherosclerosis? | Complicated lesions |
| three types of lesions of atherosclerosis | fatty streaks,fibrous plaque, and complicated lesions |
| the earliest lesion in atherosclerosis. | fatty streak |
| fatty streak: what is the color? | Yellow |
| fatty streak: causes an obstruction true or false | false |
| fatty streak: found in what area of the body by age 10? | aorta |
| fatty streak: found in coronary arteries by what age? | 15 |
| fatty streak: are irreversible, true or false | false |
| fatty streak: S/Sx | none |
| Nurse learns that there is fibrous plaque in the pts arteries. She knows this is what stage of atherosclerosis? | progressing stage because fibrous plaque is only seen in the progressing stage. |
| What is the color of fibrous plaque? | whitish, grayish |
| Fibrous plaque contributes to loss of arterial ____ and impairs ____. This impairs the vessels ability to meet increased ___ needs. | elasticity; vasodilate; O2 |
| if plaque formation occur slowly, what type of circulation may develop? | Collateral circulation |
| new branches of blood vessels that grow from existing arteries to provide increased blood flow: | collateral blood vessels |
| non-modifiable risk factors with atherosclerosis-name 4 | gender, age, heridity, race |
| how does gender protect women from developing atherosclerosis? | Hormone secreted-stops protecting women by menopause |
| what are the early signs and symptoms of coronary artery disease? | none: CAD is asymptomatic during early stages |
| Why do pts w/ early stage CAD not show any S/Sx (asymptomatic) | collateral circulation forms to compensate |
| when do S/Sx appear in CAD | when blood supply is reduced by at least 50% |
| CAD: clinical manifestations | angina pectoris, ACS(unstable angina and MI), sudden cardiac death |
| the most common symptom of CAD | angina pectoris |
| Angina pectoris results when? | demand for O2 by Myocaridal cells exceeds supply of O2 delivered |
| name 3 types of angina pectoris | stable, unstable, variant angina |
| stable angina: Characteristics - occurs when? subsides when? constant? not predictable? how long does it last? relieved w/ what med? | occurs w/ activity, subsides w/ rest; intermittent and predictable, lasts only a few minutes, nitro |
| risk factors of stable angina | stress, heavy meals, smoking, exertion |
| viselike, squeeszing, smothering pain on the sternum | stable angina |
| stable angina: pain may radiate to 5 places | arms, shoulder, jaw, neck, epigastrium |
| stable angina S/Sx | diaphoresis, dyspnea, nausea, vomiting |
| two names for unstable angina | pre-infarction angina and crescendo angina |
| unstable angina is treated as what type of condition | acute coronary syndrome: ACS |
| unstable angina characteristics | more severe, occurs at rest or minimal activity, not relieved by NTG, or require frequent NTG, not predictable |
| unstable angina may occur in a patient with a history of? | Stable angina |
| unstable angina pain characteristics | described as more severe, changing pattern |
| what may be the first clinical manifestation of CAD? | unstable angina |
| patients with unstable angina are higher risk for what type of condition? | AMI |
| a type of angina caused by coronary artery spasms | variant angina |
| variant angina characteristics | not associated with CAD, unpredictable, often occurs at rest, pain goes away when spasms stop |
| treatment for variant angina | calcium channel blockers for prevention |
| ABCDE therapy for CAD stands for | aspirin and anginal therapy; beta blockers and blood pressure; cigarette and cholesterol; diet and diabetes; education and exercise |
| low-dose aspirin is administered to interfere with___aggregation; reduce the risk of___. | platelet; MI |
| if patient cannot tolerate aspirin what is given? | another antiplatelet medication (plavix) |
| Antianginal therapy includes three things: | nitrates, beta blockers, calcium channel blockers |
| nitroglycerin are used to treat what two things? | actual episodes of angina, prevent angina |
| two routes of med administration for the onset of angina pain | sublingual, buccal |
| three routes used to admin nitrates for angina attack prevention | oral, transdermal, topical |
| Beta blockers and calcium channel blockers are prescribed for ___management of angina | long-term |
| after initial relief and control of anginal pain, the focus of therapy will turn to__reduction | risk |
| some risk reduction measures are: | blood pressure management, stop smoking, lipid control, diet, exercise, education, glucose control |
| what medication may be prescribed for patients with stable angina to reduce the risk of AMI? | Ace inhibitors |
| medical treatment for unstable angina | same as other angina is; additional anticoagulation therapy with LMWH |
| Cultural: which two americans develop CAD earlier than other americans | Native American and African-Americans |
| coronary artery disease is highest among which Americans? Lower among which Americans? | Caucasian; Latin Americans |
| death of myocardial tissue | AMI |
| myocardial tissue dies as a result of prolonged lack of ____ and ____ supply to the heart | blood, oxygen |
| modifying factors of AMI | smoking, high-fat diet, hypertension, sedentary lifestyle, stress |
| AMI occurs more frequently in men or women | men: considered a risk factor |
| pathophysiology of AMI | begins w/ occlusion of coronary arteries -> ischemia -> injury and infarction |
| how long must ischemia last for damaged tissue to be considered irreversible? | 20 mins |
| how many hours after an MI will the healing process begin | 24hrs |
| what happens on the third day | dead tissue broken down by enzymes and removed by macrophages |
| what develops to supply blood to the injured area? | Collateral circulation |
| between what days after AMI is the myocardium vulnerable to stress? Why | 10 to 14 days; weakness of the healing tissues |
| after an AMI, how long does it take for tissues to heal? | 6 wks |
| two categories of acute coronary syndrome | unstable angina, AMI |
| STEMI and NSTEMI: which is partially occluded, which is completely occluded | partial = NSTEMI; total = STEMI |
| Why is ST segment important to note in an ECG | the segment will look different w/ partial or total lack of oxygen |
| name five complications of AMI | dysrhythmias, heart failure, rupture, cardiogenic shock, thromboembolism |
| a disturbance in heart rhythm is called | dysrhythmias |
| what intervention is ordered for patient w/ dysrhythmias | continuous cardiac monitoring |
| most common complication of AMI | heart failure |
| most frequent cause of death after an AMI | cardiogenic shock |
| after AMI,thrombi may form in what two parts of the body | injured heart chambers, veins of the legs |
| Pulmonary embolism may cause | pallor, cyanosis, heart failure |
| How can ruptures/aneurysms happen after an AMI | weakened, inadequate scars from healing tissue may cause artial walls to buldge and rupture |
| AMI break down | 1) occluded coronary arteries in 4-6 = ischemia = injury = infarction. 2) 20 mins, tissue damage irreversible. 3)after 24 hours, dead tissue breaks down 4) colleteral circulation occurs 5) 10-14 days susceptible to stress 5) complete healing in 6 wks |
| classic symptom of AMI: where is the pain and what is the description | pain located below or behind sternum that is heavy, constrictive |
| AMI pain may radiate where? | arms, back, neck, jaw |
| AMI begins w/ exertion: T or F | false, it is w/ and w/o |
| If AMI progresses what is the S/Sx | same as stable angina: diaphoretic, dsypnea, nausea, vomiting, light head |
| AMI: skin is frequently | cold, clammy |
| AMI: what feelings does pt feel | impending doom, great anxiety |
| Which group shows atypical signs of AMI | older adults, women, diabetics |
| If confusion arises w/ chest pains and other S/Sx of AMI what did Mrs. G say must be done: | immediately put on ECG (not sure of my notes) |
| What confirms AMI? | ECG and lab evidence |
| which lab did Mrs. G say lasts the longest | Troponin: 2 weeks |
| in what extraordinary situation is troponin drawn vs. other enzymes or markers | ER for early diagnosis |
| Mrs G said to remember which is the quickest test for AMI but why is not always useful | Myoglobin, no specific to cardiac injury |
| when does CPK-MB return to normal level after an AMI | 2 to 3 days |
| ECG appearances: ischemia | ST segment is depressed, T wave inverted |
| ECG appearances: when is ST segment elevated | total occlusion |
| ECG appearances: ST segment of partial occlusion | not elevated |
| most frequent dsyrhythmias for AMI | PVC, V-fib, V-tach |
| what is the difference in pain regarding AMI and unstable angina? | Indistinguishable |
| name 3 antiplatelet medications | aspirin, ticlid, Plavix |
| Mrs. G said that calcium channel blockers are more for which type of angina | variant |
| non-modifiable risk factors of AMI | DM, Family Hx, male gender |
| dysrhythmias occur in approximately how many percent of AMI? | 80% |
| CHF can cause what two conditions | cardiogenic shock and death |
| Cardioshock is marked by what syptoms | hypotension, cool, moist skin, decreased alertness, oliguria |
| S/Sx of pulmonary embolism | SUDDEN SEVERE DYSPNEA, pallor, HF, cyanosis |
| T or F: ventricular rupture/aneurysm is not always fatal | false: its always fatal |
| AMI EKG changes | ST elevation in two or more leads, Q is 1/3rd the height of the R wave |
Created by:
Jgar2007