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Angina .&. CAD

QuestionAnswer
What is the accumulation of deposits of lipids/fibrous tissue within the walls of arteries? Coronary Atherosclerosis
Coronary atherosclerosis is the major cause of what? CAD
What is the #1 cause of death in the U.S.? CV disease
Put the following in order as they happen during development of CAD: 1. Less bloodflow and O2 to heart 2. Fatty streaks form in arterial walls 3. Lumen of vessel narrows 4. Angina or MI 5. LDLs and platelets stick to arterial wall and form plaques Correct order: 2, 5, 3, 1, 4
What is the term for when the heart has a number of different pathways for blood to reach it often occuring in old age? Collateral circulation
What is the diet prescribed for CAD pt.s? TLC diet (Therapeutic lifestyle changes diet)
What are the drugs that lower cholesterol? WHat do they usually end with? HMG-CoA Reductase Inhibitors (Statin, tor, col)
What are 3 manifestations of CAD? Angina, acute coronary syndrome and sudden cardiac death
What is chest pain or discomfort that is caused by REVERSIBLE myocardial ischemia? Angina
With angina, there is insufficient coronary blood flow secondary to CAD which results in an increased blood demand and a decreased blood supply. True
What is 'PQRST' in nursing? Assessment technique for chest pain: P- Precipitating events Q- Quality R- Radiation S- Severity T- Timing
What type of angina consists of a temporary decrease in o2 to myocardium? Stable
What is another name for unstable angina and what does it entail? Acute coronary syndrome: Rupture of plaque which can lead to MI; usually occurs without exertion
What is the term for a coronary vasospasm (type of angina)? Prinzmetal's
What happens with silent angina? No pain but changes seen on ECG
What 5 things must happen within 10 minutes of a pt reporting chest pain according to the ACC/AHA? VS, IV access, 12 Lead EKG, Brief H&P, Blood dra for cardiac markers, lytes, coags
What test related to diabetes is considered for risk for CAD and what are the risk levels? A1C greater than 8% is high risk for CAD
What complication from drug therapy for hyperlipidemia (statin)suggests that therapy should be stopped immediately? Muscle pain/aches
What is a severe side effect of taking statins? Can cause hypoglycemia, and increase platelet aggregation which can lead to formation of a thrombus
What water soluble vitamin can be given to reduce cholesterol and how does it work? Niacin- reduces LDL, increases HDL
How to bile-acid sequestrants work? Mixes bile with cholesterol and it is excreted in feces
What does ETOH raise in the blood? Triglycerides
What cardiac complication is not reversible and therefore cannot cause angina? Blockages
What are 3 factors that can contribute to angina? Physical exertion, hyperlipidemia, plaques
When doing a CXR for chest pain, what are we looking for? Enlarged heart
What cardiac test is performed with no ECG changes and negative enzymes? Stress test
What cardiac test is performed for ECG changes consistent with MI and positive enzymes? Cardiac Cath
What is med is initiated as first treatment med for angina? Oxygen
What med is given for chest pain that dilates coronary arteries? Nitro
What are two common side effects of nitro? Decreased BP and HA
What are the typical dosing instructions for nitro? 1 tab or spray q5minX3, if systolic drops below 90, stop drug and push fluid
What does the heart require more of in response to nitro? Oxygen
What med decreases HR, BP, contractility, afterload, and demand for oxygen? Beta blockers
At what HR should we hold beta blockers? <60
What diabetes related event can be masked by beta blockers? Hypoglycemia
For what type of heart blocks do we hold beta blockers? 2nd and 3rd degree
Beta blockers are also contraindicated in pt.s with what respiratory disease? Asthma
What med is substituted when B blockers are contraindicated? Calcium channel blockers
For what type of angina are Ca channel blockers the first choice for? Printzmetal's
How do Ca channel blockers work? Systemic vasodilation
What range of ASA dosages are given to prevent MI? 81-325mg
What are two common Ca channel blockers? Cardizem and Norvasc
What is the inability of the heart to pump enough blood to meet the needs of the tissues for oxygen and nutrients? Heart failure
Name the four characteristics of HF. Ventricular dysfunction, reduced activity tolerance, diminished quality of life, shortened life expectancy
What are the 3 primary risk factors for HF? Age, CAD, HTN
What are 4 interferences with CO contribute to onset of HF? Injury/stress to myocardium, decreased elasticity for afterload, increased HR, decreased contractility
What are the four compensatory mechanisms? SNS activation, RAAS, ventricular dilation, ventricular hypertrophy
What are the two types of HF? Systolic HF- Impaired ventricular pumping Diastolic HF- Impaired ventricular filling
What is the most common type of HF and what is it characterized by? Systolic (pumping)- LV dilated and hypertrophied
What is diastolic HF characterized by? Stiff, noncompliant ventricles
What are major causes of Systolic HF? Decreased contractility from MI, increased afterload and mechanical abnormalities
What are major causes of diastolic HF? Chronic HTN, aortic stenosis, pulmonary congestion
What is the most common type of HF that causes back up of blood into pulmonary vessels and causes fluid in alveoli? Left sided HF
Where does blood back up with right sided HF and what is the primary cause? Into venous circulation- Caused by left side HF
What are the S&S of left sided HF? DOPE FACT: Dyspnea Oxygen decreased Pink, frothy sputum Elevated HR Fatigue Altered LOC Crackles in lungs Tachypnea
What are the S&S of right sided HF? JAB A FEW: JVD Ascites BP changes Anorexia Fatigue Edema Weight gain
What other S&S are found with chronic HF along with those listed above? Orthopnea (lying down) and dusky color
What meds are necessary for HF? Diuretics, vasodilators (ACE, B blockers, Nitrates), positive inotropes (Digoxin)
What hormone test is used to diagnose HF? BNP- >100 = CHF
What is the choice med for CHF and what do they do? Ace inhibitors ('prils')- decrease afterload (improving CO), decrease RAAS and decrease ventricular remodeling
What do diuretics reduce in the heart and what should be monitored for? Preload- hypokalemia
What side effect can vasodilators have that is more dangerous due to elderly increase in falls? Orthostatic hypotension
What does Digoxin do? Increases CO, decreases HR and promotes diuresis
What are S&S of Dig toxicity? Bradycardia, confusion
What is a nursing intervention to improve CO? Administer o2, change position
Created by: mm318