2000- Test 1 Angina Pectoris

Front 1

Angina Pectoris is ____.

Back 1

chest pain

Front 2

Angina pectoris is caused by a inadequate imbalance between _____ and the demand for myocardial contractility.

Back 2

myocardial oxygen supply

Front 3

The demand for oxygen is controlled by

Back 3

preload
afterload
contractility
heart rate

Front 4

The myocardial oxygen supply is met with

Back 4

arterial oxygen content and coronary artery blood flow

Front 5

When a person has angina there is significant atherosclerosis and there is decreased ____ with increased _____.

Back 5

supply
demand

Front 6

Situations in which oxygen demands are increased are:

Back 6

-exercise
-stress
-higher elevations
-anxiety
-cold

Front 7

When a person has chronic atherosclerosis for years they develop channels between small arteries that provide alternative routes for blood flow. This is called _____.

Back 7

collateral circulation

Front 8

Collateral circulation hopefully minimizes the amount of _____.

Back 8

dead tissue in the event of an MI.

Front 9

There are 3 types of angina:

Back 9

-stable
-unstable
-Prinzmetal's/Variant

Front 10

___ angina is triggered by predictable pattern of onset, duration and intensity relieved by rest and or NTG.

Back 10

Stable

Front 11

____ angina is unpredictable, not relieved by rest or nitrates and lasts longer than stable angina.

Back 11

Unstable

Front 12

____ angina occurs with rest and is due to coronary artery spasm.

Back 12

Prinzmetal's/Variant

Front 13

Clinical manifestations of angina are pain that might feel

Back 13

-tight
-squeezing
-heavy
-constricting substernal pain that radiates to jaw, epigastric area and back

Front 14

Additional manifestations of angina pectoris are:

Back 14

-dyspnea
-pallor
-tachycardia
-great anxiety or fear

Front 15

Anginal symptoms in women include:

Back 15

-indigestion
-nausea
-vomiting
-upper back pain
-FATIGUE

Front 16

Management of Angina Pectoris focuses on maintaining ____ and _____.

Back 16

coronary blood flow and cardiac function

Front 17

Assessment of chest pain includes:

Back 17

-pain scale (0-10), PQRST
-LOC, tissue perfusion
-VS, heart rhythm, pulse ox
-Dx: 12 lead EKG, lab tests

Front 18

PQRST=

Back 18

Precipitating factors
Quality (describe pain)
Radiation
Relieving factors
Severity
Symptoms
Timing

Front 19

Goals of angina treatments are

Back 19

-reduce frequency of anginal episodes
-terminate acute anginal pain in progress

Front 20

Angina medications do 4 things:

Back 20

-slow HR
-dilate veins so heart receives less blood (less preload)
-cause heart to contract with less force (reduced contractility)
-offer heart less resistance when ejecting blood from LV (reduced afterload)

Front 21

Anti-anginal meds dilate veins so that the heart receives less blood. This reduces _____.

Back 21

preload

Front 22

Anti-anginal meds cause the heart to contract with less force. This reduces ______.

Back 22

contractility

Front 23

Anti-anginal meds offer the heart less resistance when ejecting blood from the LV. This causes reduced _____.

Back 23

afterload

Front 24

3 types of anti-anginal drugs are:

Back 24

-Nitrates
-Beta blockers
-Calcium Channel blockers

Front 25

The mainstay drug therapy for angina is _____.

Back 25

Nitrates

Front 26

The major difference between the routes of administration for nitrates is the

Back 26

onset of action and rate of elimination

Front 27

Nitrates are a _____.

Back 27

vasodilator

Front 28

Nitrates dilate arterioles and venules. Dilated arterioles cause decreased ____ and decreased _____.

Back 28

peripheral resistance
afterload

Front 29

Nitrates also dilate venules which decreases ____ and decreases ____.

Back 29

venous return and preload

Front 30

Adverse effects of nitrates include:

Back 30

-h/a
-dizziness
-orthostatic hypotension
-rash
-rapid drug tolerance

Front 31

___ is not an issue with ER nitrate tablets.

Back 31

Headache

Front 32

____ is an issue with nitrates therefore it is important to have a drug free period.

Back 32

Rapid Drug tolerance

Front 33

A major adverse effect of nitrates is

Back 33

syncope related to orthostatic hypotension

Front 34

Nursing care for nitrates includes:

Back 34

-BP and HR prior to administration
-proper and careful application
-consult MD prior to taking erectile dysfunction drugs

Front 35

____ is rapid acting and given for acute episodes of angina.

Back 35

Sublingual nitrate

Front 36

If apt with angina pectoris has CP they should

Back 36

take 1 sublingual NTG, wait 5 min.
if no relief call 911 and take 2nd
wait 5 min and take 3rd

Front 37

Propanolol
Atenolol
Metoprolol
Nadolol are types of

Back 37

Beta blockers

Front 38

If a patient has respiratory problems and angina they will take a ____ because it only works on the heart.

Back 38

selective beta blocker

Front 39

Beta 1 Blockers affect the ____.

Back 39

heart

Front 40

Beta 2 Blockers affect the ____.

Back 40

lungs

Front 41

Beta blockers cause decreased ____ and _____ which results in decreased myocardial oxygen demand and decreased angina.

Back 41

heart rate and myocardial contractility

Front 42

Beta blockers keep ___ and ____ from attaching to receptor sites when the SNS is initiated.

Back 42

epinephrine and nor-epinephrine.

Front 43

Adverse effects of beta-blockers include:

Back 43

-bradycardia
-hypotension
-dizziness
-fatigue

Front 44

A major adverse effect of beta blockers is

Back 44

rebound tachycardia

Front 45

Nurses should educate patients that beta blockers must be _____. They should not _____.

Back 45

tapered
stop abruptly

Front 46

Nursing care for beta blockers includes:

Back 46

-BP and HR prior to administration
-don't give if pulse<60
-causes fatigue (compliance)
-don't stop abruptly
-long term prevention of angina, not for immediate relief

Front 47

____ and _____ are for long term prevention of angina, NOT IMMEDIATE RELIEF!

Back 47

Beta Blockers Calcium Channel Blockers

Front 48

Procardia, Cardizem, Calan, and Norvasc are types of ______.

Back 48

Calcium Channel blockers

Front 49

CCBs dilate the ___ and ____ therefore decreasing cardiac contractility and decreasing _____ and conduction at the _____.

Back 49

coronary arteries and peripheral arterioles
automaticity
AV node

Front 50

Adverse effects of CCBs include:

Back 50

-bradycardia
-hypotension
-constipation
-edema of ankles and feet

Front 51

Pt's taking CCB's should be taught to increase ___ and ____.

Back 51

fluids and fiber

Front 52

Nursing care for CCB's includes:

Back 52

-take BP and HR prior to administration
-teach family to check radial pulse before taking med