Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
43 Cards in this Set
- Front
- Back
- 3rd side (hint)
|
Define Cardiovascular Disease.
|
the class of diseases that involve the heart or blood vessels. While the term technically refers to any disease that affects the cardiovascular system, it is usually used to refer to those related to atherosclerosis (arterial disease).
It the leading cause of mortality in the US for both men and women. Understanding the pathophysiology allows nuses to anticipate and plan interventions |
|
|
|
Define Atherosclerosis.
|
hardening of the arteries. over 75% of deaths are as a result of CVD. it is the primary underlying cause of PAD, and another underlying cause for CAD and CVAs
|
|
|
|
The Right Coronary Artery Supplies...
|
right atrium and ventricle, SA and AV nodes, posterior portion of the LV
|
|
|
|
The Left Anterior Descending Supplies...
|
anterior left ventricle, lateral left ventricle, and the intraventricular septum
|
|
|
|
Define Atherosclerosis
|
a hardening of the arteries.
it is an immune inflammatory disorder, causing injury to the intimal lining. it is progressive and characterized by plaque formation in the intimal lining of the medium/large arteries |
|
|
|
What is the primary cause of peripheral artery disease (PAD)?
|
Atherosclerosis
|
|
|
|
What does the right coronary artery supply blood to?
|
right atrium, right ventricle, SA node, AV bundle, posterior portion of the left ventricle
|
|
|
|
What does the left anterior descending (LAD) artery supply blood to?
|
anterior left ventricle, lateral left ventricle, and the interventricular septum
|
|
|
|
What does the Left Circumflex artery (LCA) supply blood to?
|
the left atrium and the posterior left ventricle
|
|
|
|
Sources of chronic injury to the cardiovascular system. (5)
|
1. HTN
2. Smoking 3. Viruses 4. High Cholesterol 5. High Glucose |
|
|
|
How does damage occur to the artery?
|
factors that damage the endothelium. monocytes enter the intimal lining and become macrophages. they oxidize the LDL and the macrophages engulf LDL and become "foam cells" and a group of foam cells becomes a 'fatty streak'
|
|
|
|
What is an atheroma?
|
An atheroma (fibrous plaque) is a basic lesion associated with atherosclerosis, which develops from fatty streaks. It is an accumulation of lipids, collagen, scar tissue, and vascular smooth muscle.
|
|
|
|
Define Advanced Atherosclerosis.
|
The atheroma becomes calcified. These can stay in place to narrow the lumen and decrease blood flow (ischemia). This eventually causes the plaque to rupture and cause clotting in the lumen. Usually they heal, but leave behind scar tissue and cause stenosis (further narrowing). They can also travel and cause complete closure, which will cause ischemia and infarction.
Around these plaques the blood has to push harder to get through, causing a net aneurysm. This makes the vessel walls weakened and can rupture. |
The atheroma becomes calcified, causing decreased blood flow. A thrombus forms that can break off to become an embolus- this occludes the CAs resulting in injury/infarction, which initiates a coagulation cascade with platelet aggregation at the site. |
|
|
What is adhesion?
|
platelets bind to a receptor
|
|
|
|
What are the platelet changes associated with advanced atherosclerosis?
|
1. Activation
2. Adhesion 3. Aggregation atherosclerosis causes endothelial damage. the tear in the endothelium of the arteries releases collagen. Collagen causes the platelets to change shape and then they leak serotonin. This serotonin then activates the glycoprotein receptors, and binds to Von Willebrand factors. this forms fibrin strands. Platelets bind to a receptor site in the intimal lining. The platelets than clump together. |
|
|
|
What is activation?
|
platelets change shape, and release thromboxane A2/Serotonin, activate glycoproteins IIb/IIIa receptors to bind with Von Willebrands Factor- they form fibrin strands
|
|
|
|
What is aggregation?
|
the platelets clump together. (ASA and Gp IIb/IIIa inhibitors are used to stop this process)
|
|
|
|
AHA Classification of Lesion Progression. Define Type One.
|
lesions are small and not visible to the unaided eye. can be present in children
|
|
|
|
AHA Classification of Lesion Progression. Define Type Two/Three
|
Precursor lesions, which can form as early as the teenage years.
II- fatty streaks III- bridge to atheromas |
|
|
|
AHA Classification of Lesion Progression. Define Type Four/Five.
|
Significant narrowing/ischemia.
|
|
|
|
Risk Factors for developing Type Four/Five Atherosclerosis Lesions
Non-Modifiable vs. Modifiable |
Non-Modifiable: age (women over 45, men over 55), genetic predisposition, gender, race.
Modifiable: smoking, HTN, DM, obesity, inactivity, cholesterol, stress, metabolic syndrome, chronic kidney disease |
|
|
|
What is LDL, and what are the important blood levels to know?
|
"bad" cholesterol.
under 130 if low risk under 100 if high risk under 70 if very high risk if your cholesterol is under 70, you can actually REVERSE atherosclerotic changes! |
|
|
|
What is HDL, and what is the appropriate level?
|
"good" cholesterol
over 40 for men over 50 for women |
|
|
|
What is collaborative MGMT for hypercholesteremia?
|
decrease the serum levels, get that LDL down!! Physical activity is a must. diet changes per the AHA guidelines. control HTN, CKD, and metabolic syndrome.
|
|
|
|
Define hypercholesterolemia.
|
Hypercholesterolemia is the presence of high levels of cholesterol in the blood. it is NOT a disease, but a metabolic derangement secondary to many diseases
|
|
|
|
What are the medications for hypercholesterolemia?
|
Statins and Bile Acid Sequestrates
|
|
|
|
What are Statins?
|
Statins decrease the LDL by creating more LDL receptors in the liver cells.You must watch the LFTs closely, because not all patients are candidates for statins.
|
|
|
|
What are bile acid sequestrates?
|
they bind to cholesterol and excrete it via the bowel. These are effective meds with fewer side effects and be more tolerant for the patient.
|
|
|
|
What is Hyperlipidemia?
|
high levels of lipids, which include: high LDL, low HDL, high cholesterol, and high triglycerides
|
|
|
|
What does S3 usually indicate?
|
CHF/fluid overload. occurs after the S2
|
|
|
|
What does S4 usually indicate?
|
post-mi (the atria may contract more forcefully)
|
|
|
|
What information do you get from an EKG?
|
rhythm, ischemia, injury, or infarct
|
|
|
|
What does a Holter monitor assess?
|
It helps to diagnose a suspected arrhythmia.
|
|
|
|
What does a stress test measure, and what are the two ways it can be done and why?
|
Exercise induced ischemia with meds or without.
with meds: for the exercise intolerant with treadmill: for those who can tolerate the exercise |
|
|
|
What is a percutanious coronary intervention?
|
also known as angioplasty, it is a therapetuic procedure used to treat narrowed coronary arteries of the heart.
PTCA |
|
|
|
How is Percutaneous Transluminal Coronary Angioplasty performed?
|
inflating a balloon to crush plaque buildup in the walls of the artery.
|
|
|
|
What is an Atherectomy?
|
it is usually performed in conjunction to PCI, it is a minimally invasive method of removing plaque. this involves a scraping blade in the artery that scrapes buildup off of the arterial wall instead of just crushing it against the walls.
|
|
|
|
What are the two types of Cardiac catheterization?
|
Right sided (measure) and Left sided (visualize)
|
|
|
|
How is a Right Sided Cardiach Cath performed and what does it find?
|
catheter is inserted into the right atrium, right ventricle, and then the pulmonary artery. it measures the pressures in chambers of the heart, cardiac output, and blood gas measurement.
|
|
|
|
What does a left sided cardiac catheter visualize?
|
Visualizes coronary arteries, locates areas of infarcts with radioisotopes, percutaneous transluminal coronary angioplasty.
|
|
|
|
What are the nursing interventions Pre cath?
|
initial assessment/history
vital signs IV access monitor vascular checks |
|
|
|
What are the nursing interventions during the cardiac catheterization?
|
prepare the insertion site
monitor vital signs admin IV concious sedation monitor rhythm abnormalities assist with interventions |
|
|
|
Nursing interventions after a cardiac catheterization are...
|
depends on the closing of the site, but essentially
collagen/suture/pressure no driving/bathing/avoid stairs no submerging the access site for approx 7 days. CAD risk factors. |
|
