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40 Cards in this Set
- Front
- Back
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Atherosclerosis |
Soft deposits of fact that Hardin with age consequently hardening of the arteries although it can happen in any artery of the body fatty deposits prefer the coronary arteries |
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CRP |
a protein produced by the liver is a non-specific marker of inflammation it increased in levels with patients with CAD |
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Modifiable risk factors for CAD |
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CAD diet |
Decrease saturated fat such as red meat eggs and whole milk products and increase complex carbohydrates fatty fish and tuna |
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Statins |
Cholesterol lowering agents inhibit synthesis of cholesterol in the liver decreases LDL, increases HDL nurse needs to monitor for liver damage and myopath NIACIN does also |
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Chronic stable angina |
A constructive squeezing heavy choking or suffocating sensation usually with the same symptoms intensity and duration pain last for only a few minutes and subside swim precipitating factor is relieved |
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Long-acting nitrates |
Reduces angina side effect headaches orthostatic hypertension |
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Cardiac catherization / coronary angiography |
Visualizes blockage opens blockage invasive procedure nurse needs to check for allergies to shellfish BUN/ creatinine levels no metformin before procedure Noah's patient is on aspirin or plavix and pulses in feet |
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Placement of coronary stent |
First line for unstable angina and MI after procedure patient should not have EKG changes and patient should not have chest pain before procedure EKG will show ST segment depression and/or T wave inversion indicating ischemia |
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Short acting nitrates |
Dilating peripheral blood vessels which decreases preload dilating coronary arteries and collateral vessels |
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Collaborative care chronic stable angina |
Decreased oxygen demand or increase oxygen supply continuous emphasis on reduction of risk factors Antiplatelet, cholesterol-lowering drug, nitrates, b blockers, and calcium channel blockers |
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Acute coronary syndrome |
Associated with a one stable atherosclerosis plaque the once stable plaque rupture exposing the intima to blood and stimulating platelet aggregation and local vasoconstriction with thrombus formation, copying unstable angina |
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Partial occlusion of coronary artery |
Unstable angina or NSTEMI |
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Total occlusion of coronary artery |
STEMI |
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Unstable angina |
New onset occurs at rest, worsening pattern, increase in frequency, unpredictable, medical emergency, symptoms in women may be more vague |
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Myocardial infarction |
Results from ischemia greater than 20 minutes causing irreversible myocardial cell death, necrosis of entire thickness of myocardium takes 4 to 6 hours lot of contractile functions |
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Clinical manifestations of myocardial infarction |
Severe immobilizing chest pain not relieved by rest, position change, or nitrates, catecholamine release their first increased heart rate and blood pressure then decrease blood pressure secondary to decreased coronary output crackles abnormal heart sounds s3 s4 nausea vomiting fever in the first 24 hours systemic inflammation process |
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MI healing |
Pathological Q wave, 10-14 days heart still weak and vulnerable 6 weeks later part is said to be healed but is less compliant normal myocardial muscles will hypertrophy then dial 8 in an attempt to compensate for the infarct muscle |
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Most common complication of myocardial infarction |
Dysrhythmias, Life-threatening dysrhythmias often seen with anterior mi |
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Prinzenetal's angina |
Occurred at rest due to spasm of a major coronary artery may occur with or without CAD, not precipitated by increased demand chest pain marks with transit ST segment elevation |
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Cardiogenic shock |
Occurs because of severe left ventricular failure requires aggressive management |
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Complications of myocardial infarction |
Papillary muscle dysfunction, causes mitral valve regurgitation ventricular aneurysm myocardial wild become thin and bottoms out during contraction leads to heart failure dysrhythmias and angina |
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Acute pericarditis |
May result in cardiac temponade, chest pain, pericardial friction rub, ECG changes treated with anti-inflammatory agents |
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Acute coronary syndrome initial |
12 lead ECG semi Fowler's position, oxygen, IV access, nitro, aspirin trouble, morphine |
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Emergent PCI |
The first line of treatment for patients with confirmed mi, the advantages is alternative to surgical intervention performed with local anesthesia the patient is ambulatory 24 hours after the procedure the hospital stay is approximately 1I know how it 5 days55, and 6 |
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Thrombolytic therapy |
When PCI is not available, stops infarction process by dissolving thrombus, within 6 hours of onset of symptoms given IV, nurse draw blood from 223 IV site monitor closely for bleeding and assesses for reperfusion indicated by the return of St segments to baseline, IV heparin to prevent reocclusion |
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Who gets coronary surgical revascularisation |
Patients with frail medical management, have left main coronary artery or three vessel disease, or not a candidate for PCI examples lesions are long are difficult to assess, have failed PCI with ongoing chest pain, have DM |
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B-adrenergic blocker |
Decrease myocardial oxygen demand by reducing heart rate, blood pressure, and contractility the patient who is not at risk for complications such as cardiogenic shock in the first 24 hours of MI reduces the risk of reinfarction and ventricular fibrillation the continuation of these medications are indefinite, after CABG beta blockers should be started as soon as possible unless contraindicated |
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Angiotensin-converting enzyme inhibitors ACE inhibitors |
ACE inhibitors should be started and continue indefinitely and patience recovering from STEMI with EF </= 40% they help prevent ventricular remodeling and prevent or slow the progression of heart failure |
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Anti Disraeli address |
Dysrhythmias are most common complication after and MI |
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Drug thsrapy |
Lopid-zetia lower LDL increase HDL GI- issue ASA for most patients if it is contraindicated for women plavix is used |
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Coronary artery bypass graft |
Consist of placement of conduit to transport blood between the a order and other major artery and the myocardium distal to the blockage cabbage requires opening of the chest cavity, with minimal invasive there are several small incisions between the ribs the heart is slow with beta blockers or stop temporarily with adenosine any mechanical immobilize the operative site |
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Cardiopulmonary bypass how it works |
Blood is diverted from the patient's heart to a machine where it is oxidized and returns the air pump to the patient this allows the surgeon to operate on a quiet night beating bloodless hard while perfusion to vital organs is maintained |
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Internal mammary artery and saphenous Vein graft |
The internal mammary artery is the most common lottery for BiPAP grass and has a 10-year vacancy rate, the Saphenous has a 5260 after 10 year right |
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IV nitroglycerin |
Swallow therapy is to reduce angina and improve coronary blood flow it works by decreasing preload and afterload while increasing the myocardial oxygen supply the onset is immediate titrate nitroglycerin still control and stop chest pain monitor blood pressure |
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Morphine sulfate |
Is the drug of choice if nitros do not relieve angina it is a Visio dilator decreases cardiac workload by lowering myocardial oxygen consumption reducing contractility and decreasing blood pressure and heart rate in addition morphine can help reduce anxiety and fear monitor for bracket penia and hypotension |
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Beta blockers |
Decrease myocardial oxygen demand by reducing heart rate and blood pressure and contractility |
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ACE inhibitors |
For acute coronary syndrome should be started in patients should remain on this indefinitely impatiens recovering from skinny ACE inhibitors can prevent ventricular remodeling and prevent or slow progression to heart failure for patient who cannot tolerate a season hamburgers angiotensin receptor blockers should be considered |
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CABA- postoperative nursing care |
Assessing the patient for bleeding hemodynamic monitoring checking fluids status replacing electrolytes as meeting restoring temperature example warm blanket post-operative dysrhythmias specifically atrial dysrhythmias are common in the first 3 days after surgery post operative atrial fibrillation occurs 20% to 50% of patients beta blockers should be restarted as soon as possible after surgery unless contraindicated to reduce the incidence of AF |
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Postoperative nursing care for radial artery harvest |
Postoperative care includes monitoring for sensory motor function distal to the hand patient should be on calcium channel blockers for approximately 3 months to decrease the incidence of atrial spasms at the armoire anastomosis site |
