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MedSurge 3 > Acute Coronary syndromes > Flashcards

Acute Coronary syndromes Flashcards

1
Q

What is coronary artery disease?

A

an umbrella term that includes angina and acute coronary syndrome

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2
Q

Ischemia

A

insufficient oxygen is supplied to meet requirements

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3
Q

Infarction

A

necrosis when ischemia is prolonged causing decreased perfusion and irreversible damage

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4
Q

what is the difference between stable and unstable angina?

A

stable is predictable and occurs with exertion
unstable is new onset, poorly relieved by NTG

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5
Q

What is angina pectoris?

A

chest pain caused by temporary imbalance of oxygen supply and the demand for oxygen

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6
Q

What is Chronic stable angina?

A

chest discomfort that occurs with moderate to prolonged exertion due to FIXED atherosclerotic plaque

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7
Q

Typical 3 features of chronic stable angina

A

substernal chest pain or heaviness
precipitated by stress
relieved by rest or NTG

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8
Q

What is a diagnostic indicator for stable angina?

A

cardiac biomarkers like troponin are not elevated

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9
Q

what is the usual dosage for plavix?

A

75 mg/day

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10
Q

What is acute coronary syndrome?

A

used to describe patients with unstable angina or acute MI

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11
Q

Vasospastic angina

A

chest pain from coronary artery spasm and occurs at rest

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12
Q

Myocardial infarction

A

myocardial tissue is deprived of oxygen

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13
Q

what are the 2 types of MIs?

A

Non ST segment elevation (NSTEMI)
ST elevation (STEMI)

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14
Q

How does an NSTEMI present on an EKG?

A

ST segment depression and T inversion

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15
Q

How does a STEMI present on a EKG?

A

ST segment elevation

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16
Q

What are the cardiac biomarkers?

A

Troponin T
Troponin I
CK-MB
Myoglobin

17
Q

Characteristics of Unstable angina

A

pressure lasting longer than 15 min
poorly relieved by NTG
severe activity limitation
increase in number of attacks

18
Q

What does the T-wave inversion represent for NSTEMI?

A

some ischemia

19
Q

What does the ST elevation represent for STEMI?

A

zone of injury

20
Q

What happens over a 2-3 month period after an infarction?

A

ventricular remodeling

21
Q

What is the problem with ventricular remodeling?

A

scar tissue decreases left ventricular function
causes HF
does not contract or conduct electrically

22
Q

What is the immediate tx for a patient presenting with MI symptoms?

A

Morphine
Oxygen (NC)
Nitroglycerin
Aspirin 324-650mg

23
Q

Dosage for sublingual NTG

A

0.4 mg 5 min up to 3 doses for stable angina
multiple doses titrated for NSTEMI

24
Q

Nursing management for ACS

A

Managing acute pain
increase perfusion
identify and manage dysrhythmias
monitor and manage heart failure

25
Q

what are some diagnostic procedures to rule out cardiac etiology?

A

stress test
imaging
angiogram

26
Q

What is a coronoary angiogram?

A

catheter is snaked through femoral artery and contrast is injected to visualize blockages

27
Q

What is an angioplasty?

A

a balloon is used to stretch the vessels of the wall and put in a stent

28
Q

what are some things to take into consideration for an angiogram?

A

allergies
bleedings
pulses
creatinine

29
Q

What is a CABG?

A

coronary artery bypass graph
disease in multiple areas
harvest veins from body and create bypass graphs

30
Q

what are examples of percutaneous therapies?

A

angiogram and angioplasty

31
Q

what are some complications of CABG?

A

bleeding
cardiac tamponade
change in LOC
hypo or hypertension

32
Q

What do you assess after a CABG?

A

distal pulses

33
Q

what medication can interact with nitroglycerin?

A

Viagra

34
Q

Why would we do a transesophageal echo? (TEE)

A

to get a clearer view
to look for clots or vegetation

35
Q

what is the pre procedure for cath lab?

A

vital signs
auscultate lungs
assess pulses
allergy hx
make sure signed consent is done
analyze labs
withhold anticoagulants or diuretics

36
Q

potential complications for cath lab

A

tamponade
hematoma
retroperitoneal bleeding

37
Q

post cath nursing interventions

A

assess VS every 15 min
keep leg straight for 2-6 hrs
assess site

38
Q

what is cardiogenic shock?

A

heart can’t pump enough to meet demands

39
Q

s/s of cardiogenic shock

A

tachycardia
hypotension
cold clammy skin
tachypnea

MedSurge 3 (28 decks)

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