CAD: Chronic stable angina

Question 1

What is the most common type of CV disease?

Answer 1

CAD

Question 2

CAD includes what?

Answer 2

Chronic stable angina and acute coronary syndrome

Question 3

Chronic stable angina patho

Intermittent decreased blood flow to the myocardium leads to ischemia or necrosis? What does it lead to?

Answer 3

Ischemia

Ischemia can lead to temp/pain pressure in chest

Question 4

Chronic stable angina patho

What brings the pain on?

Answer 4

Low O2 usually due to exertion

Question 5

Chronic stable angina patho

What relieves the pain?

Answer 5

Rest and/or nitroglycerin SL

Question 6

Chronic stable angina tx: Nitroglycerine

How is it given?

Answer 6

SL

Question 7

Chronic stable angina tx: Nitroglycerine

What does it cause?

Answer 7

Venous and arterial dilation —dilation causes decrease in preload and after load

Question 8

Chronic stable angina tx: Nitroglycerine

Dilates and causes decrease in preload and after load. It also causes dilation of ____ which will increase blood flow to actual heart muscle (myocardium)

Answer 8

Cornary arteries

Question 9

Chronic stable angina tx: Nitroglycerine

How often to take?

Answer 9

Take 1 every 5 min for 3 doses

Question 10

Chronic stable angina tx: Nitroglycerine

Ok to swallow?

Answer 10

No

Question 11

Chronic stable angina tx: Nitroglycerine

How to store

Answer 11

Dark, glass bottle
Dry
Cool

Question 12

Chronic stable angina tx: Nitroglycerine

How it feels when its in mouth

Answer 12

May or may not burn or fizz

Question 13

Chronic stable angina tx: Nitroglycerine

T/F: HA is to happen

Answer 13

T

Question 14

Chronic stable angina tx: Nitroglycerine

Call doc for HA?

Answer 14

NO..this is expected to happen, nothing life-threatening. don’t need to call doc

Question 15

Chronic stable angina tx: Nitroglycerine

How often to renew?

Answer 15

Every 3-5 months

Question 16

Chronic stable angina tx: Nitroglycerine

What if it is spray–how often to renew?

Answer 16

Every 2 years

Question 17

Chronic stable angina tx: Nitroglycerine

After giving this, what should BP do?

Answer 17

Decrease

Question 18

Never leave who?

Answer 18

An unstable client

Question 19

Take one NTG SL, after 5 min if chest pain/discomfort is unimproved or worsened, do what?

Answer 19

Activate emergency response

Question 20

Chronic stable angina tx: BB

What do BB do to BP, P and myocardial contractility?

Answer 20

Decrease

Question 21

Chronic stable angina tx: BB

What does this do to workload of heart?

Answer 21

Decrease

Question 22

Chronic stable angina tx: BB

BB block beta cells. These are the receptors sites for what?

Answer 22

Catecholamines (epi and norepi)

Question 23

Chronic stable angina tx: BB

Decreased contractility so ___ to CO?

Answer 23

Decrease

Question 24

Chronic stable angina tx: BB

Decrease or increase workload of heart?

Answer 24

Decrease

Question 25

Chronic stable angina tx: CCB Examples?

Answer 25

Nifedipine Amlodipine Verapamil Diltiazem

Question 26

Chronic stable angina tx: CCB What do these do to BP?

Answer 26

Decrease

Question 27

Chronic stable angina tx: CCB These cause vasodilation of the ____

Answer 27

Arterial system (after load)

Question 28

Chronic stable angina tx: CCB Dilate what?

Answer 28

Coronary arteries

Question 29

Chronic stable angina tx: CCB 2 benefits?

Answer 29

Decrease after load | Increase oxygen to muscle

Question 30

Chronic stable angina tx: Acetylsalicyclic acid What is this drug?

Answer 30

Aspirin --anti platelet

Question 31

Chronic stable angina tx: Acetylsalicyclic acid How is dose determined?

Answer 31

By doc (81-325 mg)

Question 32

Chronic stable angina: Education/teaching Rest how often? Avoid what? (3) When to exercise after eating? How to dress?

Answer 32

Rest frequently Avoid overeating, excess caffeine/drug that increase HR, and isometric exercises (lifting weights) Wait 2 hours after eating to exercise Dress warmly in cold weather (any temp. extreme can precipitate an attack)

Question 33

Chronic stable angina: Education/teaching When to take nitro? Stop what? Lose what? Reduce what?

Answer 33

Take nitro prophylactically Stop smoking Lose weight Reduce stress

Question 34

Cardiac cauterization--Pre procedure Ask about what?

Answer 34

If they are allergic to shellfish or iodine

Question 35

Cardiac cauterization--Pre procedure What do we want to check because dye is excreted here?

Answer 35

Check kid function bc dye is excreted through kidneys

Question 36

Cardiac cauterization--Pre procedure What may be ordered pre procedure if they have kidney problems and why?

Answer 36

Acetyclysteine -- helps protect the kidneys

Question 37

Cardiac cauterization--Pre procedure What does it feel like when dye is injected?

Answer 37

Hot shot

Question 38

Cardiac cauterization--Pre procedure T/F: Palpitations normal

Answer 38

T

Question 39

Cardiac cauterization--Post procedure Monitor what? Watch what? Assess what?

Answer 39

Monitor VS Watch puncture site for bleeding/hematoma formation Assess extremity distal to puncture site (5Ps)

Question 40

Cardiac cauterization--Post procedure What are 5Ps?

Answer 40

``` Pulselessness Pallor Pain Paresthesia Paralysis ```

Question 41

Cardiac cauterization--Post procedure Position after?

Answer 41

Bed rest Flat Extremity straight for 4-6 hr

Question 42

Cardiac cauterization--Post procedure Major complication ?

Answer 42

Bleeding

Question 43

Cardiac cauterization--Post procedure Report what ASAP?

Answer 43

Pain (could be arterial occlusion; bleeding)

Question 44

Cardiac cauterization--Post procedure What if client is on metformin?

Answer 44

Hold the med for 48 hours post procedure! Worried about kidneys!