Cardio dse CAD Flashcards by christian de pedro

Coronary artery dse

race common:
A___
A___

african

american

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gender common:

male

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Age common;

older than 50

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modifiable factor;
High____
high_____

carbohydrates

fat

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modifiable factor:
hyper___

hyperlipidemia

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modifiable factor
Low ____

low estrogen

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modifiable factor; disorder
D___
H____
D____

diabetes mellitus
hypertension
dysrhythmias

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types of CAD

fat deposition and fibrous formation

atherosclerosis

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types of CAD

hardening of blood vessel

arteriosclerosis

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types of CAD

chest pain and chest discomfort

angina

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types of CAD

Heart attack

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causes of myocardial ischemia

A______
A______
V_______
V_______

Arterioclerosis
atherosclerosis
vasocompression
vasospasm

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medication can cause myocardial ischemia/angina?

B
D
E
T

bronchidilator
decongestant
epinephrine
thyroid replacement

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example of bronchodilator

aminophylline

theophylline

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ecg for ischemia

inverted T wave

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nursing disgnosis for myocardial ischemia

altered tissue perfusion

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first nursing action for chest pain?

morphine

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best nursing position for chest pain

semi fowlers

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sign?

clenched fist held over the chest to describe chest pain

levine sign

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chest pain relieved by REST and NITROGLYCERIN

angina

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chest pain UNRELIEVED by rest and nitroglycerin

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chest pain lasting less than 10-15mins

angina

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chest pain lasting more than 20mins

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chest pain related to arteriosclerosis

stabke angina

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chest pain brought by increase physical activities

stabke anginA

chest pain related to atherosclerosis

unstable angina

chest pain also called PREINFARCTION angina

unstable angina

chest pain even at rest/ increased physical activities

unstBle angina

chest pain most likely progress to MI

unstable angina

chest pain also called prinzemetal angina

variant angina

chest pain related to spasm

variant angina

chest pain related to cold temperature

variant angina

an ANGINA that patient is asymptomTic but ecg tracing reveal INVERTED T WAVE

silent angina

drug induced angina pectoris

LUDWIG angina

types of MI infarction is in endocardial layer of the heart

subendocardial infarction

types of MI ecg tracing: ST depresion

subendocardial i farction

types of MI infarction goes beyond endocardial layer it reaches myocardial to pericardial

Transmural Infrction

types of MI ecg tracing for transmural i farction

ST elevation

ecg zone of ischemia: 2 answer

inverted t wave st depresion

ecg zone of infarction

pathological Q wave

ecg zone of injury

ST elevation

diagnostic test for CAD an ambulatory ecg

holter test

diagnostic test for CAD how many hours consume when using Holter test

24-48hrs

``` what to avoid during Holter test? E S S S ```

electric device swimming shower sweating

diagnostic test for CAD exammining the heart to check blood supply to the heart muscle with the use of camera. radioactive liquids is injected to blood stream serve as a tracer

thallium scan or muga scan

diagnostic test for CAD used dye to detct blockage in coronary arteries caused by plaque build up

coronary angiography or cardiac catheterization

cardiac catheterization mgt. prior to procedure

void prior to procedure

cardiac catheterization what to check before and after procedure

peripheral and distal pulses

cardiac catheterization what laboratory result should check prior to procedure

BUN & CREA

cardiac catheterization post procedure best position 1st : 2nd :

1st Flat on bed 2nd HOB elevated <20degree

cardiac catheterization equipment use to avoid bleeding post procedure

sandbag

cardiac enzymes sensitive to brain injury

CPK BB

cardiac enzymes sensitive to skeletal muscle injury

CPK MM

cadiac enzymes sensitive to cardiac muscle injury

CPK MB

cardiac enzymes sensitive to small infarct and cardiac injury

trop T

cardiac enzymes sensitive to large infarcts and skeletal muscle injury

TROP I

cardiac muscle sensitive to skeletal muscle and cardiac muscle injury

MYOGLOBIN

managemnt for CAD ``` diet: high- high- Low- Low- increase- ```

``` high protein high fiber low fat low carbohydrate increase fluid ```

mgt for CAD analgesic: best time to give:

morphine sulfate before pain become severe

mgt CAD antidote for morphine:

naloxone/narcan

``` mgt for CAD Medication: B C S antiplatelet anticoagulant T V A ```

``` betarblocker calcium channel blocker stool softener anticuagulant- heparin/warfarin antiplatelet- aspirin thrombolytics vasodilators antilipidemics ```

Mgt. for CAD antidote for aspirin *2 answers

activated charcoal sodium bicarbonate

Mgt for CAD antidote for heparin

protamine sulfate

Mgt for CAD antidote for warfarin

vit k

MGT for CAD thrombolytic drug: S T A

Streptokinase TPA alteplase

MGT for CAD antidote for thrombolytics brand/generic

amicar (aminocarproic acid)

mgt for CAD streptokinase is contraindicated in which dse?

immunocompromised, streptococcal infection

``` nursing alert: aspirin heparin warfarin ROUTE? aspirin - heparin - warfarin (coumadin) - ``` enoxaparin -

aspirin -orem heparin -iv coumadin -orem enoxaparin - SUB Q

``` nursing alert; aspirin heparin warfarin best diagnostic test? aspirin- heparin- warfarin- ```

aspirin- platelet fxn test heparin- PTT warfarin- PT

nrsing alert; aspirin heparin warfarin PTT normal values- PTT theraputic values- PT normal value- PT theraputic value-

PTT normal 20-36secs PTT theraputic 60-80secs PT normal 9-12secs PT theraputic <30secs

nrsing alert; aspirin heparin warfarin clotting time normal values clotting time therraputic value INR normal value INR theraputic value

clotting time normal- 5-10mins clotting time theraputic- 16-20mins *theraputic level is 2-2.5x higher INR normal- 2-3 INR theraputic- <4.5 *theraputic level is 2-2.5x higher

Nrsing alert: aspirin contraindicated in what condition of the patient?

pregnant

nursing alert; aspirin heparin warfarin may be given to pregnant because cannot cross the placenta

heparin

nursing alert; warfarin contraindicated in what condition of the patient?

pregnant

nursing alert; aspirin patient is for surgery or any invasive procedure.... when will you discontinue?

48hrs or 2days prior to surgery

nursing alert; Heparin patient is for surgery or any invasive procedure.... when will you discontinue?

1 day prior to surgery

nursing alert; warfarin patient is for surgery or any invasive procedure.... when will you discontinue?

1 week prior to surgery

nursing alert; nitroglycerin tablet storage; D- D- route of administration-

dry dark sublingual

nursing alert: nitroglycerin tablet administration time interval per tablet- maximum doses- how many tablet will you call AP if unrelieved?

5mins interval 3 doses after 3rd tablet if patient is still unrelieved

nursing alert: nitroglycerin patch Rule: Do not touch the medicated surface because it causes _______

hypotension

nursing alert: nitroglycerin PATCH administration Rule: to avoid nitroglycerin tolerance time of administration is important. Day time nitro is- night time nitro is-

daytime nitro is on | night time nitro is off

MGT for CAD Nursing alert 2 vasodilator drug

nitroglycerin tablet nitroglycerin patch

nursing alert; vasodilator drug contraindicated when taking nitroglycerin

viagra (sildenafil) cause fatal hypotension

``` nursing alert: antilipidemics 3 types of drug H- F- B- ```

HMG-COA reductase inhibitor fibric acid derivative bile acid sequestrant

nursing alert; HMG coa reductase inhibitor known drug-

atorvastatin

nursing alert; Fibric Acid Derivative known drug- G______ (L_____) generic(brand name) F_______

gemfibrozil (lopid) | fenofibrate

nursing alert; Bile Acid Sequestrants known drug- C______ (Q______) generic(brand name)

cholestyramine (questran)

``` nursing alert: antilipidemics (possible answer) HMG COA reductase inhibitor fibric acid derivative bile acid sequestrant ``` teratogenic?

HMG

``` nursing alert: antilipidemics (possible answer) HMG COA reductase inhibitor fibric acid derivative bile acid sequestrant ``` hepatotoxic?

HMG

``` nursing alert: antilipidemics (possible answer) HMG COA reductase inhibitor fibric acid derivative bile acid sequestrant ``` action: decrease LDL and increase increase HDL increasing cholesterol synthesis

HMG

``` nursing alert: antilipidemics (possible answer) HMG COA reductase inhibitor fibric acid derivative bile acid sequestrant ``` action: decreases triglycerides

Fibric Acid derivatives

``` nursing alert: antilipidemics (possible answer) HMG COA reductase inhibitor fibric acid derivative bile acid sequestrant ``` action: binds with fats and excreted via stool

Bile Acid sequestransts

``` nursing alert: antilipidemics (possible answer) HMG COA reductase inhibitor fibric acid derivative bile acid sequestrant ``` side effect: constipation, decrease fat soluble vitamin (adek) absorption

Bile Acid Sequestrants

``` nursing alert: antilipidemics (possible answer) HMG COA reductase inhibitor fibric acid derivative bile acid sequestrant ``` given only at night

HMG COA recductase inhibitor

``` nursing alert: antilipidemics (possible answer) HMG COA reductase inhibitor fibric acid derivative bile acid sequestrant ``` it causes cataract

HMG COA recductase inhibitor

``` nursing alert: antilipidemics (possible answer) HMG COA reductase inhibitor fibric acid derivative bile acid sequestrant ``` it causes rhabdomyolysis

HMG COA recductase inhibitor

``` nursing alert: antilipidemics (possible answer) HMG COA reductase inhibitor fibric acid derivative bile acid sequestrant ``` Hepatotoxic effect

HMG COA recductase inhibitor

Surgical Mgt for CAD: C- P- P-

CABG- coronary artery by pass Grafting PTCA- percutaneous transluminal coronary angioplasty Pacemaker Implantation

Surgical Mgt for CAD: CABG, PTCA, Pacemaker Open heart surgery, to reroute the blood flow

CABG

Surgical Mgt for CAD: CABG, PTCA, Pacemaker balloon tipped catheter use to open/ dilate obstructed artery

PTCA

Surgical Mgt for CAD: CABG, PTCA, Pacemaker for SA/AV node malfunctioning

Pacemaker

Surgical Mgt for CAD: CABG common blood vessel used: M________ artery S_________ veins S_________artery

Mammary artery saphenous veins subclavian artery

Surgical Mgt for CAD: PTCA what medicine used for 3-6mos post PTCA

antiplatelet

Nursing ALert: POST Open Heart Surgery transporting patient from OR to C-ICU __RN __anesth

2 RN | 2 anesth

``` Nursing ALert: POST Open Heart Surgery Prioritization of care: (rank the FF) airway VS Dressing Tubes and Drainage ```

1 airway 2 VS 3 dressing 4 tubes/drainage

Nursing Alert; Open heart Surgery Normal cvp: increase CVP= decrease CVP=

Normal cvp: 2-8cm H2o or 2-6mmhg increase CVP= hypervolemia decrease CVP= hypovolemia

Nursing Alert; Open heart Surgery Normal urine output: Normal GFR:

Normal urine output: 30-60ml | Normal GFR: 120ml/minute

Nursing Alert; Open heart Surgery chest tube drainage normal drainage 24-48hrs:

<100ml/ hr

Nursing Alert; Open heart Surgery complication: Air embolism best position:

Head lower than his feet and on LEft side lying

Open heart Surgery: Complication accumulation of fluid in pericardium causing compression of the heart

cardiac tamponade

Nursing care: Cad best position

semi fowlers position

Nursing care: Cad first action

Analgesic

Nursing care: Cad weeks to resume sexual activity

4-6weeks after attack or more than 10 steps of stairs or 2 flights without chest discomfort

Nursing care: Cad best time for sex

morning

Nursing care: Cad Best position for sex

sidelying

``` Open heart Surgery: Complication: cardiac tamponade H M T D D P ```

``` Hypotension tachycardia dyspnea mufflead heart sounds(pericardial friction rub pulsus paradoxus ```

Open heart Surgery: Complication: cardiac tamponade a heart rate or pressure that decrease during inhalation

pulsus paradoxus

Open heart Surgery: Complication: cardiac tamponade Surgical Mgt: P P

pericardiocentesis-fluid pericardioectomy-part

Open heart Surgery: Complication: cardiac tamponade Medication V O

vasopressor- Levophed-increase BP Oxygen

Cardio dse CAD Flashcards

CAD (119 cards)