Cardiovscular Disorders - Angina Flashcards Preview

NUR 102- Test 4 > Cardiovscular Disorders - Angina > Flashcards

Flashcards in Cardiovscular Disorders - Angina Deck (20):
1

Cardiovascular Disorders - Angina

What is angina?

It is chest pains that occurs when theres is a temporary imbalance between myocardial blood supply and demand.

2

Cardiovascular Disorders - Angina

Briefly describe stable angina. When does it occur? How is it normally releived?

It is the common and predictable form of angina. It occurs with a known amount of activity or stress. It is relieved by rest and nitrates.

3

Cardiovascular Disorders - Angina

Describe unstable angina. How does it occur? Describe the pain. What is the client at risk for?

It is chest pain that occurs with increasing frequency, severity and duration. The pain is unpredictable and may occur at rest. Clients are at risk for MIs.

4

Cardiovascular Disorders - Angina

What is Prinzmetal's angina? When does it occur? What causes Prinzmetal's angina?

Is atypical angina (chest pain) that occurs without an identified precipitating cause, usually the same time each day, often waking the client from sleep.

It is caused by coronary artery spasm.

5

Cardiovascular Disorders - Angina

What is the CARDINAL manifestation of angina?

Chest pain.

6

Cardiovascular Disorders - Angina

What are other manifestations of angina?

Pain radiating to neck, arms, shoulder, or jaw
Tight, squeezing, constricting, or heavy sensation
SOB
Pallor
Anxiety

7

Cardiovascular Disorders - Angina

What is the "gold standard" diagnostic test used to evaluate the coronary arteries in a client with angina?

Coronary Angiography.

REMEMBER:
Obstruction of the coronary artery reduces blood flow to the part of the heart normally supplied by that vessel.

8

Cardiovascular Disorders - Angina

What are the obvious ECG changes during an episode of angina?

ST-segment depression

9

Cardiovascular Disorders - Angina

What are some medications that would be prescribed in the event of angina? Which one would the nurse expect to administer in the event of an acute angina attack?

Nitroglycerin
Beta blockers (propranolol and atenolol)
Calcium channel blockers
Low-dose Aspirin (81 mg/day) (b/c of risk of MIs with significant narrowing of the coronary arteries).

Sublingual nitroglycerin is the drug of choice for an acute anginal attack

10

Cardiovascular Disorders - Angina

What are the various forms of Longer Acting Nitroglycerin preparations?

Oral tablets
Ointment
Transdermal patches

11

Cardiovascular Disorders - Angina

What are some of the common adverse effects of nitroglycerin?

Headache, N&V, Dizziness, and hypotensions.

12

Cardiovascular Disorders - Angina

What is the action of nitroglycerin? (HINT: Think about the class of the drug)

It is a vasodilator, therefore, it dilates the blood vessels, increasing the blood flow to the myocardium and reducing the workload of the heart.

13

Cardiovascular Disorders - Angina

What are sublingual and buccal spray nitroglycerin used to treat?

They are used to treat acute angina.

14

Cardiovascular Disorders - Angina

What are oral and transdermal forms of nitroglycerin used to treat?

They are used to reduce the frequency and severity of anginal attacks.

15

Cardiovascular Disorders - Angina

When applying a transdermal nitroglycerin patch on a client to treat the frequency of anginal attacks, what is the important thing for the nurse to remember?

The patch should be removed at night.
When applying a new patch (in the morning), rotate sites.
Remove old patch before applying a new one.

16

Cardiovascular Disorders - Angina

If the client is prescribed a nitroglycerin sublingually, how should he/she take the medication in the event of an acute anginal attack?

In the event of onset of chest pain the client should:

1) Administer one tablet under tongue and let dissolve (DO NOT CHEW)
2) If chest pain is not relieved within 5 minutes, take a 2nd dose
3) After 5 minutes more, a 3rd dose may be taken.
4) If pain continues, seek medical help IMMEDIATELY.

17

Cardiovascular Disorders - Angina

What is the action of Beta Blockers (Atenolol (Tenormin), (Metoprolol (Lopressor), Propranolol (Inderal))? When are they used?

They decrease the cardiac workload by blocking sympathetic nervous system stimulation. They are frequently used to PREVENT angina and to treat hypertension.

18

Cardiovascular Disorders - Angina

What is the action of Calcium Channel Blockers (Amlodipine (Norvasc)), Nifedipine (Procardia), Diltiazem (Cardizem))? When are they used?

They reduce the cardiac workload and increase blood flow to the myocardium. They are used to control angina, hypertension, and dysrhythmias.

19

Cardiovascular Disorders - Angina (Chapter 16 - Burke WKBK)

A nurse is caring for a client in an urgent care clinic who reports chest pain. Which of the following findings should indicate to the nurse that the client is experiencing angina and not a MI? (Select all that apply.)

A. The client states the pain is relieved with the administration of nitroglycerin within 15 min.
B. The client has a Q wave on his ECG reading.
C. The client reports nausea.
D. The client was exercising before the episode occurred.
E. The client has an elevated Troponin level.

A. The client states the pain is relieved with the administration of nitroglycerin within 15 min.
D. The client was exercising before the episode occurred.

Rationale:
Chest pain that is relieved by the administration of nitroglycerine within 15 min is a clinical finding of angina. Angina is commonly followed by emotional stress or exercise prior to the episode of chest pain occurring. The client showing a Q wave on his ECG is a clinical finding of an MI. Other clinical manifestations associated with an MI can be nausea, as well as an elevated Troponin level.

20

Cardiovascular Disorders - Angina

What should the nurse remember when assessing for angina? (THINK: PQRST)

P - Precipitation of pain
Q - Quality of pain
R - Radiation of pain
S - Severity of pain
T - Timing