ch13 CAD

Question 1

patho, risk factors, clinical manifestations, treatment of (cad related)

Answer 1

coronary atherosclerosis and angina pectoris

Question 2

The most common cause of cardiovascular disease is ________ _________.
Atheromas or plaques protrude into the lumen of the vessel.
Thrombi may form and obstruct blood flow, leading to sudden cardiac ____ or an acute MI.
The anatomic structure of the coronary arteries makes them particularly susceptible to the mechanisms of atherosclerosis.

Answer 2

coronary atherosclerosis, death

Question 4

risk factors such as Age
Gender
Race
Family history

Answer 4

nonmodifiable

Question 5

risk factors such as Metabolic syndrome
Diabetes
Hypertension
Smoking
Obesity
Physical inactivity
High cholesterol

Answer 5

modifiable

Question 6

Consists of three or more of the following:
Insulin resistance
Abdominal aka central obesity
Dyslipidemia
Hypertension
Proinflammatory state
Prothrombotic state

Answer 6

metabolic syndrome

Question 7

An inadequate blood supply that deprives the cardiac muscle cells of oxygen needed for their survival. A clinical manifestation of coronary atherosclerosis.

Answer 7

ischemia

Question 8

A clinical manifestation of coronary atherosclerosis. Chest pain that is brought about by myocardial ischemia

Answer 8

angina pectoris

Question 9

Acute onset of chest pain
Shortness of breath
Extreme fatigue
Diaphoresis
Nausea and vomiting

Answer 9

s/s of myocardial ischemia

Question 10

Control cholesterol levels. Diet, exercise, medication, smoking cessation. Desired levels of LDL, HDL. Manage HTN and
diabetes.

Answer 10

prevention and management of coronary atherosclerosis

Question 11

Episodes of pain, pressure, or discomfort in the chest, jaw, shoulder, back, or arm caused by myocardial ischemia. Happens when oxygen demand exceeds supply. Almost always associated with a significant obstruction of a major coronary artery. This type of pain can widely vary.
Diagnosed usually by history, ECG, and cardiac biomarker analysis.

Answer 11

angina pectoris

Question 12

Stable angina
Unstable angina
Intractable or refractory angina
Variant angina
Silent ischemia

Answer 12

types of angina

Question 13

Nitrates
Beta blockers
Calcium channel blockers
Antiplatelet medications and anticoagulants.
Oxygen administration

Answer 13

meds to manage CAD and angina

Question 14

positive inotropic, negative chronotropic drugs

Answer 14

amiodarone, digoxin

Question 15

both negative inotropic and chronotropic drugs

Answer 15

beta blockers (-lol), calcium CB

Question 16

solely positive inotropic (doesn’t effect chrono-) drug

Answer 16

dobutamine

Question 17

both positive inotropic and chronotropic drugs

Answer 17

dopamine and epinephrine

Question 18

Monitor vital signs with neurovascular checks. Assess site and affected limb.
TR band in place per policy. Report and treat chest pain immediately.
Administer anticoagulants
Maintain fluids
Maintain bedrest

Answer 18

nursing care for PCIs (percutaneous coronary interventions)

Question 19

Medication regimen
Angina management
Bleeding precautions
Risk factor reduction
When to call emergency services
Encourage cardiac rehabilitation

Answer 19

nursing interventions for PCIs

Question 20

Bleeding or hematoma
Lost or weakened pulse distal to sheath insertion site
Pseudoaneurysm and arteriovenous fistula
Retroperitoneal bleeding
Acute kidney injury
Allergic reaction
Cardiac tamponade
Chest pain/acute ischemic event/spasm

Answer 20

PCI post-op complications

Question 21

Coronary artery revascularization. Surgical procedure in which a blood vessel is grafted to the occluded coronary artery so that blood can flow beyond the occlusion.

Answer 21

CABG (coronary artery bypass graft)

Question 22

The coronary arteries to be bypassed must have approximately a 70% occlusion (50% if in the left main coronary artery).
The artery beyond the area of blockage must be patent, or the flow through the bypass will be impeded.

Answer 22

qualification criteria for CABG

Question 22

Initial postoperative care focuses on hemodynamic stability and recovery from general anesthesia
Later care focuses on the monitoring of cardiopulmonary status, pain management, wound care, progressive activity, and nutrition
Frequent, multisystemic assessment is imperative

Answer 22

nursing process post-op cardiac surgery

Question 23

Restoring cardiac output
Maintaining adequate tissue perfusion
Maintaining body temperature
Preventing infection
Preventing fluid and electrolyte imbalances
Preventing impaired gas exchange
Promoting cerebral circulation
Pain control

Answer 23

nursing interventions post-op cardiac surgery