Chronic Stable Angina

Question 1

chronic stable angina

Answer 1

chronic, progressive, and asymptomatic; intermittent chest pain that occurs over a long period with similar pattern of onset, duration, and intensity of symptoms

Question 2

what creates a myocardial ischemia

Answer 2

an O2 demand is greater than the O2 supply

Question 3

what is angina a clinical manifestation of

Answer 3

one or more arteries are blocked 70% or more by atherosclerotic plaque; 50 % or more is from left main coronary artery

Question 4

what is the onset of chronic stable angina

Answer 4

physical exertion, stress, or emotional upset

Question 5

how do patients react with angina

Answer 5

many deny pain; have pressure, heaviness, or discomfort in chest; may be accompanied by dyspnea or fatigue; no change with position and breathing

Question 6

what is the duration of pain with chronic stable angina?

Answer 6

a few minutes

Question 7

what are some changes on a 12 lead ECG resulting from angina

Answer 7

ST segment depression or T wave inversion; ECG does return to normal after pain subsides

Question 8

what are the risk factors for angina

Answer 8

males; sedentary lifestyles; hypertension, tobacco use, hyperlipidemia, obesity; excessive alcohol use; stress; diabetes; elderly and age

Question 9

silent ischemia

Answer 9

ischemia that occurs in absence of any subjective symptoms; associated with diabetic neuropathy

Question 10

how is silent ischemia confirmed

Answer 10

ECG changes

Question 11

what causes unstable angina

Answer 11

rare; occurs at rest; with or without CAD

Question 12

prinzmetal’s angina

Answer 12

spasm of a major coronary artery from an increase in intracellular calcium

Question 13

what are the contributing factors of prinzmetal’s angina

Answer 13

increased levels of certain substances, narrowed blood vessels from medications, or exposure to cool weather

Question 14

what is the treatment for unstable and prinzmetal’s angina

Answer 14

moderate exercise, SL NTG, Ca channel blockers, stopping offending substance; may resolve on its own

Question 15

what is the goal of nursing care for angina

Answer 15

reduce oxygen and/or increase oxygen supply

Question 16

how do you optimize myocardial perfusion

Answer 16

administer oxygen, antiplatelet and lipid-lowering drugs in addition to: nitrates, ACE inhibitors, beta blockers, and calcium channel blockers

Question 17

planning nursing care for angina

Answer 17

relief of pain, immediate and appropriate treatment preservation of heart muscle if MI is suspected; effective coping with illness-associated anxiety; participation in a rehab plan; reduction of risk factors

Question 18

diagnostic studies of angina

Answer 18

12-lead ECG; lab studies; chest x-ray; echocardiogram; exercise stress test; electron beam computed tomography; coronary computed tomography angiography

Question 19

what lab studies are you looking for with angina

Answer 19

cardiac biomarkers, lipid profile, and CRP

Question 20

acute care with angina patient

Answer 20

upright; apply oxygen; check ECG, cardiac biomarkers, and chest x-ray; NTG, IV opioid; reduce anxiety

Question 21

drug therapy for patients with angina

Answer 21

aspirin; short-acting nitrates; sublingual nitroglycerin (SL NTG)

Question 22

short-acting nitrates

Answer 22

dilate peripheral and coronary arteries and collateral vessels

Question 23

SL NTG

Answer 23

1 tab or 3-4 metered sprays; relief in 10 min, duration 30-40 min; may repeat for 3 doses, then call EMS

Question 24

what might SL NTG cause

Answer 24

headache, dizziness, flushing, orthostatic hypotension

Question 25

patient education for angina patient

Answer 25

CAD, angina; precipitating factors and how to manage them; reduce risk factors; medications; psychological support