Class 2 Flashcards
1
Q
CAD definition
A
atherosclerosis along inner arterial walls of coronary arteries leading to decreased myocardial blood flow
2
Q
main symptom of CAD
A
angina
3
Q
what can occur as a result of CAD
A
MI
4
Q
term for intermittent cramping
A
cautication
5
Q
angina that occurs with activity or increased emotions
A
stable
6
Q
this type of angina is predictable and consistent
A
stable
7
Q
tx of stable angina
A
nitroglycerin
8
Q
angina that may occur at rest that is sudden and severe
A
unstable
9
Q
this type of angina increases in frequency, duration, and intensity
A
unstable
10
Q
nitroglycerin does not help this type of angina
A
unstable
11
Q
this type of angina is considered an emergency
A
intractable/refractory
12
Q
this type of angina is thought to be related to coronary artery spasm
A
variant/prinzmetal
13
Q
meds that reduce coronary artery spasms that may cause variant angina
A
CA channel blockers
14
Q
anterior wall MI: left or right sided
A
left
15
Q
inferior wall MI: left or right sided
A
right
16
Q
STEMI
A
ST segment elevation MI
17
Q
non-STEMI
A
ST segment depression, T wave inversion MI
18
Q
class of med given for STEMI
A
fibrinolytic
19
Q
class of med given for non-STEMI
A
anti-platelet
20
Q
what area of the heart does an anterior wall MI effect
A
left ventricle
21
Q
possible consequences of anterior wall MI
A
high risk for cardiogenic shock and pulmonary edema
22
Q
immediate tx for chest pain
A
Morphine
Oxygen
Nitroglycerin
Aspirin
23
Q
a discrepency in this wave indicates an MI at one time in a person’s life
A
Q wave
24
Q
issue with statin drugs
A
can damage striated muscles leading to rhabdomyolysis
25
examples of cardiac enzymes
total creatine kinase
isoenzyme CK-MB
troponin T or 1
26
when is the CK elevated
when there is tissue damage
27
rhabdomyolysis caused by statin drugs can lead to what being elevated
CK-MM (specific to skeletal muscles)
28
what percent of CK is CK-MB
0-5%
29
if CK-MB is elevated it is indicative of what
damage to myocardium
30
which cardiac enzyme is unique to the myocardium
troponin
31
which cardiac enzyme stays elevated the longest
troponin
32
what is done if a patient has chest pain but a normal EKG and normal cardiac enzymes
further dx testing
33
what is done if a patient has chest pain and has an abnormal EKG and cardiac enzymes
medications: ACE, antiplatelet, anticoag, beta, CA channel blockers, nitrates
revascularization: fibrinolytic, thrombolytic, coronary artery bypass
34
purpose of a stress test
determines amt of exercise induced ischemia
35
what meds may be used in a pharm stress test
adenosine
| dobutamine
36
procedure in which contrast is injected to assess perfusion in the coronary arteries and a catheter is inserted through vessels into the heart
cardiac cath
37
it is important to monitor for this following a cardiac cath
contrast induced nephrotoxicity
38
what 2 meds can protect the kidneys in relation to a cardiac cath
mucomyst (prevent contrast induced renal dysfxn)
| metformin (do not give 24 hrs before and 48 hrs after to protect kidneys)
39
these 3 things may be used to achieve hemostasis at the insertion site of a cardiac cath
sandbag, angioseal, femostop
40
which hemostasis device is a mechanical inflation device developed by a nurse
femostop
41
EKG changes indicative of ischemia
ST segment elevation/depression
| T wave inversion
42
ACE inhibitors and angiotensin II receptor blockers aim to prevent what
vasoconstriction and sodium reabsorption
43
examples of ACE inhibitors
catopril
enalapril
lisinopril
44
examples of angiotensin II receptor blockers
losartan
| valsartan
45
ACE inhibitors are commonly used to treat what
HF
MI
HTN
46
why can tachycardia result due to taking ACE inhibitors
BP is low so perfusion must be maintained
47
respiratory SE of ACE/angiotensin
dry cough
| angioedema
48
important labs to monitor when pts taking ACE/angiotensin
BUN and creatinine
potassium (hyper)
sodium (hypo)
WBC
49
why is it important to prevent hyponatremia in pts taking ACE/angiotensin
the tx is with 150-200 ml/hr of IVF and if the pt has HF, they may not be able to tolerate lots of fluid
50
oral antiplatelet agents
aspirin
| plavix
51
IV antiplatelet agents
aggrastat
| intergrilin
52
SE of oral antiplatelet agents
increased risk for bleeding
GI distress
TTP
53
T or F: pts taking IV antiplatelet agents should be on bedrest
TRUE, the medication can cause bleeding to occur very quickly and the risk for injury should be reduced
54
anticoagulants
heparin
| lovenox
55
normal and therapeutic level for aPTT
normal: 20-35 seconds
therapeutic: 40-70 seconds
56
aPTT is related to what drug
heparin
57
heparin induced thrombocytopenia
decrease in platelets by 25% or more OR a platelet count below 100,000
58
what can occur due to HIT
bruising
destruction of platelets
clotting
59
reversal agent for HIT
protamine sulfate
60
those with allergies to what cannot take protamine sulfate
fish: salmon in particular
61
which class of meds decrease platelet aggregation
antiplatelet agents
62
which class of meds prevent prothrmbin--->thrombin and fibrinogin--->fibrin
anticoagulants
63
which claass of med decreases myocardial o2 demand by decreasing the force of contractions, improve filling time by decreasing AV conduction and decreases afterload by vasodilating peripheral vessels
beta blockers
64
beta blockers
```
metoprolol
atenolol
propranolol
nadolol
labetalol
```
65
what are beta blockers commonly used to treat
HTN
anxiety
HF
migraines
66
be careful when giving pts with these issues beta blockers
COPD
asthma
constricts bronchioles
67
assess for these 3 things when giving beta blockers and ca channel blockers
bradycardia
hypotension
orthostatic changes
68
which class of med decreased myocardial o2 demand by decreasing contractility and AV conduction and by vasodilating peripheral vessels leading to decreased afterload and increase the myocardial o2 supply by vasodilating coronary arteries/prevent and treat CA vasospasm
calcium channel blockers
69
calcium channel blockers
diltiazem
verapamil
amlodipine
nifedipine
70
these 2 classes of meds can be given for SVT, a-fib, and a-flutter
beta blockers and ca channel blockers
71
which class of med decreases myocardial o2 demand by vasodilating peripheral vessels leading to a decreased afterload and increase myocardial o2 supply by vasodilating CA
nitrates
72
nitrates
nitrogylcerin, any med beginning with "nitro"
73
what should you assess for when pt is taking nitrates
hypotension
| HA
74
EKG change that is indicative of blood clot
elevated ST segment
75
which class of med activates the fibrinolytic system to generate plasmin and breakdown fibrin clots
fibrinolytics (thrombolytics)
76
fibrinolytics
streptokinase
anisolated plasminogen-streptokinase activator complex (APSAC)
TNKase
77
important to monitor for what when taking fibrinolytics
allergic rxn
78
T or F: there is an increased risk of bleeding when taking fibrinolytics
TRUE
79
how to tell if pt taking fibrinolytics has evidence of reperfusion
monitor EKG
80
EKG change associated with LBBB
notched QRS complex
81
what can indicated dissection of AAA
difference in the L and R arm BPs
82
procedure done to open narrowed CA
percutaneous transluminal coronary angioplasty (PTCA)
83
how many mins do you have to administer fibrinolytic following heart issue
30 mins
84
how many mins do you have to get the balloon inflated in PTCA following heart issue
90 mins
85
drug eluding stents
stent inserted into CA that releases a clot preventing drug over time
86
surgical placement of artery or vein near blocked CA
coronary artery bypass graft (CABG)
87
what is used to paralyze the heart during CABG
potassium
88
complication related to induced hypothermia during CABG/cardiopulmonary bypass
blood becomes thickened
89
complication related to hemodilution during CABG/cardiopulmonary bypass
can cause 3rd spacing and edema
90
cardiopulmonary bypass
provides o2 and circulation for systemic perfusion during open heart surgery
91
tx of low CO secondary to blood loss/vasodilation following CABG/cardiopulmonary bypass
IVF
| colloids (RBC, volume expanders)
92
tx of low CO secondary to poor ventricular fxn following CABG/cardiopulmonary bypass
diuretics
| positive inotropes
93
tx of low CO secondary to bradycardia following CABG/cardiopulmonary bypass
cardiac pacing (epicardial)
94
what is used to treat HTN following CABG/cardiopulmonary bypass
IV nitroglycerin
95
what is used to treat pericardial effusion following CABG/cardiopulmonary bypass
emergency sternotomy to release fluid around heart
96
device that inflates during diastole and perfuses coronary arteries and decreases afterload
intra-aortic balloon pump (IABP)
97
when may a ventricular assistive device be used
following open heart surgery
| in endstage HF
98
device that removes blood from the L vent and takes it to the aorta when the L vent is weak and not pumping well
ventricular assistive device (VAD)
99
meds given for pulmonary edema
diuretic
| morphine
