Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Adult Nursing II - Exam 2 > Coronary Artery Disease (Week 1) > Flashcards

Coronary Artery Disease (Week 1) Flashcards

(57 cards)

Start Studying
1
Q

What is the cause of coronary artery disease?

KNOW THIS!!!

A

cholesterol-filled atherosclerosis / plaque build up in the coronary arteries that obstructs blood flow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are potential causes of chest pain?

A

Cardiac: acute coronary syndrome, aortic dissection, tamponade, takotsubo cardiomyopathy

Pulmonary: PE, pneumothorax

Esophageal: rupture or impaction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What do you need to consider as a nurse when a patient presents with chest pain?

A

History: DVT, DM, HTN, etc.

Risk Factors: CAD, Marfans, hyperlipidemia, HTN, DM, CKD, obesity, etc.

Onset: sudden (MI, PE, pneumo, dissection) vs progressive (pneumonia)

Severity, quality, & radiation

Associated symptoms

Position & effect of activity (including inspiration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How would a patient with an aortic dissection describe their chest pain?

KNOW THIS!!!

A

Tearing pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

How would a patient with a pulmonary embolism describe their chest pain?

KNOW THIS!!!

A
  • Sudden onset
  • Shortness of breath
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How would a patient with a pneumothorax describe their chest pain?

KNOW THIS!!!

A

Increased pain (she said tearing…) when taking a deep breath

  • NO breath sounds
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What findings can the nurse expect when examining a patient with pneumonia?

KNOW THIS!!!

A
  • Coarse breath sounds
  • Low pulse ox
  • Shortness of breath
  • Cough
  • Fever
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Pain Characteristics to Consider

A
  • Acute or Chronic
  • Onset
  • Sleep (does it wake them from sleep)
  • Location
  • Character
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Modifiable & Non-Modifiable Risk Factors for Heart Disease

KNOW THIS!!! (IN RED)

A

Unmodifiable
* Age
* Heredity
* Race
* Sex

Modifiable
* Cigarette smoking
* High cholesterol
* Hypertension
* Physical inactivity
* Obesity
* DM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Common symptoms associated with ischemia / cardiac related

A

Crushing or squeezing pain +

  • cold sweats
  • SOB
  • tachycardia
  • N/V
  • choking / difficulty swallowing
  • numbness or discomfort in hand or arms
  • pain that radiates from the chest to the neck, jaw, shoulders, or arms
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What characteristics should the nurse assess when a patient presents with chest pain?

A

Type of Pain
* Acute
* Chronic

Onset
* Sudden onset
* Onset with activity - angina
* Onset with trauma - contusion, rib fx, pneumo
* Onset lying down - esophagitis

Sleep
* does pain awaken patient from sleep? (serious)

Location / Character
* Dull
* Sharp
* Stabbing
* Aching
* Pressure / Heavy
* Pins & needles
* Shock
* Throbbing
* Gnawing
* Heavy

Radiation

Exacerbating / Relieving Factors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What signs & symptoms are associated with an MI?

KNOW THIS!!!

A
  • Nausea
  • Vomiting
  • Diaphoresis
  • Shortness of breath
  • Syncope (+)
  • Left arm pain / radiation of pain
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What signs & symptoms are associated with a P.E.?

KNOW THIS!!!

A
  • Shortness of breath
  • Apprehension (anxiety)
  • Hemoptysis
  • Increased pain with respirations
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What signs & symtoms are associated with pneumonia?

KNOW THIS!!!

A
  • fever
  • cough
  • sputum change
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are potential GI causes / origins of chest pain?

KNOW THESE!!!

A
  • Herpes Zoster: burning, knife life, may restrict movement & respiration (usually in the chest or flank; pain before rash)
  • Costochondritis: inflammation of cartilage that connects ribs to sternum
  • Sickle Cell: extreme pain
  • Marfan Syndrome: connective tissue disorder
  • Peptic Ulcer Disease: may have bloody emesis (hematemesis)
  • Cholecystitis: R sided chest pain w/ radiation to R shoulder & upper back
  • Pancreatitis: excrutiating constant LUQ pain w/ radiation to chest, shoulder & arm (associated with HTN)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is ST elevation indicative of?

What is ST depression indicative of?

A

ST Elevation = NO O2 or HIGH K+ (hyperkalemia)

ST depression (T-wave inversion) = low O2 (ischemia)

ST is HIGH, heart muscles have DIED

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is a zone of ischemia?

What does it look like on an EKG?

KNOW THIS!!! – highlighted & red

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the zone of injury?

What does it look like on an EKG?

KNOW THIS!!!

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is the zone of infarction?

What does it look like on an EKG?

KNOW THIS!!!

A

Area of complete death of cardiac muscle (cannot be regenerated)

Looks like DEEP Q waves (longer than normal, 1/3 or more of the R wave)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is a transmural infarction?

A

involves all vascular layers of the heart (endocardium, epicardium, myocardium)

STEMI (ST elevated MI)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What symptoms do women commonly present with when having an MI or ACS (acute coronary syndrome)?

**KNOW THIS!!! – red **

A
  • nausea
  • vomiting
  • dyspnea
  • fatigue
  • neck pain
  • abnormal pain location (abdomen, chest, etc.)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Chest Pain Evaluation

KNOW THIS SCALE!!!

A

Onset
Precipitating factors
Quality (stabbing, dull, aching, etc.)
Region / Radiation
Severity-Use scale (scale of 1 - 10)
Timing

Also ask about:

Relieving factors: nitroglycerin, oxygen, position change

Aggrevating factors: exercise, environment

Associated symptoms: n/v, diaphoriesis, dysnpea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is stable angina?

Study These Flashcards
A

Chest pain that is relieved with rest & taking nitroglycerin

  • substurnal discomfort, pressure, or tightness
  • Can radiate to left arm, back, shoulders, jaw, neck
24
Q

What is unstable angina?

Study These Flashcards
A

Chest pain that does not go away and was previously stable angina

  • may awaken from sleep
  • more intense pain
  • Change in level or frequency of sx requires immediate medical intervention
25
**What is variant or prinzmetal angina?** List risk factors & associated symptoms
**Due to vasoconstriction & spasms of coronary arteries** **CYCLICAL --** happens at the same time every day * **Risk Factors:** smoking, EtOH use, cocaine use * **Assoc. Sx:**Chest pain & ST elevation
26
**What is silent ischemia?** **What patient population is most at risk for silent ischemia?**
**Objective EKG evidence wihtout subjective complaint of chest pain** DIABETICS (type 2) with autonomic neuropathy are at high risk
27
**Nursing Responsibilities for stable angina**
Patient Education & Lifestyle Modifications * smoking * EtOH * obesity (diet & exercise) Educate them on when to call 911 if they have chest pain
28
**What diagnostic labs or tests should be done when determining if a patient is having an MI?** | **KNOW THIS!!!**
**TROPONIN** * EKG * Cath lab * Stress test * Echocardiogram * Myoglobin - not cardiac specific * Creatinine kinase - not cardiac specific
29
**What labs are drawn to determine if a patient is having an MI? Which labs are and are not cardiac specific?**
**TROPONIN:** cardiac specific Creatinine Kinase (CK-MB): not cardiac specific Myoglobin: not cardiac specific
30
**Explain the conduction system of the heart**
* SA Node * AV Node * Bundle of His * R & L Bundle Branches * Purkinje Fibers
31
**What abnormalities are seen on an EKG when a patient is having an MI?**
ST elevation
32
**What is the J Point (junction) on an EKG?** | **KNOW THIS!!!**
The point where the QRS complex & ST segment meet
33
**What is a pathological Q-wave on an EKG and what does it represent?** | **KNOW THIS!!!!**
* Q-wave is LOWER than normal * Patient has had a prior MI ## Footnote Greater than 1 small box in duration & deeper than 1/3 of the R wave
34
**Where are the 6 pericordial leads placed?**
* **V1 =** 2nd intercostal space R of sternum * **V2 =** 2nd intercostal space L of sternum * **V3 =** halway between V2 & V4 * **V4 =** L midclavicular line, 5th intercostal space * **V5 =** L anterior axillary line, 5th intercostal space * **V6 =** L midaxillary line 5th intercostal space
35
**What is an Anterior Wall MI?** | **KNOW THIS!!!**
**Affects LAD artery** (L anterior descending) MOST DANGEROUS because LAD supplies the rest of the body with O2 & blood
36
**What is seen on an EKG that would indicate an anterior infarct (anterior wall MI)?**
ST Elevation in leads V2 - V4
37
**What is interventions are taken with a patient who has an anterior wall MI?** | **KNOW THIS!!!!**
**Pressors** * giving a patient fluids will put them into fluid overload & pulmonary congestion **Pressors are given because in an anterior MI, the L ventricle isn't pumping properly**
38
**What is an anterior infarct (anterior wall MI)? What is seen on an EKG to indicate an anterior infarct? What interventions are taken?**
**improper blood flow to LAD** (dangerous because LAD supplies the rest of the body with blood & O2) **ST Elevation in leads V2 - V4** **Interventions:** Pressors ## Footnote do not give fluid because this can lead to fluid overload & pulmonary congestion
39
**What is a lateral MI? What is seen on an EKG to indicate a lateral MI? What does this type of MI usually accompany?**
Caused by **blockage in L circumflex artery** **Changes in leads I, aVL, V5, V6** * Usually accomanies an anterior or inferior MI
40
**40 - 50% of acute MI's are usually what type of MI?**
**Lateral MI** * damage to the L circumflex artery
41
**What is an anterior MI? What is seen on an EKG to indicate a anterior MI? What complications can this type of MI lead to?**
**Occlusion of R coronary artery** **Changes in leads II, III, & AvF** **Complications:** ventricular failure or BBB (bundle branch block), bradycardia, sinus arrest, PVCs
42
**How do the zone of ischemia, zone of injury, & zone of infarction present on an EKG?** | **KNOW THIS!!!**
**Zone of Ischemia =** ST segment depression **Zone of Injury =** ST segment elevation (STEMI) **Zone of Infarction = DEEP Q Waves (pathological Q wave due to absence of depolarization)**
43
**What is the difference in a STEMI and an NSTEMI on an EKG?** | **KNOW THIS!!!**
STEMI = ST - elevation **NSTEMI = ST depression & T wave inversion**
44
**What 4 things should be administered to patients who present with chest pain when there is concern for an MI?** | **KNOW THIS!!! - HIGHLIGHTED, BOLD, RED**
**Oxygen** (4 L / min) **Aspirin** (160 mg or 325 mg -- CHEW) **Nitroglycerin** (sublingual or IV) **Morphine** (2-4 mg q5-10 min.) | **OANM**
45
**What is the primary reason for administering morphine to a patient with an MI?** **a.)** To sedate the patient **b.)** To decrease the patient's pain **c.)** To decrease the patient's anxiety **d.)** To decrease oxygen demand on the patient's heart
**d.) To decrease oxygen demand on the patient's heart** ## Footnote PER NIH * to decrease HR, BP, & venous return * decrease pain * reduce myocardial oxygen demand
46
**What must be done in under 10 minutes (immediate assessment) when a patient arrives to the ER with chest pain?** | **KNOW THIS!!! -- HIGHLIGHTED, BOLD, RED**
* 12-lead EKG * **IV** - 1-2 lines * **O2** * **Monitor** (vital signs, cardiac monitor, etc.) * **ABCs** (**A**irway, **B**reathing, **C**icrulation) * Draw initial labs * Chest x-ray
47
**What are potential complications of an acute MI?**
* **Rhythm disturbances** * Ventricular **aneurysm** * **Ventricular septal rupture** * **Papillary muscle rupture** (responsible for closing the heart valves; therefore, if muscle ruptures the valves won't work) * Cardiac wall rupture * Pericarditis * Heart Failure
48
**What are the different types of therapy used for myocardial infarctions?** | **KNOW THIS!!! - BOLD, RED**
**Reperfusion (acute; used in the moment)** * fibrinolytic therapy (like tpa) * percutaneous coronary intervention (PCI) **(CATH LAB)** **Adjunctive (usually after an MI)** * beta-blocker * ACE inhibitor * glycoprotein IIb/IIIa * Heparin
49
**What are the two different types of reperfusion therapy used for myocardial infarctions?**
* fibrinolytic therapy **(like TPA)** * percutaneous coronary intervention (PCI) **(Cath Lab)**
50
**What are the 4 different types of Adjunctive Therapy used for a myocardial infarction?**
* Beta-blockers * ACE inhibitors * Glycoprotein IIb / IIIa inhibitors * Heparin
51
**When are fibrinolytic therapies used for treatment of an MI?**
* **onset of symptoms was < 12 hours prior** **Class I Intervention when...** * clinical complaints are consistent with ischemic type pain * ST elevation > or = 1mm in 2 anatomical contiguous leads * There are no contraindications * Patient is < 75 years old
52
**Nursing management for patients receiving drug therapy for an MI**
* Identify the candidates * Monitor for signs of bleeding * **Observe for evidence of reperfusion (either by medications, fibrinolytics, or surgery -- ST segment normalization)** * Patient education
53
**Patient Education for patients who have had a myocardial infarction.**
* Pathophysiology * Angina * Use of pain scale & EMS notification * Avoid valsalva * Risk factor modification * Cardiac rehab * Medication education * Follow up care after d/c * Symptoms to report to HC professional * Discuss emotional stress, anger, & sex
54
**What is therapeutic hypothermia & why is it used?**
**Cooling the body to 32-34 degrees C ** * used when cardiac death causes the heart to stop pumping blood throughout the body...it's shown to improve mortality & neurological function **Return cardiac output initiates cerebral reperfusion injury**
55
**What is Wolff-Parkinson White Syndrome & what does it look like on an EKG?** | **KNOW THIS!!!**
Presence of an abnormal pathway between the atria & ventricles. **ON EKG...** * **Short PR interval** * **Prolonged QRS with delta wave (slurred, slow rise of initial upstroke of QRS complex)** ## Footnote Ablation is usually done
56
**What is Wolff-Parkinson White Syndrome & what does it look like on an EKG?** | **KNOW THIS!!!**
Presence of an abnormal pathway between the atria & ventricles. **ON EKG...** * **Short PR interval** * **Prolonged QRS with delta wave (slurred, slow rise of initial upstroke of QRS complex)** ## Footnote Ablation is usually done
57
**What is a Bundle Branch Block?** | **KNOW THIS!!!!**
delay or blockage of pathway causing dealyed contraction of a ventricle **Can be a pre-existing condition** ** Can be caused by acute coronary syndrome** * **Wide QRS (> 0.12)!!!!!!** * **Crown on top**

Adult Nursing II - Exam 2 (4 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions