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ANATOMY AND PHYSIOLOGY > CV TEST 2 > Flashcards

CV TEST 2 Flashcards

obstruction issue

1
Q

What is arteriosclerosis?

A

Artery/arteriole intimal lining loses elasticity & weakens

  • Weakening secondary to high pressure
  • Part of the aging process
  • Hardening of an artery
  • Intimal layer is innermost
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2
Q

A PT is told they have arteriosclerosis. “This is a very stressful situation. I feel the urge to smoke a cigarette.” Why does the nurse recognize this is a problem?

A

cigarettes can cause HDL loss, making it a modifiable risk factor

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3
Q

Define Plaque. What can plaque cause?

A
  • irregular edges, allow blood cells & material to adhere to wall
  • it can calcify, harden, break off to form a thrombus/occlusion*

it’s made of smooth muscle cells & fibrous protein

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4
Q

The HCP tells the PT they have atherosclerosis. The PT asks what that is. How would the nurse respond?

  1. A one-step process where an artery loses elasticity
  2. Obstructed bloodflow to the myocardium
  3. a multi-step process that may be dormant from childhood
A

3

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5
Q

True or False

a decreased low density lipoprotein level equals increased risk

A

false, an a decreased level level equals decreased risk (this is bad cholesterol)

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6
Q

Quitting which of the following would benefit a PT struggling with high cholesterol?

  1. Cardio exercises
  2. High fat and high salt foods
  3. Fluids and water
  4. Tobacco products
  5. Sugary natrual fruits
  6. Lipid-lowering meds
A

the rest would benefit the PT

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7
Q

True or False

C.A.D. is obstructed blood flow to the endocardium

A

False, blood should flow to the myocardium is obstructed in C.A.D.

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8
Q

Modifiable vs Nonmidifable Risk Factors

A
  • Modifiable: smoking, HTN, diabetes, obesity, inactive lifestyle, hyperlipidemia
  • Nonmodifable: age, gender, ethnicity, genetics
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9
Q

The Nurse can expect the PT with C.A.D. to be educated on:
1. Insomnia and sleep apnea
2. Low cholestrol dietary choices and Lovastatin
3. Sugar intake and insulin administration

A
  1. A low cholesterol intake may be supported with a “Sartin” med, which is a lipid-lowering agent
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10
Q

A PT, due for a PTCA, shares they’re nervous with the LPN. The LPN reassures the PT by
1. Explaining that a catheter balloon will be inserted into the <3 and inflated for plaque compression
2. Talk the PT out of consenting for the procedure
3. Call the HCP

A
  1. That is the definition of a Percutaneous transluminal coronary angioplasty
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11
Q

The RN instructor can gauge successful education on C.A.D. Interventions when the LVN identifies which group as C.A.D. surgical remedies?

  1. Annuloplasty, CABG, Fasciectomy
  2. Valve replacement, colonoscopy, Bucks traction
  3. Coronary atherectomy, artery stents, Transmyocardial revascularization
A
  1. artery stents (Angioplasty-metal mesh tube implanted at site of blockage), artherectomy (cute/remove plauqe), CABG–Vessel from leg or chest used to reroute blood around occluded artery, is also one
    **
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12
Q
  1. Define five things a nurse should monitor a PT for post Cardiac surgery
A

pain, ineffective airway, impaired gas, infection, knowledge deficit

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13
Q

____, the main symptom of C.A.D. and M.I. is caused by pain due to ishemia

A

Angina Pectoris

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14
Q

TRUE OR FALSE

Stable Angina occurs DURING excessive exertion

A

false, it occurs with moderate exertion (walking, getting up)

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15
Q

TRUE OR FALSE

Variant Angina can occur during resting periods and at the same time each day

A

true

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16
Q

The LVN expects a PT suffering from angina to complain of
1. gas and heartburn
2. heavy pain in the intercostals radiating to their neck
3. squeezing pain in the sternum radiating to their shoulder

A
  1. Anginal pain can be squeezing, tight or heavy pain in the chest’s center
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17
Q

A stranger, clutching their chest, appearing dyphoretic and pale, arrives at the ER. They tell the LPN they took one nitroglycerin pill about 6 minutes ago when the pain started. What should the LPN do next?

A

advise PT to take another pill…if that doesn’t work after 3 pills are taken START EMERGENCY TREATMENT/CALL 911

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18
Q

Myocardial infarction may:
1. affect conduction and blood flow
2. Affect Rhythm and size
3. Cause damage depending on location & extent
4. Cause backwards blood flow and affect valve closure
5. Permanently damage irreplaceable heart cells because of blockage
6. PT may develop diabetes post-MI

A

1., 3., 5.

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19
Q

Coronary artery disease may cause _______ ________

A

Myocardial infarction

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20
Q

With decrease blood supply the_____ nervous system will kick in making you have increase heart rate.

A

Sympathetic

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21
Q

TRUE OR FALSE

If there is treatment within an hour of MI, the area of damage can be minimized and the zone of injury can be restored

A

TRUE

During a MI(heart attack) you can have the zone of necrosis and around that you can have a zone of injury.

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22
Q

TRUE OR FALSE

A blockage in the right coronary artery can affect the conduction of the heart, causing conduction issues.

A

TRUE

Arrhythmias that are produced can be life threatening.

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23
Q

TRUE OR FALSE

Right anterior descending artery blockage is considered a “widow maker” because it affects the largest part of the heart

A

FALSE… it’s the left anterior descending artery

it requires IMMEDAITE MEDICAL ATTENTION

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24
Q

What are the 2 STEM.I. types?

A

**NON-ST SEGMENT ELEVATIONMI-”NSTEMI” ALSO KNOWN AS “NON-Q WAVE” — doesn’t show elevated ST which = blockage of coronary artery

  • ST-SEGMENT ELEVATION –”STEMI” ALSO CALLED “Q-WAVE” MI—*does** show blockage via ST elevation
    Q-WAVE= DEADLIEST TYPE-OFTEN CAUSED BY COMPLETE BLOCKAGE
    **
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25
Q

What are some M.I. symptoms?

A

radiating, crushing chest pain not relieved with nitro, SOB, dizziness, nausea, diaphoresis

26
Q

atypical M.I. signs

A

women/older adults, chest cramping, fatigue, anxiety, epigastric/abdominal pain

27
Q

Vessel from leg or chest used to reroute blood around occluded artery is called __________

A

Coronary artery bypass graft (CABG)

28
Q

Which lab value is detrimental in determining heart damage
1. Creatine kinase
2. Potassium
3. INR
4. aTTP

A

1.

29
Q

Which group are cardiac biomarkers
1. ESR, ALP, sodium
2. Ck, myoglobin,troponin, magnesium, potassium
3. Myoglobin, potassium, GFR

A

2.

30
Q

What catheter with a balloon tip is inserted & advanced into heart to compress plaque?

A

Cardiac Cath

31
Q

When prescribed nitroglycerin, PT teaching should include:

A
  • Keep it in dark bottle
  • Take it before any activity that causes chest pain.
  • Rise slowly after taking it to avoid causing dizziness
  • Take it sublingually (under tongue)
32
Q

nursing care for Angina Pectoris includes

A
  • Vital signs (1st)
  • Oxygen
  • Sublingual NTG
  • Remain with patient*
  • Emotional support
33
Q

Cardiography can be used to diagnose

A

C.A.D.

34
Q

Elongated, tortuous, dilated veins with a familial orgin are ____ veins

A

varicose

35
Q

contributing factors of varicose veins includes

A
  • Prolonged standing
  • Pregnancy
  • Obesity
36
Q

primary vs secondary varicose veins

A
  • Primary: structural defect in vessel wall
  • Secondary: acquired or congenital condition of deep venous system

Causes dilation of collateral & superficial veins…Stasis, pooling in deep venous system

37
Q

Varicose veins interventions

A
  • Reduce contributing factors
  • Compression stockings
  • Injection sclerotherapy
  • Surgical intervention
  • Radiofrequency ablation
38
Q

periphreal vascular disease pathophysiology

A
  • Chronic, progressive vessel narrowing causing Reduced blood supply
  • Ischemia
  • happens in veins and arteries
  • MAJOR complication result of atherosclerosis
39
Q

P.A.D.

A
  • Intermittent claudication
  • Pain in calf with activity
  • Cool skin (even in warm environment)
  • Reddish-purple when dependent (cyanotic) when in dependent position
  • Pale when elevated
    * Diminished/absent pulses usually as the blockage or occlusion progresses
  • Hair loss/ dry skin (to legs/ankles)
  • Thickened toe nails

When assessing check CCSM and 6 Ps( pain pallor pulselessness, poikilothermia, paralysis)

40
Q

P.A.D. Diagnostics

A
  • Ankle-brachial index ( compared blood pressure of upper and lower extremities)
  • Usually BP in thighs it’s high but with PAD it’s lower
  • Duplex US (measures blood flow specifically viscosity or thickness of blood)
  • MRI/ CT ( images of the vessels. Looking for closure or blockage )
  • Arteriography
    *
41
Q

P.A.D. Therapy Interventions

A
  • low fat, low cholesterol, low cal diet
  • Meds: antiplatelets, thrombolytics
  • Surgeries: PTA, stents, aortic-femoral bypass, atherectomy
42
Q

Venous vs Arterial Vascular Disease

A
  • venous: issue blockage in veins, so problem is with blood flow to heart
  • arterial: issue with arteries, so problem is with** blood flow away from heart**
  • RESULTS FROM ARTERIOSCLEROSIS
43
Q

A 62-year-old PT with a sedentary lifestyle comes to the clinic with chest pain complaints. The PT’s health history reveals a atheroclerosis diagnosis from 18 months ago. The nurse worries the PT’s outcome may be:

A

a C.A.D. diagnosis

44
Q

A PT’s ____ function should be tested prior to being approved for a statin drug

A

liver

45
Q

A pt at risk for athersclerosis will most likey be prescribed ____ by the HCP.
1. Atvorstatin
2. Lisinopril
3. Prednisone

A

Atvorstatin

46
Q

The nurse should educate the PT to stay away from ____ while on Atvorstatin.
1. Bananas
2. Kiwis
3. Grapefruit

A

3.

Graprfruit can cause rhabdomyalsis (msucle breakdown)

47
Q

The nurse suggests wearing gloves for the PT who lives in a cold climate and complains of blanching numb fingers. The PT also shows signs of necorsis on their toes. Why did the nurse suggest gloves?

A

The PT may suffer from Raynaud’s Disease, Vasoconstriction with cold/stress but mostly with cold that causes ischemia. Small arteries are especially effected.

48
Q

TRUE OR FALSE

abdominal aorta anuerysm is the most common anuerysm

A

true

49
Q

MATCHING

  1. saccular ____
  2. dissecting ____
  3. fusiform ____

a. Artery’s circumference
b. one-sided artery dilation
c. arterial lining tear

A
  1. B., 2. C., 3. A.
50
Q

TRUE OR FALSE

An abdominal aneurysm will likely have signs and symptoms, regardless of its size

A

false, aneurysms under 4 CMs usually are asymptomatic, known as silent aneurysms

51
Q

abdominal aortic aneurysm signs and symptoms

A
  • Back & flank pain-classic w abdominal pain causes from the aneurysm pressing on your vertebrae
  • Pulsating abdominal mass
  • Rupture
52
Q

SELECT ALL THAT APPLY

Nursing Care for aneurysm PTs
1. educate on med regimen
2. Monitor Weight
3. stress avoidance
4. avoid sugar
5. beta blockers
6. avoid lifting

A

1., 3., 5., 6.

53
Q

What is Lymphangitis

A

Inflammation of lymphatic channels

  • Bacterial infection
  • Staphylococcus or Streptococcus
  • May occur in arms or legs
  • Pain, red streak, chills, fever
  • May cause sepsis/death
54
Q

The PT with Lymphangitis should treat it with
1. Elevation, antibiotics, heat therapy
2. Excercise, antiplatelets, cold therapy

A

1.

55
Q

arterial vs venous vascular disease

A

Venous: Extremity warm, ruddy, Edema usually present, Nails normal, Pain decreases w elevation, dullness, heaviness, Decreased pulses, Ulcers moist, common malleolar area

Arterial: Extremity cool, pale, No/minimal edema, Nails thick/brittle, Pain worse w elevation, sudden, severe, Claudication, Pulses decreased, absent, Ulcers: dry/necrotic

56
Q

Buerger’s Disease Signs and Symptoms

A
  • Intermittent claudication
  • USUALLY FROM TOBACCO USE
  • Six P’s
  • Lower extremities red or cyanotic in dependent position
57
Q

Why would a PT Post-M.I. be prescribed an ASA?

A

An ASA, like Aspirin, is usually used as a thrombus-formation prevention med, or PT may take an anticoagulant

58
Q

check PT aPTT level prior to ____ therapy

A

Heparin

59
Q

Beta Blockers are used to relieve hypertension becuse they lower __________ and ______

A

blood pressure and heart rate

60
Q

Buerger’s disease in commonly found in:

A

Tobacco-using PTs

possible smoking/autoimmune response to tobacco

61
Q

A PT is due for 15 mg of Atenolol. The pharmacy sent 5 mg tablets, how many does the LVN administer?

A

3

ANATOMY AND PHYSIOLOGY (11 decks)

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