Managements of Patients with Coronary Vascular Disorders

Question 1

Most prevalent type of cardiovascular disease in adults

Answer 1

Coronary Artery Disease

Question 2

Most common cause of Coronary Artery Disease

Answer 2

Coronary Atherosclerosis

Question 3

Abnormal accumulation of lipids or fatty substances and fibrous tissue in the lining of the arterial wall vessels

Answer 3

Coronary Atherosclerosis

Question 4

Process of fatty substances, cholesterol, cellular waste products, calcium, and fibrin building up in the inner lining of an artery leading to a reduce blood flow in the myocardium

Answer 4

Coronary Atherosclerosis

Question 5

Coronary Atherosclerosis:
Clinical manifestations

Answer 5

1. Angina pectoris (chest pain)
2. Shortness of breath
3. Palpitations
4. Tachycardia
5. Weakness or dizziness
6. Nausea
7. Sweating

Question 6

Tool used to estimate the risk for having cardiac event within the next 10 years

Answer 6

Framingham Risk Calculator

Question 7

Prevention and Management for Coronary Atherosclerosis

Answer 7

1. Controlling cholesterol abnormalities
2. Promoting cessation of tobacco use
3. Managing hypertension
4. Controlling diabetes

Question 8

Coronary Atherosclerosis - Nursing Interventions

Answer 8

1. Teach the client the hazards of smoking
2. Encourage the following diet programs (low cholesterol, low fat, eat fish that are high in omega-3 fatty acids, increase intake of high fiber foods)

Question 9

Latin for squeezing of the chest

Answer 9

Angina

Question 10

Due to insufficient coronary blood flow resulting in decreased oxygen supply where there is an increased myocardial demand for oxygen

Answer 10

Angina pectoris

Question 11

Causes of Angina Pectoris

Answer 11

1. Increased metabolic demands due to strenuous exercise, exposure to cold, eating heavy meals, emotional stress, hyperthyroidism, or severe anemia
2. Oxygen supplied by the blood cannot meet the metabolic demands of the muscle
3. Anaerobic metabolic demands

Question 12

Predictable and consistent pain that occurs on exertion and is relieved by rest

Answer 12

Stable angina

Question 13

AKA as

1. Pre-infarction angina
2. Crescendo angina
3. Intermittent coronary syndrome

Answer 13

Unstable angina

Question 14

Symptoms occur more frequently and last longer than stable angina

Answer 14

Unstable angina

Question 15

The threshold for pain is lower, and pain may occur at rest

Answer 15

Unstable angina

Question 16

Rest and nitroglycerine do not relieve attacks

Answer 16

Unstable angina

Question 17

Severe incapacitating chest pain

Answer 17

Intractable or Refractory angina

Question 18

AKA “Prinzmetal’s angina”

Answer 18

Variant angina

Question 19

Pain at rest with reversible ST-segment elevation

Answer 19

Variant angina

Question 20

Thought to be caused by coronary artery vasospasm not of atherosclerosis, usually occurs in the cold mornings (12am - 8am)

Answer 20

Variant angina

Question 21

Objective evidence of ischemia (such as electrocardiographic changes with a stress test) but patient reports no symptoms

Answer 21

Silent ischemia

Question 22

Possible occurring during rapid eye movement (REM) sleep during dreaming

Answer 22

Nocturnal angina

Question 23

Paroxysmal and occurs when client reclines, lessens when the client sits or stands up

Answer 23

Angina decubitus

Question 24

Occurs after MI

Residual ischemia may cause episodes of angina

Answer 24

Post-Infarction angina

Question 25

Angina pectoris - Medical Management

Answer 25

1. Restricted activity
2. Pharmacologic management
3. Weight loss
4. Oxygen therapy during attack
5. Coronary artery bypass graft
6. Percutaneous transluminal coronary angioplasty

Question 26

Angina Pectoris - Nursing Interventions

Answer 26

1. Provide physical and mental rest
2. Relieve pain by administration of vasodilators
3. Discourage smoking
4. Health teachings regarding diet, medications, and activity

Question 27

Client clenches fist over sternum when describing discomfort

Answer 27

Levine’s sign

Question 28

Emergent situation characterized by an acute onset of myocardial ischemia that results in myocardial death

Answer 28

Myocardial Infarction

Question 29

It is an acute necrosis of the heart muscle caused by interruption of oxygen supply to the area, resulting altered function and reduced cardiac output

Answer 29

Myocardial Infarction

Question 30

An enzyme found mainly in the heart, brain, and skeletal muscles

Answer 30

CPK

Question 31

An enzyme found mostly in the brain and lungs

Answer 31

CPK-1 (CPK-BB)

Question 32

An enzyme found mostly in the heart

Answer 32

CPK-2 (CPK-MB)

Question 33

An enzyme found mostly in the skeletal muscles

Answer 33

CPK-3 (CPK-MM)

Question 34

A system used in individuals with an acute myocardial infarction, in order to risk stratify them

Answer 34

Killip Classification

Question 35

Includes individuals with no clinical signs of heart failure

Answer 35

Killip Classification I

Question 36

Includes individuals with rales or crackles in the lungs, an S3 sound, and elevated jugular venous pressure

Answer 36

Killip Classification II

Question 37

Describes individuals with acute pulmonary edema

Answer 37

Killip Classification III

Question 38

Describes individuals in cardiogenic shock or hypotension and evidence of peripheral vasoconstriction

Answer 38

Killip Classification IV

Question 39

Patient has ECG evidence of acute MI with characteristic changes in 2 continuous lead on a 12 lead ECG

Answer 39

STEMI - ST Elevation Myocardial Infarction

Question 40

There is no significant damage to the myocardium

Answer 40

STEMI - ST Elevation Myocardial Infarction

Question 41

Patient has elevated cardiac biomarkers but no definitive ECG evidence of acute MI

Answer 41

NSTEMI - Non-ST Elevation Myocardial Infarction