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NURS216A > Perfusion 4 > Flashcards

Perfusion 4 Flashcards

1
Q

Atherosclerosis: three reasons for cell damage

A
  • Mechanical Stress (htn)
  • Immune Response (high cholesterol and cytokines)
  • Oxidative stress (free radicals)
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2
Q

Alcohol intake plays what part in HTN?

A

Alcohol is high in carbs. excess food is converted to triglycerides and stored as fats

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3
Q

High LDL is also known as

A

hyperlipidemia

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4
Q

High Cholesterol is also known as

A

hypercholesterolemia

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5
Q

Free radicals can cause oxidative stress in the form of:

A
  • insulin resistance
  • Decreased immunity
  • aging
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6
Q

Antioxidants do what?

A
  • reduce reactive molecules

- support normal cellular enzyme

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7
Q

Nicotine triggers ____ and increases ____

A

clotting and LDL

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8
Q

Clotting Cascade:

A
  1. Injury
  2. vascular spasm
  3. platelet plug formation
    - platelet activation, release signal for aggregation (adenosine diphosphate, thromboxane A2, thrombin,_
    - glycoprotein IIB/IIIA receptor activation makes them sticky
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9
Q

Prothrombin activator converts thrombin which leads to

A

fibrinogen converting to fibrin

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10
Q

Thrombin

A
  • converts fibrinogen to fibrin
  • activates factor XIII
  • enhances platelet aggregation
  • Facilitates its own synthesis
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11
Q

Narrowing of the vessel causes

A

Turbulent flow, ischemia

can cause CAD, Angina, PVD, HF

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12
Q

Vessel obstruction due to plaque can cause

A

ischemia, MI, HF, CVA

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13
Q

Thrombosis leading to emboli can cause

A

ischemia, DVT, PE, MI, CVA

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14
Q

Weakening of the vessel wall can lead to

A

aneurysm, hemorrhage, tamponade

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15
Q

3 drug classes for clotting tx

A

Antiplatelet (during platelet aggregation)

Anticoagulant (during coagulation cascade)

Thrombolytic (post clot formation)

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16
Q

Antiplatelet Meds

A

ASA, dipyridamole.
aggrenox: combo of ASA and dipyridamole

ASA - risk of bleeding through cox 2 inhibition

Clopidogrel (Plavix)
-block ADP in activation. good for kids (decreased platelet adhesion)

Abciximab (reopro), integrillin, aggrastat
-decreased fibrin receptor binding. expensive. good for pts receiving tx for decreasing blockage.

17
Q

Baby Aspirin

A

Not actually for babies.
Recommended ASA dose for pain inflammation is 325-650mg)

recommended ASA for CV os 81 mg (aka baby sized aspirin)

only use for kids in Kawasaki syndrome (10-15mg)

18
Q

Anticoaglulants

A

inhibit thrombin: heparin
-low molecular weight heparins: enoxaparin, daltaparin. pt can give themselves subcut. for DVT or PE prevention

Block thrombin receptors and factor IIa: dabigatran (prodrug) for stroke prevention

inhibit hepatic formation of clotting factors: warfarin (coumadin) long t1/2, high ppb, narrow ti. good for a fib pts

19
Q

HIT Heparin induced thrombocytopenia

A

immune rx. to heparin

-leads to disseminated coagulation. up to 50% of pts on heparin get this, 3% fatal.

20
Q

What is a prothrombin time test used to look at

A

body’s clotting time, to see how the body responds to the med.

21
Q

Which two tests are used to see how fast the body clots

A

activated partial thromboplastin time and anti factor Xa levels.

22
Q

Thrombolytics

A

Plasminogen in the blood gets converted to plasmin via tPA which lyses the clot.
med: tPA (altepase, reteplase)
t1/2 is 13-16 min, IV

23
Q

Acute CAD

A

ACS

  • unstable angina (with exertion the pt feels pain, wall between vessel and plaqu may rupture)
  • risk of MI
  • unstable plaque
24
Q

Chronic CAD

A

Stable Angina

-thick fibrous plaque.

25
Q

STEMI

A

st elevation MI.

st elevation means ventricles cannot fully contract or depolarize

26
Q

Ischemia of Heart

A

fast onset of 1 min.
myocardial cells leak intrinsic enzymes: troponin, creatinine kinease, myoglobin
necrosis comes in 20-40 mins.

high troponin levels mark an MI

tx: organic nitrates, o2, tx obstruction and clotting, htn.

27
Q

Organic Nitrates

A

med: nitroglycerin. stimulates smooth muscle relaxation. too much can cause pt to faint or have low BP

28
Q

Angioplasty

A

stent put in to hold open artery

29
Q

CABG

A

use artificial or graft vein to bypass the coronary arteries. must be a healthy portion of the coronary artery for the surgery to work.

NURS216A (15 decks)

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