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med surg cardiovasc
Stack #197853
| Question | Answer |
|---|---|
| What is the number one cause of death in the USA? | CAD |
| What does CRP test for? | Inflammation |
| Name 2 hormones that are released with CAD | BNP and ANF |
| What is the death rate of AMI in the 1st hour? | 60% |
| What percent of patients die of AMI before they reach the ER | 40% |
| Name 3 Invasive procedures | Stents, CABG, Mid CAD |
| What are some medications given for CAD? | Statins, Nicotinic Acids, Bile Acid Sequestrants |
| What are some medications given for Angina Pectoris? | NTG, ASA, Beta Blockers, CA Channel Blockers |
| What are some medications given for HTN? | Ace Inhibitors. Beta Blockers, Ca Channel Blockers, Diuretics |
| What are some medications given for AMI? | Antiarythmics, Heprin, Beta Blockers, Ace Inhibitors, Stool Softners |
| Give a breif description of pathophysiology of an AMI | Occurs when the coronary artery becomes occluded, blocking the blood flow to a portion of cardiac muscle for a prolonged period of time. |
| Give a breif description of pathophysioloy of CAD | Athrosclerosis- plague lines the walls of med and large arteries. These lesions protrude into the artery and may affect blood flow through the artery. |
| Give a breif description of pathophysiology of heart failure | Compensatory mechanisms are activated to maintain blood flow to the body and tissues. Heart failure occurs when CM can no longer maintain cardiac output that meets the metabolic needs of the body. |
| Give a breif description of pathophysiology of Acute Pulmonary Edema | There is an accumulation of fluid in the interstitial spaces and alveoli of the lungs. This can occur due to severe left sided heart failure. |
| Give a breif description of pathophysiology of HTN | Peripheral vascular resistance is the primary cause of HTN. The resistance to blood flow is increased, primarily due to the constriction of the atrioles. |
| What are 2 early signs of HTN? | Vague HA's and Dizziness |
| What are some of the target organs damaged by HTN? | Eyes, Heart, Brain, Kidneys and Vascular System |
| Give a breif description of why Angina Pectoris occurs | There is a temporary imbalance between myocardial O2 needs and supply avaliable. Supply and demand |
| What are two types of Angina | Stable and Unstable |
| What are some clinical manifestations of Angina | Chest Pain substernal or precordial (across the chest). pain may radiate into arms, neck, jaw. Pain may be described as tight, constricting, pressure, heavy. SOB, pallor, anxiety, fear |
| What is NSG main focus with Angina | Decrease workload, increase o2, increase blood supply, NTG |
| Describe unstable angina | Unprovoked occurs with increasing frequency, severity and duration. Patients at risk for AMI |
| What level should O2 be set to with Angina Pectoris | O2 4-6L |
| Name 4 modifiable risks with CAD | Diet, Exercise, Smoking, HTN |
| What are some nonmodifiable risks for CAD | Age, heredity, Gender, Race / Ethnic background |
| What are some labs ran for CAD | Lipid profile, CBC, Cardiac Marker, CRP or HS CRP, Homocystine Level, Coag studies |
| How is the WBC affected | Increases within 72 hours |
| What is the normal Triglycerides | Less than 100 |
| What is the normal level for HDL | More than 35 |
| What is the normal level for LDL | Less than 100 |
| What are the cardiac markers | Myoglobin, troponin, CKMBI |
| How is Myoglobin effected with cardiac damage? | Level increases in 2-6 hours post skeletal and cardiac muscle damage |
| How is Troponin effected with cardiac damage? | Level increases in 3-5 hours cardiac cell damage. |
| How is CKMBI effected with cardiac damage? | Level increases in 4-6 hours and peaks in 12 hours. |
| What are some labs that are ran with CAD? | ANF, BNP, Lipid profile, Cardiac Markers |
| What are some diagnostic tests that are ran with CAD? | Echo, Angiography, CXR, EKG, ETT, Event Monitor, CT |
| What does an ECHO show? | Shows how the heart and valves are working. |
| What does an Angiography show? | Allows for visualization of arteries and measures pressure. |
| What should be done prior and post cath? | Check vitals including pedal pulses. D/C anticoagulants |
| What are two types of closures used with CAD? | Vasoceal which is a collagen plug. Bed rest 8 hours. Star Closure cuts bed rest in half. |
| What can a CT show regarding CAD? | Allows for measuring calcium deposits. The more calcium the more plague |
| How does a Beta Blocker work? | This medication - Decreased HR, Decreased cardiac work and myocardial work demand. |
| What is a Calcium channel blocker work? | Decreased blood pressure, decreases force of contraction, prevents calcium levels from increasing |
| What is an Ace Inhibitor? | Medication blocks the effects of RAAS, reduces vasoconstriction and sodium water retention. Result is decreased cardiac workload and decreased edema. |
| When does Ishemia occur with an AMI | Within 20-45 minutes of MI. Causes irreversible damage--> Tissue death |
| What are some nursing priorities with AMI | Decrease workload, increase O2, Treat and prevent complications |
| What are some patient problems with AMI | Pain secondary to Ischemia,SOB, Denial and problems coping |
| What vital sign changes might you see with AMI | Increase HR, Temp, BP, Respirations |
| How does the skin look with AMI | Cool, Clammy, Diaphoretic, Pallor |
| Silent MI occurs most often with what type of patient? | Diabetic and neuropathic |
| What type of symptoms might you see in a women with AMI | Fatigue, sleep disturbances, pain in other areas, dizziness |
| What are some complications with AMI | Sinus Brady, Sinus Tachhy, Ventricular Tachy and Ventricular Fib |
| What is Cardiogenic Shock? | Occurs when more than 40% of left ventricle is infaracted. Impaired tissue perfusion due to pump failure. |
| What are signs and symptoms of Cardiogenic Shock? | Hypotension, decreased urinary output, decreased LOC, Cool clammy skin |
| What are nursing care and treatment concerns for AMI | Decrease workload, decrease pain, Increase O2 2-6L |
| What are 2 meds patient can take at home to treat Angina | ASA and NTG |
| What are some meds used in ER for AMI | MS by IV, O2, Fibrinolytics which needs to be administered within 6 hours to decrease tissue damage and decrease the size of infarction. |
| What are some causes of heart failure? | CAD, HTN, AMI |
| What is the Compensatory Mechanism? | Works to replace ineffective heart pump. Activates SNS and RAAS |
| What is the function of RAAS | Helps to maintain intravascular fluid balance and BP. Regarding CM BP increases, Blood Volume increases with HF. Vasoconstriction, salt and H2O retention occurs, Kidneys don't get enough blood. |
| How does the SNS react to CM | Increases HR, BP, Respirations, Stroke Volume. Arteries and veins constrict to increase blood return to the heart and brain |
| Describe Left Sided Heart Failure | Effected more often since Lt Side is the work horse. Requires high O2 demand. Results from ventricular muscle damage. As left side fails CO decreases and pressure in the pulmonary vascular system increases. Fluid pushed into lung space. |
| What are the clinical manifestations of Heart Failure? | Symptoms are from pulmonary congestion and decreased CO. Fatigue, Activity Intolerance, DOE, Orthopnea, Increase pillows, Crackles, Gurgles |
| In Heart failure how is Systole and Diastole effected? | With Systole there is an inability for contraction. With Diastole the is an inability for relaxation and filling. |
| What are the symptoms of Acute Pulmonary Edema? | Severe dyspnea, CP, SOB, Diaphoresis, Crackles, Gurgles and pink frothy sputum. |
| What are the nursing priorities with APE? | Increase O2, Decrease fluid retention and intake, Cluster activities, Diet- decrease sodium |
| What are some patient problems with APE? | Decrease in CO, Excessive fluid volume, Activity Intolerance, Changes in mental status due to lack of O2, Decrease in HR |
| What medications are prescribed for APE? | Ace Inhibitors, Diuretics, SNS mimetics, Primacore Vasodilator, and anticoagulants. |
| What medication is given as the first line of defense for APE? | Ace Inhibitors |
| What are 2 statistics for HTN | 71% of people over 80 have HTN and 35% are blacks |
| What is the normal BP? | 120/80 |
| What is considered prehypertension | 120-139 / 80-89 |
| What is considered stage I hypertension | 140-159 / 90-99 |
| What is considered stage II hypertension | 160/110 |
| What is the primary percentage for HTN? | 95% |
| What are two types of HTN and how do they differ? | Primary and Secondary. Secondary there is a possibility to get control it and BP returns to normal. Stenosis , Stimulants, Chronic renal failure (can't cure), Thyroid and pregnancy. |
| What are diagnostics and labs for HTN? | V.S., Orthostatic BP, Lipid Panel, Bytes, BUN, Creatinine and creatinine clearence. |
| What diet should be used for HTN patients? | DASH diet. Veges and fruite, low fat and sodium |
| What are two nurse teaching for HTN | Control = zero cure adn report side effects- educate |
| What is the characteristic pattern of Angina | Exercise=pain Rest=relief |
| What is Ischemia | Lack of blood supply which equals lack of O2 |
| What are the 4 "E" s | Exercise, Emotions, Eating Heavy, and Extreme temp changes |
| What are the clinical manifestations of Angina Pectoris | CP for less than 3-5 minutes. Pain is relieved by rest and with exertion pain is less than 15 minutes. |
| What medications are given for heart failure? | Ace Inhibitors, Diuretics, Positive Inotrops Digoxin and SNS mimetic dopamine |
Created by:
preetyenya
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