NUR 372 Exam 2 Questions and Correct Answers, With Complete Solution. Exam Prep.

NUR 372 Exam 2 Questions and Correct Answers, With Complete Solution. Exam Prep. Coronary artery disease (CAD) coronary arteries are obstructed or dysfunctional ischemic or infarcted athertosclerosis most common cause of coronary artery disease infarcted 0 oxygen muscle dies and is irreversible treatment for CAD lifestyle changes medication heart cath with balloon and/or stent coronary artery bypass grafting goal of medications for CAD decrease oxygen demand and increase oxygen supply Acute coronary syndrome damage or destruction of heart muscle from lack of oxygenated blood STEMI NSTEMI Unstable Angina unstable angina chest pain at rest emergency NSTEMI non-ST elevation MI partial occlusion or temporary complete blockage STEMI ST elevation MI complete occlusion common MI women/diabetes Who might have abnormal symptoms of ischemia Nitro vasodilator increases blood flow to heart muscle but dilating coronary arteries Antihypertensives reduce workload of the heart beta blockers and calcium channel blockers Antiplatelet prevent platelet aggregation Aspirin, Clopidogrel Anticoagulants prevent thrombus formation Meds for Angina treatment Nitro Antihypertensives Antiplatelet Anticoagulants Immediate intervention If the patient starts complaining of chest pain Aspirin first medication given if patient complains of chest pain - might chew Nitroglycerin given after Aspirin if chest pain is reported every 5 min, max of 3 doses Administer oxygen third action if patient has unrelieved chest pain and if symptomatic Morphine given fourth for chest pain (with caution!) and only after Nitro Myocardial infarction tissue death from prolonged and severe ischemia (irreversible) long term complications from MI heart failure dysrhythmias Coronary artery bypass grafting bypass blocked coronary artery Systolic heart failure impaired contraction weak, floppy heart muscle Diastolic heart failure impaired filling stiff, rigid heart muscle Ejection fraction % of blood ejected from left ventricle with each contraction normal = 50-70% HF = 40% Right heart failure blood can not pump into lungs, and blood backs up into the body causes of RHF pulmonary hypertension pulmonary embolism symptoms of RHF edema ascites JVD hepatomegaly Weight gain Left heart failure blood can not pump out of the LV and blood backs up into the lungs (fluid volume overload) LV becomes enlarged and weak Congestive heart failure congestion (fluid build up) in the body can be from RHF, LHF, or both symptoms of LHF pulmonary congestion (cough, crackles, wheezes) tachycardia fatigue cyanosis BNP specific lab value for heart failure Medications for HF diuretics angiotensin system blockers vasodilators positive inotropes Potassium, BUN & Cr, Sodium What are some pertinent labs related to HF meds? assess lab work, check BP, HR What assessments should you complete pre- and post- admin for HF meds? Valvular Disease disrupted flow over the cardiac valves will hear murmur and/or click most common valvular disease aortic stenosis and mitral regurgitation Mitral valve regurgitation backward flow into left atrium backs up from LA into pulmonary vessels leads to pulmonary edema mimics left heart failure Aortic stenosis blood flow is obstructed out of left ventricle causes LV muscle to enlarge due to excess work to force blood out mimics left heart failure Echo (TTE/TEE) primary diagnosis tool for valvular disease Infective endocarditis infection of the inner layer of the heart (endocardium) treat with IV antibiotics clinical manifestations of infective endocarditis Osler's nodes Janeway lesions splinter hemorrhages s/s of infections myocarditis inflammatory disease of the myocardium most commonly caused by infection or autoimmune disease Labs for myocarditis cardiac biomarkers, sed rate, CRP typically use an echocardiogram treatment for myocarditis treat underlying cause and symptom management Pericarditis inflammation of pericardium idiopathic infectious/noninfections pleuritic chest pain (relief with sitting up, leaning forward) friction rub fever Pericardial effusion accumulation of fluid in pericardial sac complication - cardiac tamponade Pericardiocentesis draining of fluid via needle to aspirate fluid Cardiac tamponade heart is not able to contract and expand like it needs to because of the fluid Beck's Triad (JVD, muffled heart sounds, hypotension) Atherosclerosis buildup of plaque in arterial walls caused by high cholesterol atherosclerosis if in coronary arteries myocardial infarction atherosclerosis if in peripheral arteries pain, difficulty walking peripheral arterial disease severe blockages could result in gangrene Peripheral arterial disease obstruction of blood flow through peripheral arteries intermittent claudication (muscle pain in extremities while exercising) atherosclerosis main cause of peripheral arterial disease 5 P's of diagnosing peripheral arterial disease Pain Pulse Pallor