RNSG 1443 - Cardiovascular
What are the stages of plaque development? - Answer- Fatty streak
Fibrous plaque
Complicated lesion
What is collateral circulation and why is it important? - Answer- *What:* Circulation of blood established through minor modified vessels and anastomosis of vessels...
RNSG 1443 - Cardiovascular
What are the stages of plaque development? - Answer- Fatty streak
Fibrous plaque
Complicated lesion
What is collateral circulation and why is it important? - Answer- *What:* Circulation of
blood established through minor modified vessels and anastomosis of vessels with
those of adjacent parts when a major vein or artery is functionally impaired
(obstruction).
*Why:* It provides an alternate route of circulation should an obstruction occur.
Younger people have not yet developed Collateral Circulation and therefore have a
lower survival rate.
What are the modifiable and non-modifiable CAD risk factors? - Answer-
*Modifiable:* High cholesterol, Htn, tobacco, physical inactivity, obesity, stress
*Non-modifiable:* Age, Gender, Family history, Ethnicity
*Contributing:* Diabetes, Insulin resistance, physiologic states, homocysteine
What teaching can we do to decrease risk factors of CAD? - Answer- Exercise, limit
animal fats/dairy, smoking cessation
What is Angina? - Answer- Chest pain caused by a lack of oxygen to the cells
What are the different types of Angina? - Answer- Chronic Stable Angina
Nocturnal Angina
Prinzmetals' angina
Unstable Angina
What are the characteristics of Chronic Stable Angina? - Answer- - Predictable
- May feel like indigestion
- Pain at rest is unusual
- Relieved by rest, NTG or position change
What is Nocturnal Angina? - Answer- Angina that occurs at night; Not necessarily
while sleeping
What is Prinzmetals' Angina? - Answer- Angina that occurs at rest in response to a
coronary artery spasm
What are the characteristics of Unstable Angina? - Answer- Unpredictable
May occur at rest
S/S - fatigue and SOB
What are the treatments for Angina? - Answer- Nitrates
Beta blockers
Calcium channel blockers
ACE inhibitors
, What are the diagnostic tests for Angina? - Answer- Stress test
Cardiac catheterization
PCI/stent
What are the characteristics of a Myocardial Infarction? (What happens?) - Answer-
Sustained ischemia- usually after *20* minutes (magic number)
Thrombus > perfusion stops > necrosis
Pain not relieved by rest, position change, or NTG
BP may go up at first
Decreased renal perfusion
Sweating, nausea and vomiting; Sometimes fever
What are the complications associated with a Myocardial Infarction? - Answer-
*Dysrhythmias-* Likely AFib; most common cause of death
*Heart failure-* Pumping power of the heart is diminished. Crackles and JVD are
common
*Cardiogenic Shock-* Severe left ventricular failure
*Papillary muscle dysfunction-* Mitral Valve regurgitation
*Ventricular aneurysm-* Wall becomes thinned, bulges out during contraction
*Pericarditis-* Friction rub may be heard; Can be up to 2 weeks after MI
*Dressler Syndrome-* Pericarditis with effusion and fever 4-6 weeks after MI
What is MONA? - Answer- Drug therapy for MI patients
Stands for: Morphine, Oxygen, Nitroglycerin, Aspirin
Given in the order of: OANM
What are the diagnostic tests for a Myocardial Infarction? - Answer- *ECG-* STEMI
vs. Non-STEMI (elevated ST segment)
*Cardiac enzymes-* troponin and creatine kinase (in the bloodstream)
*Cardiac catheterization*
*PCI/stent*
*Fibrinolytic therapy-* "clot busters" Give within 6 hrs of chest pain
What question should we ask patients when they complain of chest pain? - Answer-
When did it start? (To know if fibrinolytics are a viable treatment option -- Can only
be given within 6 hours of chest pain)
How would you assess the effectiveness of a fibrinolytic medication? (What would
you look for?) - Answer- Absence of chest pain
What is a Coronary Artery Bypass Graft? - Answer- Construction of new conduits
between the area that is blocked and another major artery
The internal mammary artery is most commonly used but the saphenous vein is also
common.
Post op neurovascular checks are important.
What should be included in patient teaching after a Myocardial Infarction? - Answer-
*Prevention of anginal attacks*
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