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NUR 339 ( LATEST 2024 / 2025 ) FINAL EXAM 3 | GRADED A+ | PASSED | NEW FULL EXAM ACTUAL
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NUR 339 ( LATEST 2024 / 2025 ) FINAL EXAM 3 | GRADED A+ | PASSED | NEW FULL EXAM ACTUAL
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NUR 339 Final Exam 31. coronary heart disease
-heart disease caused by impaired coronary blood flow
-AKA ischemic heart disease, coronary artery disease
-leading cause of death in US
-main cause
atherosclerosis
-includes
angina, myocardial infarction, cardiac dysrhythmias, HF, sudden death
2. atherosclerosis pathophys
-inflam response to injury vascular endothelium
-attracts macrophages to area which digest lipids and transport lipids to arterial wall, form fatty
streaks
-sm muscles proliferate and form a fibrous cap over lipids and inflammatory deposits
atheroma or plaque
-plaques protrude into artery
-narrowing of artery from
plaque buildup, endothelium w decrease antithrombin and vasodilation, 75% narrowing causes
significant decrease in blood flow
,-progresses over many years
-causes
smoking, HTN, hyperlipidemia
3. thick v thin cap atherosclerosis
-thick
plaque stable, resists blood flow
-thin
plaque unstable, thrombus risk
4. modifiable risk factors atherosclerosis
-diet
-exercise
-smoking/tobacco
-high cholesterol
-HTN
-DM
-obesity
5. nonmodifiable risk factors for atherosclerosis
-fam Hx/genetics
-age
-men>women
-race
,higher in african-am
-premature menopause (before 40yr)
-pregnancy complications
preeclampsia
6. thrombosis w atherosclerosis
-may occur when plaque ruptures
-mild injury
intermittent thrombotic occlusions may occur leading to anginal pain at rest
-thrombus formation can progress to complete occlusion of coronary artery leading to MI
-hemodynamic changes contribute to plaque rupture
increase in SNS activ w increase in BP, HR, force of contraction, and coronary blood flow
-plaque rupture freq occurs in morning
7. ischemia
-vessel partially occluded
inadequate blood supply supply > inade- quate O2 supply
-pain during activ, relieved w rest
-reversible is O2 supply restored
, no permanent damage
-meds and rest reverse
8. infarction
-vessel totally occluded (MI)
-no blood flow > no O2 to area blocked by thrombus
-pain not relieved by rest or meds
-damage occurs
9. CHD in normal coronary arteries
-due to increase in heart muscle demand (thyrotoxicosis)
-due to decreased perfusion pressure (aortic stenosis)
-due to spasm
10. LCA
-L main artery splits into circumflex and L anterior descending artery
-LAD
supplies L ventricle, anterior septum, papillary muscle
-circumflex
supplies L lat wall of LV
11. RCA
-supplies SA nodes and R ventricle> extends to back of heart
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