SDSU Nurs 323 - Quiz 3 Questions and Correct Answers
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Course
NUR 323
Institution
NUR 323
What is coronary artery disease? heart disease caused by impaired coronary blood flow
Where is the left main artery? main vessel that comes off left ventricle - supplies whole left side of heart "widow maker"
What happens if left main artery is occluded? left side loses ability to contract
Where...
SDSU Nurs 323 - Quiz 3 Questions and
Correct Answers
What is coronary artery disease? ✅heart disease caused by impaired coronary blood
flow
Where is the left main artery? ✅main vessel that comes off left ventricle - supplies
whole left side of heart
"widow maker"
What happens if left main artery is occluded? ✅left side loses ability to contract
Where is the left anterior descending artery? ✅from front and bottom of left ventricle
What happens if the left anterior descending artery is occluded? ✅bottom of ventricle
loses ability to contract
Where is the circumflex? ✅covers side and back of left ventricle - feeds left atrium
What does the right coronary artery feed? ✅right side of heart
What happens if the right coronary artery is occluded? ✅whole right side of heart loses
ability to contract
What is the pathogenesis of coronary artery disease? ✅endothelium of healthy arteries
autoregulates coronary blood flow - dilate when need for increase o2
Atherosclerosis causes a fail in... ✅autoregulation
Atherosclerosis causes a narrowing of ___________. Over time, ________ need will
exceed supply ✅vessels - o2
What is a stable plaque? ✅obstructs flow but does not travel - has thick fibrous cap
What is an unstable plaque? ✅can rupture causing platelets to stick - becomes
thrombus
What is included in plaque vulnerability? ✅thin fibrous cap w/ large lipid core
Hemodynamic triggers
Vessel tension
Sympathetic surge
,What are hemodynamic triggers? ✅blood flow turbulence - high turbulence causes
plaque to break off
What is vessel tension? ✅stretch of vessel wall - the more the stretch, the less likely it
will break off - the stiffer it is, the more likely it will break
What is sympathetic surge? ✅things that push hr and stress
What are examples of sympathetic surge? ✅emotions
Physical - cold, running, etc
Lipid core stimulates platelets to stick which stimulates.... ✅clotting cascade..thrombus
formed..decreased perfusion...ischemia and/or necrosis
Most commonly occurs in the 1st hour after waking
What are acute coronary syndromes? ✅spectrum of heart disease problems - starts w/
unstable angina to mi
Classifications of acute coronary syndromes are based on the presence or absence of
what? ✅ecg, serum biomarkers
What will an ecg show in an acute coronary syndrome? ✅st elevation or depressoin
What are serum biomarkers? ✅troponin i and t
Ck-mb (isoenzyme)
What is the most specific indicator of mi? ✅troponin i and t
When do troponin levels rise? ✅within 3 hours of damage
Can be measured for 7-10 days after mi
What is the normal troponin range? ✅0-0.05 ng/dl
What is ck-mb? ✅creatine kinase myocardial band
When does ck-mb elevate? ✅4-8 hours
Returns to normal within 2-3 days
What is the type of pain associated with an unstable angina/non-st elevation myocardial
infarction (nstemi)? ✅pain that persists and occurs at rest and last more than 20 mins
w/ no nitroglycerine given
Pain that persists and is severe w/ a new onset
More severe and prolonged pain that is increasing in frequency
, What causes nstemi? ✅unstable plaque that ruptures
Vessel obstruction that causes constriction or spasms within bv - leads to narrowing of
coronary lumen
Inflammation
Unstable angina will not have what? ✅elevated markers and st seg elevation
Nstemi -> infarction -> ✅damage to tissue that causes release of biomarkers
- main difference between unstable angina and mi
- ecg findings
What causes stemi? ✅atherosclerosis -> complete vessel occlusion -> lack of blood
flow to myocardium
O2 demand exceeds supply -> anaerobic metabolism -> build up of lactic acid
Compensatory mechanisms -> increase in hr -> vasoconstriction of peripheral vessels -
> causes more damage
What pain is associated w/ stemi? ✅pressure radiating from left shoulder/arm - may
also go up neck and into jaw
What pain might women feel w/ stemi? ✅atypical chest pain - shoulder hurts, pain in
elbow, nauseated
What gi symptoms might a pt feel with stemi? ✅nausea, heart burn/reflux
Treat gi symptoms to rule out
What skin changes happen w/ stemi? ✅pallor or flushed, diaphoretic and clammy
W/ a stemi, when does cardiac cell necrosis occur? ✅20-40 mins biomarkers are
released
What are pathologic changes associated w/ mi? ✅transmural injury
Subendocardial injury
What is a transmural injury? ✅goes full thickness of heart wall
That part is no longer able to contract/pump
What happens to st seg w/ transmural injury? ✅st seg elevation
What is subendocardial injury? ✅inner 1/3 to inner 1/2 of ventricle wall - still able to
pump, but not functionally
What happens to st seg w/ subendocardial injury? ✅st seg depression
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