NUR 405 > CHD > Flashcards

CHD Flashcards

(109 cards)

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1
Q

Other names for Coronary Heart Disease (CHD)?

A

Ischemic Heart Disease and Coronary Artery Disease (CAD)

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2
Q

What is the underlying problem in CHD?

A

Reduced blood flow to the myocardium due to coronary artery atherosclerosis

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3
Q

Non-modifiable risk factors for CHD?

A

Age; Male gender; Family history of premature cardiovascular disease

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4
Q

Why does CHD risk increase with age?

A

Risk increases significantly with each decade of life

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5
Q

Gender risk for CHD?

A

Men are at greater risk (possible Y chromosome influence)

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6
Q

Four most established modifiable risk factors for CHD?

A

Elevated serum lipids; Hypertension; Tobacco use; Physical inactivity

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7
Q

Total cholesterol level indicating increased CHD risk?

A

> 200 mg/dL

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8
Q

Triglyceride level indicating CHD risk?

A

> 150 mg/dL fasting

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9
Q

Which lipoprotein is protective?

A

HDL

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10
Q

Which lipoprotein increases CHD risk?

A

LDL

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11
Q

Hypertension definition for CHD risk?

A

> 140/90 mmHg OR >130/80 with diabetes or CKD

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12
Q

Relationship between smoking and CHD risk?

A

Risk increases proportional to number of cigarettes smoked

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13
Q

Other modifiable CHD risk factors?

A

Obesity; Diabetes mellitus; Stress/depression

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14
Q

Body fat distribution associated with higher CHD risk?

A

⚠️ Apple-shaped body (abdominal obesity)

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15
Q

Patient teaching for high cholesterol?

A

Regular lipid screening and statin therapy

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16
Q

Patient teaching for hypertension?

A

Monitor BP regularly and take antihypertensive medications

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17
Q

Key smoking cessation teaching?

A

Benefits occur almost immediately after quitting

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18
Q

Exercise recommendation to reduce CHD risk?

A

40 minutes exercise with warm-up and cool-down 3–4 times per week

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19
Q

Alternative if patient cannot exercise moderately?

A

Walk 30 minutes daily or any distance possible

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20
Q

Dietary teaching for obesity and CHD risk?

A

Avoid fad diets; limit saturated fats sweets and cholesterol

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21
Q

Diabetes teaching to reduce CHD risk?

A

Monitor glycemic index and maintain regular HbA1C checks

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22
Q

Stress reduction strategies for CHD?

A

Incorporate stress management techniques

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23
Q

Definition of chronic stable angina?

A

Chest pain with predictable exertion relieved by rest or nitroglycerin

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24
Q

Cause of chronic stable angina?

A

Fixed atherosclerotic plaque

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25
Activity limitation in chronic stable angina?
Usually mild and predictable
26
Typical treatment for stable angina?
Medication therapy and lifestyle modification
27
First diagnostic step for stable ischemic heart disease?
History and physical examination
28
Common diagnostic tests for stable ischemic heart disease?
ECG; stress testing; echocardiogram
29
Purpose of stress test?
Detect ischemia not present at rest
30
High-risk stress test findings lead to what?
Coronary angiography and revascularization
31
Primary goal in treating stable angina?
Decrease oxygen demand and increase oxygen supply
32
Medication used to reduce clot risk in stable angina?
Antiplatelet therapy such as aspirin
33
Medication class proven to improve survival after MI?
Beta blockers
34
Common combination therapy for angina?
Beta blocker plus calcium channel blocker
35
First-line drug for acute angina symptoms?
Sublingual nitroglycerin
36
Newer angina medication?
Ranolazine (Ranexa)
37
⚠️ Emergency instruction after taking first nitroglycerin?
If chest pain not improved after 5 minutes call EMS
38
How is nitroglycerin administered for acute angina?
Sublingual under the tongue
39
Expected onset of sublingual nitroglycerin?
<3 minutes
40
What sensation indicates nitroglycerin is active?
Tingling under the tongue
41
⚠️ Unexpected nitroglycerin finding?
No tingling may indicate medication inactive
42
Nitroglycerin storage teaching?
Protect from light and replace every 6 months
43
Common nitroglycerin side effects?
Headache flushing dizziness hypotension
44
⚠️ Dangerous drug interaction with nitroglycerin?
Erectile dysfunction medications
45
Major risk with nitrates?
Postural hypotension
46
Definition of Acute Coronary Syndrome (ACS)?
Spectrum including unstable angina NSTEMI and STEMI
47
Characteristics of unstable angina?
Occurs at rest lasts >20 minutes and poorly relieved by NTG
48
⚠️ Why unstable angina is dangerous?
It is unpredictable and an emergency
49
Troponin levels in unstable angina?
Normal
50
Troponin levels in NSTEMI?
Elevated
51
Difference between NSTEMI and STEMI?
STEMI has ST elevation and more extensive infarction
52
Common atypical angina symptoms in women?
Fatigue shortness of breath indigestion anxiety
53
Angina pain characteristics?
Triggered by exertion relieved by rest or NTG lasts <15 min
54
Myocardial infarction pain characteristics?
Occurs without cause lasts >20 min relieved only by opioids
55
Common associated symptoms with MI?
Nausea vomiting diaphoresis dyspnea anxiety dysrhythmias
56
⚠️ Peak time for MI occurrence?
Early morning around 4–6 AM
57
How long myocardial cells tolerate ischemia before death?
About 20 minutes
58
Time for full thickness myocardial necrosis?
4–6 hours
59
Why rapid treatment of MI is critical?
Delays cause irreversible myocardial damage
60
Common descriptions of MI pain?
Crushing pressure heaviness burning tightness
61
⚠️ Silent MI occurs most often in?
Women and patients with diabetes
62
Most common complication of MI?
Dysrhythmias
63
Most common cause of pre-hospital MI death?
Fatal dysrhythmias
64
Heart failure after MI occurs due to?
Loss of myocardial pumping ability
65
Definition of cardiogenic shock?
Severe LV failure causing inadequate perfusion
66
⚠️ Mortality of cardiogenic shock?
Very high
67
Papillary muscle dysfunction sign?
New heart murmur
68
Pericarditis after MI occurs when?
2–3 days after infarction
69
Assessment finding in pericarditis?
Pericardial friction rub
70
First diagnostic test for ACS?
12-lead ECG
71
Time goal for ECG after arrival?
Within 10 minutes
72
STEMI ECG finding?
ST elevation in two contiguous leads
73
NSTEMI ECG findings?
ST depression or T-wave inversion
74
Purpose of serial ECGs?
Detect evolving ischemia or infarction
75
Most specific cardiac biomarker?
Troponin
76
When troponin rises after MI?
2–3 hours
77
How long troponin remains elevated?
10–14 days
78
Initial ACS nursing priorities?
Assess ABCs administer oxygen establish IV access
79
Positioning for patient with ACS?
Upright to improve ventilation
80
First medication given in ACS?
Aspirin 325 mg chewable
81
Nitroglycerin dosing for ACS?
Up to 3 doses 5 minutes apart
82
Medication given if pain persists after nitroglycerin?
Morphine IV
83
Purpose of morphine in MI?
Decrease preload afterload and anxiety
84
Lab tests monitored in ACS?
Cardiac markers electrolytes H&H coagulation studies
85
Electrolytes important for cardiac stability?
Potassium magnesium calcium
86
Mnemonic used to assess chest pain?
PQRST
87
PQRST meaning?
Precipitating factors Quality Radiation Severity Timing
88
Three reperfusion strategies for MI?
PCI thrombolytics CABG
89
First-line treatment for confirmed MI?
Percutaneous coronary intervention (PCI)
90
Door-to-balloon goal time for PCI?
Within 90 minutes of ED arrival
91
Purpose of PCI?
Open blocked coronary artery using balloon or stent
92
Advantages of PCI?
Less invasive shorter recovery shorter hospital stay
93
Typical medications after PCI?
Dual antiplatelet therapy (aspirin plus clopidogrel)
94
Major complication after PCI?
Bleeding at access site
95
Definition of thrombolytic therapy?
Medications that dissolve clots in coronary arteries
96
Examples of thrombolytics?
tPA and reteplase
97
Best timeframe for thrombolytic therapy?
Within 6 hours of coronary event
98
Door-to-needle goal time for thrombolytics?
Within 30 minutes of ED arrival
99
Major complication of thrombolytics?
⚠️ Bleeding
100
Contraindications to thrombolytics?
History of intracranial hemorrhage recent surgery active bleeding
101
Definition of CABG?
Surgical procedure bypassing blocked coronary arteries
102
Who typically needs CABG?
Patients with diabetes or multi-vessel disease
103
Graft vessels used in CABG?
Internal mammary artery or saphenous vein
104
Post-CABG complications?
Stroke MI infection dysrhythmias
105
Other CABG complications?
Pleural effusion pericardial effusion cardiac tamponade renal failure
106
Definition of cardiac tamponade?
Compression of heart from fluid in pericardial sac
107
Why CABG patients are monitored closely?
Risk for dysrhythmias and hemodynamic instability
108
Post-ACS patient care priorities?
Continuous monitoring rest anxiety management education
109
Purpose of cardiac rehabilitation?
Improve physiologic psychological mental and vocational recovery
NUR 405
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