229 Ch. 23 management of pts with coronary vascular disorders

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What is the most prevalent type of cardiovascular disease in adults?

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1

What is the most prevalent type of cardiovascular disease in adults?

Coronary Artery Disease (CAD)

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2

What is the most common cause of Coronary Artery Disease?

Coronary Atherosclerosis

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3

What are the risk factors for Coronary Artery Disease?

High LDL, diabetes (DM), peripheral artery disease, aortic aneurysm, metabolic syndrome.

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4

What does angina pectoris refer to?

Chest pain caused by myocardial ischemia.

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5

What atypical symptoms do women experience with angina?

Indigestion, nausea, vomiting, and more atypical chest pain.

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6

What is CRP and why is it significant?

C-reactive protein is an inflammatory marker for cardiovascular risk and acute coronary events.

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7

What should be the target levels for LDL and HDL cholesterol?

LDL should be less than 100, HDL should be at least 60.

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8

What diet is recommended for controlling cholesterol?

Emphasis on plant foods, fruits, vegetables, whole grains, and avoiding processed foods.

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9

What is the recommended amount of physical activity per week?

150 minutes of moderate activity or 75 minutes of vigorous activity.

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10

What are common clinical characteristics of stable angina?

Chest pain that can be stopped by medication.

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11

What differentiates unstable angina from stable angina?

Unstable angina doesn't respond to rest or medications and may indicate a myocardial infarction.

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12

What initial action should be taken if a patient experiences chest pain?

Put the patient on supplemental oxygen.

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13

What medications are typically administered for chest pain?

Oxygen, aspirin, nitroglycerin, and morphine.

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14

What does a STEMI require for diagnosis?

Two continuous changes in the ECG within 10 minutes of arrival.

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15

What is troponin and its significance in myocardial infarction?

Troponin is a protein in cardiac cells; its levels are detected within a few hours after an MI.

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16

What should be done immediately when a patient arrives with chest pain?

Start at 2L/min supplemental oxygen.

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17

What does an echocardiogram evaluate after a heart event?

It re-evaluates ventricular function.

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18

What are the phases of cardiac rehabilitation?

Phase 1: Begins at diagnosis; Phase 2: After discharge with supervised training; Phase 3: Long-term outpatient program.

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19

What is the purpose of a cardiac stent?

To provide structural support to a vessel at risk for closure.

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20

What is a possible complication of coronary angioplasty?

Restenosis, which is the re-narrowing of the treated artery.

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21

What should be monitored post-procedure for a patient who had an angioplasty?

BP and HR, as well as the site of access for bleeding.

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22

What is the purpose of beta-blockers after an MI?

To manage arrhythmias.

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23

What kind of grafts can be used for coronary artery bypass surgery?

Arteries from the patient or from an animal (pig or cow).

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24

What surgical complications can occur after coronary artery bypass grafting?

Edema, hemorrhage, myocardial infarction, arrhythmias, and organ failure.

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25

What is an important preoperative assessment for patients undergoing heart surgery?

Reducing fear and anxiety while monitoring for potential problems.

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26

What medications will a patient be on before heart surgery?

Aspirin, beta-blockers, and statins.

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27

How long should patients maintain bed rest following a cardiac procedure?

For 6 hours with the legs straight.

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28

What is important family education before surgery?

Explain what they will see and ensure they have the opportunity to talk.

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29

What does the acronym AHA stand for in relation to dietary guidelines?

American Heart Association.

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30

How should fluid balance be monitored after surgery?

Through input and output (I/O) measurements.

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31

What should be kept on hand postoperatively?

Oxygen and nitroglycerin.

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32

What additional support might be necessary for a patient post-op to adjust body temperature?

A bear hugger for warming.

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33

What is the risk for heart surgery patients related to pain management?

There may be complications such as arrhythmias or cardiac arrest.

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34

What is the importance of monitoring lung sounds postoperatively?

To detect any impairment in cerebral circulation.

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35

Why might a patient need to be placed in a supine position after complications arise?

To manage blood flow and prevent further complications.

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36

How does the patient’s age affect the reporting of chest pain?

Older patients may have diminished pain perception and may not report it accurately.

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37

What guidelines is recommended for dietary cholesterol management?

Avoid foods high in saturated fats and increase intake of plant-based foods.

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38

What kind of stress test is used for diagnosing chest pain?

Exercise or pharmacologic stress test.

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39

What role do anticoagulants play post-procedure?

To help prevent clot formation at the access site.

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40

What is necessary for a physician’s assessment of cardiac output post-op?

Monitoring vital signs and blood flow status regularly.

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41

What is a key indicator that a myocardial infarction may be occurring?

Persistent chest pain that continues with rest.

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42

What is a non-specific test that can rule out myocardial infarction?

Myoglobin test.

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43

What is an essential aspect of Phase 2 cardiac rehabilitation?

Supervised ECG-monitored exercise training.

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44

What lifestyle change is imperative for cardiac health in relation to smoking?

Smoking cessation.

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