229 Ch. 23 management of pts with coronary vascular disorders

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

Coronary Artery Disease (CAD)

What is the most common cause of Coronary Artery Disease?

Coronary Atherosclerosis

What are the risk factors for Coronary Artery Disease?

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

What does angina pectoris refer to?

Chest pain caused by myocardial ischemia.

What atypical symptoms do women experience with angina?

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

What is CRP and why is it significant?

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

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

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

What diet is recommended for controlling cholesterol?

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

What is the recommended amount of physical activity per week?

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

What are common clinical characteristics of stable angina?

Chest pain that can be stopped by medication.

What differentiates unstable angina from stable angina?

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

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

Put the patient on supplemental oxygen.

What medications are typically administered for chest pain?

Oxygen, aspirin, nitroglycerin, and morphine.

What does a STEMI require for diagnosis?

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

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.

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

Start at 2L/min supplemental oxygen.

What does an echocardiogram evaluate after a heart event?

It re-evaluates ventricular function.

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.

What is the purpose of a cardiac stent?

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

What is a possible complication of coronary angioplasty?

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

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.

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

To manage arrhythmias.

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

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

What surgical complications can occur after coronary artery bypass grafting?

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

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

Reducing fear and anxiety while monitoring for potential problems.

What medications will a patient be on before heart surgery?

Aspirin, beta-blockers, and statins.

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

For 6 hours with the legs straight.

What is important family education before surgery?

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

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

American Heart Association.

How should fluid balance be monitored after surgery?

Through input and output (I/O) measurements.

What should be kept on hand postoperatively?

Oxygen and nitroglycerin.

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

A bear hugger for warming.

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

There may be complications such as arrhythmias or cardiac arrest.

What is the importance of monitoring lung sounds postoperatively?

To detect any impairment in cerebral circulation.

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

To manage blood flow and prevent further complications.

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.

What guidelines is recommended for dietary cholesterol management?

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

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

Exercise or pharmacologic stress test.

What role do anticoagulants play post-procedure?

To help prevent clot formation at the access site.

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

Monitoring vital signs and blood flow status regularly.

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

Persistent chest pain that continues with rest.

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

Myoglobin test.

What is an essential aspect of Phase 2 cardiac rehabilitation?

Supervised ECG-monitored exercise training.

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

Smoking cessation.