cardiac - HF and CAD

another name for the apical pulse is

pulse of maximum impulse (PMI)

which artery is most commonly affected by CAD

left anterior descending

when listening to the aortic valve the nurse would place her stethoscope where

right 2nd intercostal space

when listening to the pulmonic valve the nurse would place her stethoscope where

left 2nd intercostal space

when listening to the tricuspid valve the nurse would place her stethoscope where

left 4th intercostal space

when listening to the mitral valve/apical pulse the nurse should place her stethoscope where

left 5th intercostal space at midclavicular line

what organ is affected by left sided heart failure

lungs

what is affected when someone has right sided heart failure

the body

R or L HF:

• pulmonary congestion

• dyspnea

• orthopnea

• crackles

• pink frothy sputum

• tachypnea

left

R or L HF:

• peripheral edema

• JVD

• hepatomegaly

• ascites

• weight gain

• bounding pulses

right

which chamber of the heart is affected in left sided HF

left ventricle can’t pump blood to body

which chamber of the heart is affected in right sided HF

right ventricle can’t pump blood to lungs

name the term: amount of blood put out by the left ventricle after one contraction/beat

stroke volume

stroke volume is made of what three components

preload, afterload, and contractility

what is preload

volume of blood stretching ventricles before they contract (diastole)

what are two situations where the preload increases

hypervolemia, regurgitation in valves

what is afterload

resistance left ventricle must overcome to circulate blood

afterload is increased in what two most common situations

hypertension and vasoconstriction

name the term: the amount of blood that pumps through the circulatory system in one minute

cardiac output

what two components determine the cardiac output

stroke volume and heart rate

what is the normal cardiac output for an adult

~4.7L/min

what is the leading cause of mortality/morbidity in the US

CAD

CAD results in what two things

ischemia and infarction of myocardial tissue

do NOT give digoxin if HR < __

60

what are 3 common comorbidities with CAD

HTN, DM, obesity

which cholesterol is considered “good”

HDL

which cholesterol is considered “bad”

LDL

what are 4 kinds of meds someone with CAD may be on

anticoagulants, anti-HTN, DM meds, statins

why is eloquis better for compliance than coumadin

with coumadin labs need to be checked weekly

eloquis has a higher ________ _________ than coumadin

therapeutic window

what is a popular anti-diabetic med for T2 diabetes someone with CAD may have

metformin

when taking blood thinners/anti-coagulants it is important to teach what things

• bruise easily

• soft toothbrush

• gums will bleed > keep brushing to avoid gingivitis

a common AE for lisinopril is

dry cough

metformin helps with

insulin resistance and stabilize BG

what kind of diet should someone with CAD be on

DASH diet

why would statins be given for CAD

to minimize plaque and prevent plaque from sticking to wall

why is it recommended for statins to be taken at PM

facial flushing avoided during the day

what are two risk factors for CAD

smoking and increased age

what are 4 key points to educate a patient on who has been newly diagnosed with CAD

reduce stress, med adherence, exercise, diet

why does the risk of CAD increase with age (besides diet)

veins and arteries stiffen with age