Actual CCRN CARDIAC Exam Test Bank (
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Terms in this set (468)
Syndrome of acute myocardial ischemia caused by
Acute Coronary
atherosclerotic plaque rupture and thrombus
Syndrome (definition)
formation
Acute Coronary Same as Coronary Artery Dz, Angina Pectoris, and
Syndrome (etiology) Myocardial Infarction
Coronary Artery Disease A progressive disease of the coronary arteries that
(definition) results in their narrowing of obstruction
1.Arteriosclerosis: a group of diseases characterized
by thickening and loss of elasticity (calcification) of
arterial walls
2. Atherosclerosis: the most common form of
arteriosclerosis.
a. A chronic disease process characterized by the
build-up of fatty plague along the subintimal layer
CAD (pathophysiology) of arteries leading to a decrease in arterial luman.
3. Decreased blood flow and oxygen supply to the
myocardium lead to imbalance between oxygen
supply and oxygen demand.
a. Gradual or partial occlusion: ischemia causing
angina
b. Sudden or complete occlusion: necrosis causing
MI
, 1. Angina pectoris
Pathologic Consequence 2. MI
of Atherosclerosis and 3. Heart failure
Arteriosclerosis 4. Dysrhythmias caused ischemia
5. Sudden death
Factors that decrease supply
a. Arteriosclerosis/atherosclerosis
b. Coronary artery spasm
c. Aortitis
d. Dysrhythmias
e. Anemia
Angina Pectoris f. Shock
(etiology)
Factors that increase demand:
a. HTN
b. Aortic valve dz
c. Tachydysrhythmias
d. HF
e. Hyperthyroidism
1. Subjective
a. Substernal chest discomfort that usually lasts 1 to
4 minutes and subsides with rest and/or nitro use.
1. Discomfort may be described as burning,
squeezing, tightness, pressure, heaviness,
indigestion, or aching.
Angina Pectoris (clinical
presentation - subjective)
2. Pain may radiate to shoulders, back, arms, jaw,
neck, and epigastrium
b. Dyspnea
c. N/V
d. Anxiety
e. Weakness
a. Tachycardia
b. Hypotension or HTN
Angina Pectoris c. Tachypnea
(objective) d. Pallor
e. Diaphoresis
g. S4
, a. Serum
1. Isoenzymes: negative for cardiac damage
2. Fasting glucose: to identify DM or glucose
intolerance as a risk factor
Angina Pectoris b. ECG
(Diagnostic) 1. ST segment depression in unstable angina
2. ST segment elevation in variant angina
3. Ventricular dysrhythmias may be present
c. Cardiac cauterization: coronary artery occlusion
75% or greater; may be negative in variant angina
but develop occlusion from spasm
Types of Angina Stable and Unstable Angina
- Unchanging frequency, duration, and severity
Stable Angina (signs and
- Predictable to the patient
symptoms)
- ST segment depression may occur during pain
, 1. Relieve chest pain
a. Nitro
b. Calcium channel blockers (especially for variant
angina)
c. Morphine sulfate may be required for unstable
angina
2. Increase oxygen demand
a. nasal canula 5L/min during ischemic pain unless
contraindicated by lung dz.
b. Blood transfusion if angina caused by anemia
c. Platelet aggregation inhibitors (e.g., aspirin or
ticlopidine to prevent platelet aggregation; heparin
may be prescribed to prevent clotting or extension
Angina Pectoris of clot
(Collaborative d. IABP - may be used in unstable angina; IABP
Management) increases coronary artery perfusion pressure
(CAPP)
3. Decrease oxygen demand
a. Removal of provoking factors
1. Activity cessation immediately when chest pain
occurs
2. Bed rest during pain; semi-Fowler position usually
most comfortable
b. NTG as prescribed
1. NTG in doses less than 1 mcg/kg/min is a
predominately venous dilator (decreases after load
and preload as well); it decreases myocardial
workload and myocardial oxygen consumption by
decreasing preload.
Scored 100% On Cardiac Section With This)
Recently Verified Solution
Save
Terms in this set (468)
Syndrome of acute myocardial ischemia caused by
Acute Coronary
atherosclerotic plaque rupture and thrombus
Syndrome (definition)
formation
Acute Coronary Same as Coronary Artery Dz, Angina Pectoris, and
Syndrome (etiology) Myocardial Infarction
Coronary Artery Disease A progressive disease of the coronary arteries that
(definition) results in their narrowing of obstruction
1.Arteriosclerosis: a group of diseases characterized
by thickening and loss of elasticity (calcification) of
arterial walls
2. Atherosclerosis: the most common form of
arteriosclerosis.
a. A chronic disease process characterized by the
build-up of fatty plague along the subintimal layer
CAD (pathophysiology) of arteries leading to a decrease in arterial luman.
3. Decreased blood flow and oxygen supply to the
myocardium lead to imbalance between oxygen
supply and oxygen demand.
a. Gradual or partial occlusion: ischemia causing
angina
b. Sudden or complete occlusion: necrosis causing
MI
, 1. Angina pectoris
Pathologic Consequence 2. MI
of Atherosclerosis and 3. Heart failure
Arteriosclerosis 4. Dysrhythmias caused ischemia
5. Sudden death
Factors that decrease supply
a. Arteriosclerosis/atherosclerosis
b. Coronary artery spasm
c. Aortitis
d. Dysrhythmias
e. Anemia
Angina Pectoris f. Shock
(etiology)
Factors that increase demand:
a. HTN
b. Aortic valve dz
c. Tachydysrhythmias
d. HF
e. Hyperthyroidism
1. Subjective
a. Substernal chest discomfort that usually lasts 1 to
4 minutes and subsides with rest and/or nitro use.
1. Discomfort may be described as burning,
squeezing, tightness, pressure, heaviness,
indigestion, or aching.
Angina Pectoris (clinical
presentation - subjective)
2. Pain may radiate to shoulders, back, arms, jaw,
neck, and epigastrium
b. Dyspnea
c. N/V
d. Anxiety
e. Weakness
a. Tachycardia
b. Hypotension or HTN
Angina Pectoris c. Tachypnea
(objective) d. Pallor
e. Diaphoresis
g. S4
, a. Serum
1. Isoenzymes: negative for cardiac damage
2. Fasting glucose: to identify DM or glucose
intolerance as a risk factor
Angina Pectoris b. ECG
(Diagnostic) 1. ST segment depression in unstable angina
2. ST segment elevation in variant angina
3. Ventricular dysrhythmias may be present
c. Cardiac cauterization: coronary artery occlusion
75% or greater; may be negative in variant angina
but develop occlusion from spasm
Types of Angina Stable and Unstable Angina
- Unchanging frequency, duration, and severity
Stable Angina (signs and
- Predictable to the patient
symptoms)
- ST segment depression may occur during pain
, 1. Relieve chest pain
a. Nitro
b. Calcium channel blockers (especially for variant
angina)
c. Morphine sulfate may be required for unstable
angina
2. Increase oxygen demand
a. nasal canula 5L/min during ischemic pain unless
contraindicated by lung dz.
b. Blood transfusion if angina caused by anemia
c. Platelet aggregation inhibitors (e.g., aspirin or
ticlopidine to prevent platelet aggregation; heparin
may be prescribed to prevent clotting or extension
Angina Pectoris of clot
(Collaborative d. IABP - may be used in unstable angina; IABP
Management) increases coronary artery perfusion pressure
(CAPP)
3. Decrease oxygen demand
a. Removal of provoking factors
1. Activity cessation immediately when chest pain
occurs
2. Bed rest during pain; semi-Fowler position usually
most comfortable
b. NTG as prescribed
1. NTG in doses less than 1 mcg/kg/min is a
predominately venous dilator (decreases after load
and preload as well); it decreases myocardial
workload and myocardial oxygen consumption by
decreasing preload.
