2026l Update)l Adultl Healthl Nursingl Il
Completel Guide|l Questionsl &l Answers|l
Gradel A|l 100%l Correctl (Verifiedl
Solutions)-l GCU
Q:l coronaryl arteryl disease
Answer:
diseasel ofl thel bvl inl thel atherosclerosisl family
OTHERl NAMES
-ischemicl heartl disease,l arterioscleroticl HD,l cardiovascularl HD,l coronaryl HD
Q:l etiologyl andl classification
Answer:
-atherosclerosis:l softl fatl depositsl onl thel innerl bvl walll thatl overl timel harden
-causes:l obesity,l hyperlipidemia,l smoking,l HTN,l toxins,l diabetes,l inflam,l infection
-progressive,l 3l stages,l symptomsl appearl whenl itl isl furtherl along
-collaterall circulation:l predisposedl tol angiogenesisl (formationl ofl newl bv),l andl chronicl
ischemial (decreasedl bloodl flow)
>doesntl happenl inl acute
STAGES
1.l fattyl streak:l lipidl filledl endotheliall cells,l yellowl streaksl appear,l byl agel 20.l slowl
progressionl byl decreasingl lipids
2.l fibrousl plaque:l beginningl ofl thel progressivel changesl ofl thel endotheliall wall
-LDLl causel thickeningl ofl thel wall,l collagenl coversl thel fattyl streakl causingl al fibrousl
plaque
3.l complicatedl lesion:
-thel mostl dangerous
-thel inflaml andl growthl ofl thel plaquel causel itl tol ulceratel orl rupture->thrombusl formsl
andl causesl furtherl narrowing
Q:l riskl factorsl forl CAD
,Answer:
NON-MODIFIABLE
-age:l highestl inl middlel agedl men
-gender:l womenl diagnosedl wl itl 10l yearsl laterl thanl menl
-ethnicity:l white
-genetics:l 40-60%
MODIFIABLE
Major
-obesity
-diabetes
>monitorl glucose,l takel meds,l followl eatingl plan,l reducel weighgt
-HTN:l >120/80
>control:l BPl monitoring,l takel meds,l stopl smoking,l limitl Na,l reducel weight,l workout
-highl lipids:l reducel totall andl satl fat,l reducel caloricl intakel andl maintainl normall weight,l
increasel complexl carbsl andl fiber,l workl out,l takel lipidl meds
-tobacco:l cessationl program,l avoidl environmentall smoke,l askl forl help
-physicall inactivity:l 30l minl 5l daysl al week
-metabolicl syndrome:l higherl deathl rates
Contributing
-highl Cl reactivel protein,l lipoprotein,l homocysteinel levels
-psychological:l depression,l mcl inl typel A,l hostility
>planl timel forl sleepl andl rest,l stressl reducingl techniques,l seekl professionall help
-substancel use
*HDLl greaterl thanl 40.l LDLl lessl thanl 100,l Cll lessl thanl 200
Q:l CADl management
Answer:
GOAL
-managel RF
PHYSICALl ACTIVITY
-150l minl ofl modl (bike,l recreationall swim,l walking)l orl 75l vigorousl (running,l swiml
laps),l weightl 2x/week
-FITT
>warml upl cooll down:l stretchl 3-5l minl beforel andl after
1.l Frequency:l mostl daysl ofl thel week
2.l intensity:l HRl shouldntl gol al 20l beatsl abovel resting
3.l type:l regular,l rythmic,l repetitive,l usingl Ll musclel groups
4.l time:l notl exceedl 30l mins,l startl slow
NUTRITIONl THERAPY
-eatl al lowl fatl lowl Cll diet
,>avoid:l eggl yolk,l wholel milk,l redl meat
>eat:l avocado,l nuts,l usel avocado/olive/canolal oil
>limitl fatsl solidl atl rooml airl
-highl carbsl andl fiber
>10l tol 25l gl ofl fiber
DRUGl THERAPY
-lipidl lowering:l simvastatin
>ifl havel CAD,l riskl forl andl LDLl isl >70,l ifl Cll isl >190,l ifl 45-75l wl diabetesl andl LDLl
>70,l 45-75l nol diabetesl butl 10l yearsl ofl highl riskl andl LDLl >70
-antiplatelet:
>lowl dosel aspirin,l nol ifl overl 60,l coatedl tablet
Q:l chronicl stablel angina
Answer:
chestl painl usuallyl causedl byl CAD
-chestl painl thatl occursl intermittentlyl overl al longl periodl ofl timel andl hasl similarl patternl
ofl onset,l duration,l andl intensity
-resultl froml ischemial (lackl ofl bloodl flowl tol heart)
MANIFESTATIONS
-chestl pain,l radiatel tol jaw,l neck,l arm,l shoulder
-orl heavy,l pressure,l discomfortl ofl chestl describedl asl squeezing,l heavy,l suffocating,l tight
-dyspneal andl fatigue
-epigastricl pain-indigestion/burning
*nol painl atl rest,l causedl byl emotionall distress/physicall activity/stress
-abnormal:l complaintsl ofl womenl andl OA-l dyspnea,l fatigue,l epigastricl pain,l nauseal
-lastsl forl minsl thenl subsidesl whenl causel isl controlled,l relievedl byl restl orl nitroglycerinl
tablet
CAUSEDl BY
-physicall activity
-sex
-heavyl meal
-earlyl morning,l firstl hoursl afterl waking
-stimulants
-strongl emotions
-templ extremes
-tobaccol use
Q:l chronicl stablel anginal management
, Answer:
itl canl progressl tol acutel coronaryl syndromel (unstablel angina,l MI)l sol wel wantl dol
decreasel O2l demandl ofl heart
GOAL
-painl relief
-immediatel andl appropriatel intervention
-preservationl ofl heartl musclel ifl MIl isl suspectedl
-therapyl forl illnessl associatedl anxiety
-participatel inl rehabl plan
-decreasel RF
DRUGl THERAPY
-nitrates:l sublinguall nitroglycerin
>firstl line,l worksl inl 5l mins,l ifl doesntl thenl calll 911
>placel underl tongue,l orl sprayl 1-2l under/onl tongue
>vasodilatel peripherall bvl andl coronaryl artery
>teach:l canl causel ol hypo,l storel inl dark,l usel glovesl ifl applyingl ointment,l ifl longl actingl
providel 10-14l hrl free
**usel onl anl asl neededl basis,l itl reducesl preload,l notl relievel chestl pain
-ACEl inhib:l lisinopril
>ifl ejectionl fractionl isl lessl thanl 40%,l HTN,l diabetesl tol decreasel riskl ofl stroke,l
>vasodilate
-betal blocker:l metoprololl succinate
>vasodilate,l decreasel BP,l decreasel cardiacl contractility->decreasel oxygenl demand
-Cal channell blocker:l diltiazem
>vasodilate,l decreasel cardiacl contractility->decreasel oxygenl demand,l decreasel HR,l BP
*thel drugsl decreasel cardiacl contractilityl tol decreasel O2l demand
NITROGLYCERINl TEACHING
-takel forl chestl painl everyl 5l minsl upl tol 3l tabs.l ifl doesntl workl afterl 5l minsl calll HCP
-canl takel prophylacticallyl ifl youl knowl thel activityl canl causel itl (10l minl before)
-underl tonguel andl letl itl dissolvel whilel sitting
-store:l airtight,l dark,l nol heat,l easilyl accessiblel place
-replacel everyl 6l mo
-willl causel tingling,l ol hypo,l HA,l dizzy,l flushing
-dontl takel wl EDl meds
Q:l diagnosisl andl treatmentl ofl chronicl stablel angina
Answer:
GOLDl STANDARD
cardiacl catheterization
-canl identifyl andl localizel CADl especiallyl whenl STl segmentl isl depressed