Coronary Artery Disease (CAD), Questions and answers, rated A+/ APPROVED EXAM PREDICTION PAPER/

Coronary Artery Disease (CAD), Questions and answers, rated A+ What is the major cause of CAD - -Atherosclerosis Atherosclerosis - -Begins as soft deposits of fat that harden with age Referred to as "hardening of arteries" Atheromas (fatty deposits) prefer coronary arteries Also known as ASHD, CVHD, IHD, CHD Characterized by lipid deposits within intima of artery Platelets may come in and clot to try and repair wall What plays a role in arteriosclerosis - -Endothelial injury and inflammation Coronary Artery Disease Risk Factors Non- modifiable - -Age Gender Genetics Coronary Artery Disease Risk Factors Modifiable - -Diabetes ( keep good control hypertension Lifestyle (smoking) Diet Exercise Coronary Artery Disease Etiology and Pathophysiology C-reactive protein (CRP) - -Nonspecific marker of inflammation Increased in many patients with CAD Chronic exposure to CRP associated with unstable plaques and oxidation of LDL cholesterol Lab test lets us know that inflammation is occurring Coronary Artery Disease Etiology and Pathophysiology Collateral circulation - -Arterial anastomoses (or connections) within the coronary circulation Increased with chronic ischemia May be inadequate with rapid-onset CAD In addition to all coronary arteries, as patient gets older, Vessel Occlusion With Collateral Circulation - - Two risk factors for coronary artery disease that increase the workload of the heart and increase myocardial oxygen demand are A. Obesity and smokeless tobacco use. B. Hypertension and cigarette smoking. C. Elevated serum lipids and diabetes mellitus. D. Physical inactivity and elevated homocysteine levels. - -B Which patient is most at risk for developing coronary artery disease? A. A hypertensive patient who smokes cigarettes B. An overweight patient who uses smokeless tobacco C. A patient who has diabetes and uses methamphetamines D. A sedentary patient who has elevated homocysteine levels - -A Collaborative and Nursing Management: CAD - -Prevention and early treatment Think about supply and demand of O2 Identification of people at high risk Manage high-risk persons by controlling modifiable risk factors Encourage lifestyle changes Physical fitness Nutritional therapy The nurse determines that teaching about implementing dietary changes to decrease the risk of CAD has been effective when the patient says, A. "I should not eat any red meat such as beef, pork, or lamb." B. "I should have some type of fish at least 3 times a week." C. "Most of my fat intake should be from olive oil or the oils in nuts." D. "If I reduce the fat in my diet to about 5% of my calories, I will be much healthier." - -C Lipid-lowering drug therapy STATINS - -Inhibit cholesterol synthesis, decrease LDL, increase HDL Side effects- liver damage and sore muscles Monitor for liver damage and myopathy Lipid-lowering drug therapy Niacin - -Lowers LDL and triglyceride by inhibiting synthesis Increases HDL Flushing, pruritus, GI side effects, orthostatic hypotension Lipid-lowering drug therapy Fibric acid derivatives (Lopid) - -Decrease triglycerides and increase HDL GI side effects Don't let you absorb fats Fatty stools GI upset Lipid-lowering drug therapy Bile acid sequestrants - -Increase conversion of cholesterol to bile acids GI side effects; bind with other drugs Lipid-lowering drug therapy Ezetimibe (Zetia) - -Decrease absorption of dietary and biliary cholesterol Antiplatelet therapy - -ASA