NR 507 Cardiovascular
Study online at https://quizlet.com/_a0kvw5
1. Cardiovascular Cardiovascular disorders are prevalent in primary care. Many of the disorders
disorders develop over several years, due to the risk factors to which individuals have been
exposed. For each disorder covered in this unit, a discussion of risk factors will be
included. For the concepts covered below, clinical application of each disease will
be provided so that students can understand the importance of pathophysiology
in diagnosing and treating the disease.
Prerequisite knowledge:
For this content, you should have a basic knowledge of cardiac anatomy; know
the differences between the right and left sides of the heart, in terms of structure
and function. You should also possess solid knowledge of the unidirectional blood
flow through the heart. For example, deoxygenated blood arrives to the right
side of the heart, travels to the pulmonary arteries to release CO2 and pick up
oxygen. At this point, the oxygenated blood is carried from the lungs through the
pulmonary veins to the left side of the heart where it eventually reaches the aorta
to carry oxygenated blood out to the body organs. The cellular physiology related
to cardiac contraction is another important basic concept to know, as electrolytes
(sodium, potassium and calcium) play a major role in muscle contraction. Finally,
the concepts of preload, afterload, and contractility are essential to understand, as
all of these can be affected in some way when a person has cardiovascular disease.
2. What is Coro- CAD is considered the leading cause of death in the United States (U.S.). It is the
nary Artery Dis- result of longstanding atherosclerosis.
ease (CAD)?
Atherosclerosis begins with damage to the endothelium. It is the endothelium,
under normal functioning that maintains balance between the vasoconstrictive
and vasodilation actions, prevents platelets from aggregating and control of the
production of fibrin. When the endothelium becomes damaged, our familiar
inflammatory processes occur. Macrophages attach to the endothelium, setting
up phagocytosis; plaque formation and vasoconstriction also occurs marking the
beginning of atherosclerosis. The plaque lesions located in the vessels become
enlarged which allows the plaque to progress within the enlarged vessel lumen.
, NR 507 Cardiovascular
Study online at https://quizlet.com/_a0kvw5
The plaque lesion disrupts normal blood flow and causes thrombus formation
which can be triggered by cardiac risk factors such as elevated LDL, cholesterol,
smoking and diabetes.
So, why is this a problem?
Well, the plaque takes decades to develop in the coronary arteries. With mild
disease, blood flow can get through the arteries and the patient is asymptomatic.
Overtime, this build up can lead to narrowing which results in decreased oxygen
supply. When atherosclerosis reaches a clinically significant level, the patient will
begin to experience angina. Further progression of the disease will result in acute
coronary syndrome (ACS), formerly known as myocardial infarction (MI).
3. The major risk The major risk factor for the development of CAD is family history. There is a 50%
factor for the higher risk for individuals to develop heart disease if they have a first degree
development of relative (especially father) or sibling who has suffered from ACS or premature
CAD cardiac death (< age 55 years). Lifestyle also impacts risk, especially tobacco use
and even secondhand smoke exposure. It is always important for the NP to stress
smoking cessation with all patients who smoke tobacco, in order to decrease the
patient's risk for CAD. Sedentary lifestyle will also increase one's risk for developing
CAD. Physical inactivity can lead to overweight (BMI 25-29.9) or obesity (BMI
30 and above). Male gender, hypertension, Elevated total cholesterol, elevated
low-density lipoprotein (LDL), and/or decreased high-density lipoprotein (HDL)
are also risk factors, as well as diabetes mellitus.
4. Myocardial is- Myocardial ischemia is the cause of his chest pain. Ischemia occurs when the
chemia heart's oxygen demand exceeds supply. For this patient, he experienced his chest
pain during exercise. Ischemia occurred because of the narrowing of at least
one coronary artery by atherosclerotic plaques. The result is the narrowing of
the diameter of the coronary artery. This reduces oxygenated blood flow through
the artery that leads to an insufficient oxygen supply to the heart. Adenosine
is also released that stimulates sympathetic nerve fibers that causes atrial and
Study online at https://quizlet.com/_a0kvw5
1. Cardiovascular Cardiovascular disorders are prevalent in primary care. Many of the disorders
disorders develop over several years, due to the risk factors to which individuals have been
exposed. For each disorder covered in this unit, a discussion of risk factors will be
included. For the concepts covered below, clinical application of each disease will
be provided so that students can understand the importance of pathophysiology
in diagnosing and treating the disease.
Prerequisite knowledge:
For this content, you should have a basic knowledge of cardiac anatomy; know
the differences between the right and left sides of the heart, in terms of structure
and function. You should also possess solid knowledge of the unidirectional blood
flow through the heart. For example, deoxygenated blood arrives to the right
side of the heart, travels to the pulmonary arteries to release CO2 and pick up
oxygen. At this point, the oxygenated blood is carried from the lungs through the
pulmonary veins to the left side of the heart where it eventually reaches the aorta
to carry oxygenated blood out to the body organs. The cellular physiology related
to cardiac contraction is another important basic concept to know, as electrolytes
(sodium, potassium and calcium) play a major role in muscle contraction. Finally,
the concepts of preload, afterload, and contractility are essential to understand, as
all of these can be affected in some way when a person has cardiovascular disease.
2. What is Coro- CAD is considered the leading cause of death in the United States (U.S.). It is the
nary Artery Dis- result of longstanding atherosclerosis.
ease (CAD)?
Atherosclerosis begins with damage to the endothelium. It is the endothelium,
under normal functioning that maintains balance between the vasoconstrictive
and vasodilation actions, prevents platelets from aggregating and control of the
production of fibrin. When the endothelium becomes damaged, our familiar
inflammatory processes occur. Macrophages attach to the endothelium, setting
up phagocytosis; plaque formation and vasoconstriction also occurs marking the
beginning of atherosclerosis. The plaque lesions located in the vessels become
enlarged which allows the plaque to progress within the enlarged vessel lumen.
, NR 507 Cardiovascular
Study online at https://quizlet.com/_a0kvw5
The plaque lesion disrupts normal blood flow and causes thrombus formation
which can be triggered by cardiac risk factors such as elevated LDL, cholesterol,
smoking and diabetes.
So, why is this a problem?
Well, the plaque takes decades to develop in the coronary arteries. With mild
disease, blood flow can get through the arteries and the patient is asymptomatic.
Overtime, this build up can lead to narrowing which results in decreased oxygen
supply. When atherosclerosis reaches a clinically significant level, the patient will
begin to experience angina. Further progression of the disease will result in acute
coronary syndrome (ACS), formerly known as myocardial infarction (MI).
3. The major risk The major risk factor for the development of CAD is family history. There is a 50%
factor for the higher risk for individuals to develop heart disease if they have a first degree
development of relative (especially father) or sibling who has suffered from ACS or premature
CAD cardiac death (< age 55 years). Lifestyle also impacts risk, especially tobacco use
and even secondhand smoke exposure. It is always important for the NP to stress
smoking cessation with all patients who smoke tobacco, in order to decrease the
patient's risk for CAD. Sedentary lifestyle will also increase one's risk for developing
CAD. Physical inactivity can lead to overweight (BMI 25-29.9) or obesity (BMI
30 and above). Male gender, hypertension, Elevated total cholesterol, elevated
low-density lipoprotein (LDL), and/or decreased high-density lipoprotein (HDL)
are also risk factors, as well as diabetes mellitus.
4. Myocardial is- Myocardial ischemia is the cause of his chest pain. Ischemia occurs when the
chemia heart's oxygen demand exceeds supply. For this patient, he experienced his chest
pain during exercise. Ischemia occurred because of the narrowing of at least
one coronary artery by atherosclerotic plaques. The result is the narrowing of
the diameter of the coronary artery. This reduces oxygenated blood flow through
the artery that leads to an insufficient oxygen supply to the heart. Adenosine
is also released that stimulates sympathetic nerve fibers that causes atrial and
