Coronary Disorders ch23
How many types of anginas we have? Explain the difference btw them
1. stable-predictable consistent pain, relived by rest& nitro
2.unstable-called pre-infarction or crescendo angina, sx increase in freq. & severity, not relieved by rest or nitro
3. intractable-severe incapacitating chest pain, not relived by anything
4. Variant- pain at rest with reversible ST-segment elevation, caused by artery vasospams
5. silent ischemia- pt reports no pain, but EKG shows evidence of ischemia
what is commissurotomy?
valvuloplasty- separating fused valves
sx of left side heart failure
pulmonary: cough, dyspnea, S3 gallop, oliguria,
what is intermittent claudification?
leg pain with walking due to lack of o2,
relived by rest
Which medication toxicity causes visual disturbances such as green yellow halo sign?
Digoxin toxicity
what is angina pectoris and what factors are associated with it?
-sudden chest pain (paroxysmal pain) caused by lack of o2 in coronary blood flow.
where is the coronary artery? the artery that surrounds the heart and supplies the heart with oxygen rich blood
-lack of o2 in heart leads to? MI
-factors: extreme temps, stress, heavy meal, activity
which type of valve replacement is more durable but has an increased risk for endocarditis?
-mechanical valve replacements
what characterizes cardiogenic shock?
low BP high HR tachy
most common form of aneurysms?
-saccular and fusiform
what is VAD?
VAD- ventricular assissting device
1. to bridge a recovery
2. to bridge transplant
3.destination therapy
how many times can we give nitroglycerin for angina?
3 times
how many types of tissue valve replacements are there?
1. bioprosthesis- from animal tissue
2.homograft-from cadaver tissues
3. autograft- from it's own tissue
sx of cardiac tamponade?
-narrowing pulse pressure, dyspnea, edema, JVD
what is raynaud phenomenon?
arterial vesocclusion, usually in fingertips or toes, due to cold weather
when does the first phase of cardiac rehab starts?
on the diagnosis of disease, ex. atherosclerosis
-includes education, lifestyle changes,
-continues until discharge from hospital
what do we do after MI?
-bedrest
-oxygen
-morphine
-anticoagulants
How many cardiomyopathies exist?
1. Dilated-most common
2. Hypertrophic-includes septal wall thickening- leading cause of sudden death in young adults and teens, particularly athletes
3. Restrictive
what is pulmonary embolism?
clots traveling from legs to pulmonary vessels
what is lymphedema, lymphangitis, and lymphadenitis?
-lymphangitis- infection of lymphatic channels
-lymphadenitis- infection of lymph nodes
-lymphedema-tissue swelling r/t obstruction of lymphatic flow
how do we tx cellulitis?
- antibiotics
-elevate area
what are some instructions we should give to pt post op CABG?
-shower daily, wash incisions daily with soap & water, avoid baths
-weight self daily, high protein diet
-continue use IS, elevate legs, no hydrogen peroxide for washing incisions
-monitor BP through ART line & HR daily
-apply and wear ted stockings, warm blankets
- nurses call HCP if drainage >100ml
Risk factors for infective endocarditis?
-prosthetic heart valves
-tatto
-piercing
-iv drug use, pacemakers
teaching for HF pt?
-daily weight
-wait 2hrs after eating for physical activity
-avoid extreme temps
-report weight gain of 2-3lb in a day or 5lb in aweek
-eat potassium, low sodium to subside edema
sx of dvt?
-redness, warmth, tenderness, pain,
education about varicose veins?
wear compression stockings
-elevate legs higher than heart levels
-weight reduction plans
-walk 30min each day
-avoid crossing the legs, avoid sitting or standing for long periods