Medications
Side effects include pounding headaches and orthostatic hypotension
What is nitrates
These clinical manifestations help differentiate between stable and unstable angina
What is if the chest pain stops with rest or nitroglycerine and if the chest pain lasts longer than 10 minutes
Non-specific marker of inflammation that is increased in patients with CAD
C-reactive protein
Which of the following symptoms would the nurse anticipate in a patient with right sided heart failure?
SATA
a. Pulmonary congestion
b. Shortness of breath
c. Neck vein distention
d. Enlarged abdominal girth
e. A third heart sound
C&D
Type of unstable angina that is rare and occurs at rest
What is Prinzmetal’s angina
medications used for myocardial infarctions
What is Morphine, Oxygen, Nitroglycerin and Asprin
Complications of myocardial infarction
What is
dysrhythmias: ventricular tachycardia and ventricular fibrillation
heart failure
when do tropinin levels increase, peak, and return to normal
Increase: 4-6 hours after MI
Peak: 10-24 hrs after
Normal: 10-14 days later
A client is receiving an infusion of t-PA, the nurse assesses the client to be disoriented to person, place and time. What action by the nurse is best?
a. Assess the client pupillary responses
b. Request neurological consultation
c. Stop the infusion and call the provider
d. Take and document a full set of vital signs
C
A change in neurologic status in a client receiving t-PA could indicate intracranial hemorrhage. The nurse should stop the infusion and notify the provider immediately. A full assessment, including pupillary responses and vital signs, occurs next. The nurse may or may not need to call a neurologist.
Modifiable risk factors for CAD
1. Elevated serum LDL
2. Hypertension
3. Tobacco and non-tobacco use
4. Physical inactivity
plavix should never be mixed with this medication because of increased risk for bleeding
what is Prilosec
Symptoms of left sided heart failure
Dyspnea, orthopnea, cough, hemoptysis, adventitious breath sounds, pulmonary congestion
”DO CHAP”
Purpose of Uric acid levels
Baseline of renal blood flow
A nurse assesses clients on a cardiac unit. Which client should the nurse identify as being at greatest risk for the development of left-sided heart failure?
a. A 36-year-old woman with aortic stenosis
b. A 42-year-old man with pulmonary hypertension
c. A 59-year-old woman who smokes cigarettes daily
d. A 70-year-old man who had a cerebral vascular accident
A
Although most people with heart failure will have failure that progresses from left to right, it is possible to have left-sided failure alone for a short period. It is also possible to have heart failure that progresses from right to left. Causes of left ventricular failure include mitral or aortic valve disease, coronary artery disease, and hypertension. Pulmonary hypertension and chronic cigarette smoking are risk factors for right ventricular failure. A cerebral vascular accident does not increase the risk of heart failure.
this angina occurs in absence of subjective symptoms, associated with diabetic neuropathy and confirmed with ECG changes
What is silent ischemia
These drug classes are considered hypotensive
Diuretics, beta blockers, and ACE inhibitors
Fatigue, limited activities, chest congestion or cough, edema, and shortness of breath (FACES) are symptoms of?
Chronic heart failure
The purpose of labs for hypertension
To rule out everything for essential hypertension or find the cause of secondary hypertension
A nurse is teaching a client with heart failure who has been prescribed enalapril (Vasotec). Which statement should the nurse include in this clients teaching?
a. Avoid using salt substitutes.
b. Take your medication with food.
c. Avoid using aspirin-containing products. d. Check your pulse daily.
ANS: A
Angiotensin-converting enzyme (ACE) inhibitors such as enalapril inhibit the excretion of potassium. Hyperkalemia can be a life-threatening side effect, and clients should be taught to limit potassium intake. Salt substitutes are composed of potassium chloride. ACE inhibitors do not need to be taken with food and have no impact on the clients pulse rate. Aspirin is often prescribed in conjunction with ACE inhibitors and is not contraindicated.
Coronary artery disease usually affects which arteries
Carotid, coronary, renal iliac and femoral
These classification of medications should never be given to a patient who is on sexual dysfunction medication
What is nitrates and beta blockers
Most serious complications of Peripheral Arterial disease
Gangrene and arterial ulcers leading to amputation
Which lab is used to differentiate between respiratory and cardiac concerns
What is BNP
A nurse is working with a client who takes atorvastatin (Lipitor). The clients recent laboratory results include a blood urea nitrogen (BUN) of 33 mg/dL and creatinine of 2.8 mg/dL. What action by the nurse is best?
a. Ask if the client eats grapefruit.
b. Assess the client for dehydration.
c. Facilitate admission to the hospital.
d. Obtain a random urinalysis.
A
There is a drug-food interaction between statins and grapefruit that can lead to acute kidney failure. This client has elevated renal laboratory results, indicating some degree of kidney involvement. The nurse should assess if the client eats grapefruit or drinks grapefruit juice. Dehydration can cause the BUN to be elevated, but the elevation in creatinine is more specific for a kidney injury. The client does not necessarily need to be admitted. A urinalysis may or may not be ordered.
Longer rest periods, longer warm up, longer period of low level activity are examples of what
Geriatric considerations for coronary artery disease treatment