Angina, CAD, & HTN
What is the most common cause of angina?
What is atherosclerosis?
Rationale: Atherosclerosis narrows coronary arteries which limits oxygen to the heart.
What are classic signs of right-sided heart failure? You must name at least three.
What is swelling of legs, hands, liver, abdomen (ascites); weight gain; edema (pitting); large neck veins (jugular vein distention); lethargic (weak and very tired); irregular heart rate (atrial fibrillation); nausea (from swelling of the abdomen and liver); girth of abdomen increased (from swelling of the liver and abdominal ascites)?
Rationale: Remember SWELLING!!!!
What class of drugs improves symptoms of HF by removing excess fluid?
What is diuretics (loop/oral)?
Rationale: This class of medications reduce the volume overload and edema in HF patients.
What is a major risk factor for DVT?
What is immobility?
Rationale: This can cause venous stasis leading to clot formation.
What dietary pattern helps manage both HTN and hyperlipidemia?
What is the DASH diet?
Rationale: This diet is low in sodium and saturated fats, while high in fruits and vegetables.
What symptom differentiates angina from an MI?
What is angina pain is relieved by rest/nitroglycerin?
Rationale: Angina pain is transient and can be relieved with Nitroglycerin and rest while MI pain is persistent.
What are classic signs of left-sided heart failure? You must name at least three.
What is difficulty breathing, rales (crackles), orthopnea (cannot tolerate lying down - must sit-up to breath, especially while sleeping), weakness (extremely tired and fatigued due to shortness of breath and heart cannot compensate for increased activity), Nocturnal Paroxysmal dyspnea (awaking during sleep with extreme dyspnea), increased heart rate (due to fluid overload and the heart trying to get the blood to organs but it can't because of muscle failure), nagging cough (can be frothy or blood-tinged sputum from fluid overload in the lungs), gaining weight (from body retaining fluid - 2-3 lbs./day or 5 lbs./week).
Rationale: Remember DROWNING!!!!
What are major adverse effects from the medication atorvastatin that should be reported to the healthcare provider immediately?
What is muscle pain and weakness?
Rationale: These can be signs of statin-induced myopathy which is a condition that can lead to muscle inflammation or damage. These symptoms need to be reported to the HCP immediately and a different medication started for these patients.
What assessment finding suggests PE?
What is sudden dyspnea and chest pain?
Rationale: This indicates a clot has traveled to the lungs.
What lifestyle change is essential for managing PVD and CAD?
What is smoking cessation?
Rationale: Smoking damages vessel walls and promotes atherosclerosis.
What assessment is key for a patient with HTN?
What is take the blood pressure in both arms?
Rationale: This helps to detect discrepancies and confirms the diagnosis.
What heart sound is commonly heard in heart failure?
What is S3?
Rationale: Indicates volume overload in the ventricles.
What are signs and symptoms of digoxin toxicity? You must name at least two.
What is altered vision, headache, nausea, lack of appetite, vomiting, diarrhea, confusion, anxiety, hallucinations, restlessness, weakness, depression, or irregular heartbeat.
Rationale: All of these symptoms should be reported immediately!
What is used to treat and prevent DVT?
What is anticoagulants?
Rationale: To prevent clot growth and new clot formation.
What is an effective non-pharmacologic intervention for HF?
What is daily weight monitoring?
Rationale: This helps to detect early signs of fluid retention.
What is the difference between primary and secondary hypertension?
What is primary hypertension has no known cause while secondary hypertension is due to another condition.
Rationale: This helps to guide our treatment and their cardiovascular workup.
What is the main goal of HF treatment?
What is improve cardiac output and prevent fluid overload?
Rationale: To enhance quality of life and reduce admissions for patients.
What must be monitored when giving digoxin?
What is apical HR and potassium?
Rationale: Digoxin can cause bradycardia and toxicity, especially with hypokalemia.
Why is smoking a risk factor for PVD?
What is nicotine reduces blood flow to the legs?
Rationale: Listed above.
What is the target LDL level in a patient with CAD?
What is <70 mg/dL?
Rationale: Aggressive lowering reduces cardiovascular events.
What is the priority intervention for a hypertensive crisis?
What is lower BP gradually with IV meds?
Rationale: To prevent stroke or organ damage.
Name two major risk factors for HF.
What is HTN and CAD?
Rationale: Both increase cardiac workload and damage the heart. Other risk factors include family history, cardiotoxic drugs, smoking, obesity, alcohol abuse, and diabetes mellitus.
What should you teach patients on anticoagulants?
What is use a soft toothbrush, an electric razor, report signs of bleeding, report excessive bruising, install night lights, remove rugs or other hazardous items within their home?
Rationale: To prevent bleeding complications.
What education should be provided to patients with PVD about leg care?
What is wash legs with a light soap, thoroughly dry them without rubbing, and apply a light moisturizer for skin care?
Rationale: This helps to prevent sores from forming and other complications.
What is an essential patient education point for managing chronic HTN?
What is adherence to medication and BP monitoring?
Rationale: This helps to prevent long-term complications.