Angina Pectoris: Chest pain, Squeezing feeling, radiates to jaw, Relieved by rest

and nitro. Don't take nitro with Viagra.

Drug used for Angina: Nitro
true statements regarding angina pectoris
Angina indicates a lack of oxygen and blood supply to the heart.
Angina may resemble heartburn or indigestion.
May appear as jaw pain
Angina is usually relieved by nitroglycerin.
Cardiac Disease Risk Factors: smoking, hyperlipidemia/HTN, diabetes.
CAD results from focal narrowing of the large and medium sized coronary
arteries due to deposition of atheromatous plaque in the vessel wall.
CAD modifiable risk factors: smoking, HTN, Diabetes, cholesterol
Cardiac cath: provides most definitive source of diagnosis by showing
atherosclerotic lesions.
S/S: Chest Pain/Heaviness, Pain radiating to arm, neck and jaw, Sweaty,
Nausea, Clammy, Shortness of breath, States "just don't feel right" for a couple of
days"
Nitrates: dilate coronary arteries. Put nitro under tongue
Aspirin: prevent thrombus formation
Beta Blockers: reduce BP and HR
Calcium channel blockers: dilate coronary artery and reduce vasospasm.
Tx: PTCA percutaneous transluminal coronary angioplasty: compress the plaque
against the vessel wall, increasing the arterial lumen
MI: Crushing chest pain, radiates to neck arm jaw and back, occurs without
cause in early morning, not relieved by rest or nitro, last 30mins or longer
NI: provide O2 a 2L, semi fowlers, morphine to relieve pain. Provide low sodium,
low cholesterol and low fat diet. Minimize anxiety.
Drug used for MI: Plavix, Lipitor, Vasodilators, ACE Inhibitors
Ace Inhibitors: They widen or dilate your blood vessels to improve the amount of
blood your heart pumps and lower BP. Inhibit ACE preventing conversion of
Angiotensin I into Angiotensin II. Persistent cough can occur with ACE inhibitors.
Amyloidosis: build up of protein.

Cardiogenic shock: heart fails to pump, resulting in a decrease cardiac output

and decreased tissue perfusion.
NI: place pt in modified trendelenburg pos.
CHF primary tx is reduce the workload of heart.
Left CHF has no edema. Right CHF has edema
Cardiac Tamponade: heart is unable to pump blood due to accumulation of fluid
in the pericardial sac. Results in decreased cardiac output. Acute may happen
when there is more than 30ml of fluid in sac
Assessment: Becks Triad: jugular vein distention, hypotension, distent/muffled
heart sound.
Pulmonary Edema: accumulation of fluid in lung tissue and alveoli. Complication
of CHF.
S/S: restlessness, cough, tachycardia
NI: high fowlers, O2, morphine to lessen load of resp, diuretics to get rid of fluid.
A peripheral vascular disease is any abnormal condition that affects the blood
vessels outside the heart and the lymphatic vessels. (arteries, capillaries and
veins)
PVD supplies O2-rich blood to the upper and lower extremities of the body, heart
and lungs. Chronic and more common in elderly.
Arteriosclerosis: loss in elasticity of the blood vessels. Thickening and
calcification of art walls. Lower is more involved than upper
Atherosclerosis: narrowing due to fatty yellow plaque(cholesterol) in the inner
lining of the arteries. Common site: femoral, iliac and popliteal art. In diabetics its
below the knees.
Ischemia: deficiency of blood and o2 to tissues. Involves the valves of veins.
Degenerative changes occur in the vascular system as part of the normal aging
process
Inner walls of the blood vessels (tunica interna) become thick and less compliant.
When valves become incompetent blood will not move and Venous Stasis occurs
Thrombophlebitis: inflammation of a vein with a blood clot
Phlebothrombosis: a clot without inflammation
Causes of PVD: Smoking, Gender, HTN, Hyperlipidemia, Obese, Stress,
Diabetes
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Arterial Insufficiency: pulses are diminished or absent. Sharp stabbing pain

worsens with activity. Lower feet to relieve pain. Cold skin, hairless, shiny and
pallor. Infreq edema
Pulses: Appearance: Temp: Cap refill: Hardness: Edema: Sensation:
Venous Insufficiency: decreased return of blood from the tissues to the heart
leads to venous congestion and stasis of blood. S/S: Pulses are present. Leads
to edema, aching pain, activity helps. Raising feet helps pain and stasis ulcers.
Edema: fluid left in tissues of affected extremity
Edema and cellulitis is first seen in venous insufficiency
Endarterectomy: removal of a blood clot and stripping of atherosclerotic plaque.
Buergers disease: acute inflammatory lesions and occlusive thrombosis of the
arteries and veins.
Sympathectomy: cutting off of sympathetic nerve fibers
Lasix are effective when production of urine is increased. Monitor for electrolyte
and Potassium levels. They produce more loss of fluid and electrolytes than any
others. A sudden loss of fluid can result in decreased blood pressure. When
blood pressure drops, the pulse probably will increase rather than decrease.
Lasix should not affect respirations or temperature. The nurse should also closely
monitor the patient's potassium level.
When pt is receiving heparin, observe for emesis, urine and stools for blood
Pt has abdominal aneurysm: monitor their BP
Raynaud: avoid cold, practice stress reduction, stop smoking and limit caffeine
Deep Vein Thrombosis S/S: pain, edema, increase calf circumference, +Homan
sign(calf pain), redness, warmth
Water Hammer Pulse is bounding and forceful, rapidly increasing and
subsequently collapsing,
What diagnostic test allows observation of real time movement via radiography?
Fluoroscopy
Which of the following cardiac markers is specific to the heart, not influenced by
skeletal muscle trauma or renal failure, and rises 3 hours following a myocardial
infarction? troponin I
The nurse is caring for an older woman with cardiac disease. How does the older
cardiac patient differ from the younger cardiac patient? Even with lower doses of
medications, the older adult should be observed for signs and symptoms of
toxicity.

In evaluating risk factors for cardiovascular disease, which of the following does
the nurse identify as a modifiable risk factor? Hyperlipidemia
the most serious type of arrhythmia? Ventricular fibrillation
The nurse is caring for a patient with a new pacemaker. Nursing care for this
patient would include which of the following? Monitoring the heart rate and
rhythm by apical pulse and ECG patterns
A patient was admitted yesterday for a myocardial infarction. Which of the
following statements is true regarding treatment for a patient with myocardial
infarction? The patient with an acute myocardial infarction will be on bed rest with
commode privileges for 24 to 48 hours.