Final Exam - MS

• 1. What is Perfusion?

  Delivering oxygen to the body’s tissues, organs, and cells. 
• 1. The cardiovascular system is composed of two systems:

  Circulatory System: Heart, blood vessels, and blood

  Lymphatic System: Lymphatic blood vessels, lymph, and lymph nodes 
• 1. What is Atherosclerosis?

  A build-up of plaque in the arteries leads to decreased blood flow to organs and the body’s tissue. 
• 1. What causes plaque?

  A build-up of excess cholesterol and fat deposits sits in the artery wall. 
• 1. What is considered “good cholesterol”?

  High-density lipoprotein
• 1. What are the normal ranges for HDL and how does it work?

  Levels above 60 mg/dL are considered optimal. HDL removes LDL cholesterol from the arteries, which reduces the risk of heart disease/ 
• 1. What is considered “bad cholesterol”?

  Low-Density Lipoprotein
• 1. What are the normal ranges for LDL and how does it work?

  Less than 100 mg/dL for healthy adults and less than 60 mg/dL if the patient has an underlying heart condition. Lower levels of LDL cholesterol are better because LDL leads to plaque buildup in the arteries. 
• 1. What are triglycerides? What is the normal range? Why are increased blood triglycerides and cholesterol so bad?

   Normal Range: Less than 150 mg/dL

  Triglycerides are a type of fat that is stored due to excess caloric intake. Elevated triglycerides contribute to plaque build-up in the arteries. 
• 1. What are the 3 major coronary arteries?
  2. Left Main Coronary After 
  3. Right Coronary Artery
  4. Left Circumflex Artery
• 1. What is the function of the coronary arteries?

  Provides blood to the heart muscles 
• 1. List the nonmodifiable risk factors for CAD.

  Age, Gender, Family History 
• 1. List the modifiable risk Factors for CAD

  Smoking, Hypertension, Obesity, Diabetes, Unhealthy Diet, Stress, High Cholesterol 
• 1. List the complications and manifestations of CAD.

  Angina Pectoris, Heart Failure, Heart Attack, Arrhythmia, Cardiac Arrest
• 1. Describe Angina Pectoris.

  A lack of oxygen/blood supply leads to heart which causes chest pain. 
• 1. What is Stable Angina provoked by?

  Stable Angina: Chest pain that is provoked by physical exertion. This causes a lack of oxygen to reach the heart. 
• 1. What relieves Stable Angina?

  Stable Angina is relieved by rest, and medications (nitroglycerin) 
• 1. Variant or Vasospastic Angina is also referred to as?

  Prinzmetal Angina 
• 1. What causes Vasospastic angina?

  A sudden narrowing of the coronary arteries causes a temporary decrease in blood flow to the heart. 
• 1. What is the primary complication that can occur?

  Consistent Angina can lead to myocardial ischemia (inadequate blood flow to the heart muscle), which can lead to myocardial infarction. 
• 1. Is Unstable Angina considered an MI?

  No, unstable angina can lead to a heart attack. 
• 1. How does a client with unstable angina present?

  Crushing chest pain, Pain that radiates to the neck, jaw, and left shoulder, shortness of breath, nausea and vomiting, diaphoresis, anxiety. 
• 1. Describe the pathophysiology of a Myocardial Infarction (MI). 

  A lack of blood flow to the heart leads to the death of the cardiac muscles in the heart. 
• Troponin's normal range is less than 0.04 mg/dL. Troponin is a protein found in the cardiac muscle. Elevated levels mean damage to the heart muscle. 
• CK-MB normal rang is less than 25 u/L. CK-MB is an enzyme found in the cardiac muscle. Elevated levels indicate recent damage to the heart muscle.
• Myoglobin's normal range is below 90 ng/dL is is a protein found in all muscle cells, elevated levels indicate recent muscle damage. This could indicate heart muscle damage.
• 1. What are the goals of MI medical management?

  • Pain Relief
  • Oxygen Therapy
  • Restore blood flow to the heart muscle 
  • Lifestyle medication: reduce the risk of more MI in the future
• 1. What does the MONA acronym represent?

  Morphine, Oxygen (2L), Nitroglycerin, Aspirin.
• 1. Percutaneous Coronary Interventions (PCI): A procedure used to open blocked or narrowed coronary arteries and restore blood flow to heart muscle. 
• 1. What is an indication for PCI?

  Used to treat narrowed arteries that lead to myocardial ischemias. Patients with a history of heart attacks or coronary artery disease. 
• 1. What is “balloon to door time”? Why is this important for a patient experiencing an MI?

  The time interval from the arrival of the hospital to the ignition of balloon inflating during PCI. It is important because repercussion techniques must be implemented quickly to reduce the risk of other complications. 
• 1. Describe a cardiac catheterization procedure.

  A procedure that uses contrast dye to visualize the heart and the coronary artery 
• 1. Identify priority nursing considerations and interventions Cardiac Cath pre-operatively.

  • Obtain allergies, medications, and patient history
  • Review informed consent
  • Ensure the patient is NPO. 
• 1. Identify priority nursing interventions and considerations post-op cardiac cath.

  • Monitor vital signs
  • Assess the puncture site for bleeding, and hematoma formation.
• 1. Coronary Artery Bypass Graft (CABG) 

  A surgical procedure that uses a graft of another artery to replace obstructed or narrowed coronary arteries. It is used to restore blood flow to the heart. 
• 1. What lines, drains, and incisions would you expect to see in a patient who had a CABG? What are the nursing considerations and care required to maintain these?

  Central Venous Catheter, Chest Tubes, Arterial Line. Monitor for bleeding, excessive drainage, fluid accumulation, and potency of the tubes. 
• 1. What are sternal precautions?

  Protect the sternum to promote proper healing.

  1. Avoid heavy lifting (anything larger than 5-10 pounds)
  2. Minimize arm movements 
  3. Avoid twisting and bending at the waste
  4. Use pillows for support
• 1. Describe some health promotion education you would provide to a post-MI and CABG patient.  

  • Medication Adherence
  • Heart-Healthy Diet (low fat, cholesterol, and sodium, high in fruits, vegetables, and proteins)
  • Smoking Cessation 
  • Regular physical activity
  • Stress management 
• 1. Describe the pathophysiology behind PVD: Narrowing or blockages in the blood vessels that impede blood flow to the extremities. 
• 1. What is the most common risk factor for PAD? 

  Build up of plaque in the arteries.

  Smoking, diabetes, hypertension, high cholesterol, obesity, sedentary lifestyle, family history