med surg ch 25 pt 1
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37 terms
Terms | Definitions |
|---|---|
 Arteriosclerosis | loss of elasticity or hardening of arteries w/ aging caused by calcium deposits |
| Artherosclerosis | lumen of arteries fill w/ fatty deposits of plaque composed of cholesterol;most conmon cause of peripheral arterial problem in order adults. Hyperlipidemia- high levels of blod fat triggers atherosclerotic changes. Leptin- regulates energy metabolism |
| Other atherosclerosis risks factors | smoking, stress, obesity, diabetes, hypertnsion. |
| Coronary Artery Disease | (CAD) arteriosclerotic & atherosclerotic changes in coronary arteries that supply myocardium CAD- most common cause of death in adults over 65 years. CAD s/s- classic symptom angina ,sudden pain over heart or under sterrum may radiate in shoulders arm. Inherited risk factors (CAD)- male, diabetes, high lipids, genetic, hypertension. Behavioral Risk Factors- smoking, sedentary, lifestyle, obesity, aggressive personality, high fat diet. CAD DX studies- exercise ECG, cardiac cath, nuclear stress test (thallium injected) |
| Stable aangina | chest pain lasts 15 min; rest sublingual nitrates, antihypertensive indicated |
| Unstable angina | severity and duration poorly relieved by rest or oral nitrates. |
| Variant angina | chest pain occurs at rest usually between 12 AM to 8 AM |
| micro vascular angina | constriction of myocardial capillaries |
| Electron beam computed tomography | (EBCT) test that detects calcified plaque in coronary arteries before clients who don't fit usual cardiac risk profile become symptomatic |
| CAD treatment | lifestyle changes, stop smoking, wt loss, exercise, nitrates, diuretics, niacin, statins, low dose aspirins |
| Percutaneous Transluminal Coronary Angioplasty | (PTCA) AKA ballon angioplasty; balloon tipped catheter inserted to coronary artery |
| Cornary stent | small metal coil w/ mesh like opening placed in coronary artery during PTCA |
| Client family teaching angioplasty | avoid lifting more than 10 lbs x 3 days, refrain from sexual activity x 1 wk, report any signs of bleeding, infection, impaired circulation, notify MD if tightness or pain in chest |
| Artherectomy | cardiac catheter with a cutting tool at the tip |
| Coronary artery bypass graft surgery | (CABG) taking healthy leg vein or chest artery to bypass a diseased coronary artery. |
| Transmycardial revascularization | (TMR) laser procedure creates channels 1 mm deep; suggested neoangiogenesis (growing new vessels) |
| CAD nursing interventions | assess characteristics of chest pain, administer meds, encourage rest and give oxygen, if no relief call M.D. |
| MONA | Morphine, oxygen, nitrates, aspirin |
| Client teaching Nitro | 1 tab under tongue, let dissolve slowly, tingling sensation, may take up to 3 tabs 5 min apart; if no relief call 911 |
| Myocardial Infarction | common cause coronary thrombosis; necrosis of myocardium process can take up to 6 hrs |
| 3 zones of MI damage | first zone necrotic; second zone may live if blood supply restored; third zone ischemic area that will probably survive |
| MI complications | dysrhythmias, cardiogenic shock, ventricular ruptures/aneurysms, artherial/ pulmonary emboli, pericarditis |
| Male MI S/S | squeezing/ crushing chest pain |
| Women MI S/S | more vague, symptoms, unexplained fatigue, abdominal pain |
| General MI S/S | squeezing/ crushing chest pain, pale & diaphoretic, vomiting, pulse rapid & weak, cyanotic |
| MI Dx findings | serum cardiac markers, WBC ct, blood glucose all elevated |
| Troponin | enzymes specific to myocardial contractile tissue; present only in myocardial tissue GOLD standard for determining heart damage |
| MI treatment | reduce hypoxia, relief pain, alleviate dysrhythmias, thrombolytics |
| Thrombolytics | given within 30 min, if within 2 hrs MI greatly minimized; contraindicated in prior intracranial hemorrhage or active bleeding |
| Amicar | antidote for thrombolytics |
| Cardiac rehab | gradual exercise, est. physical limits, recognize depression, min stress factors, modify diet, stop smoking |
| Sexual teaching after MI | check w/ M.D. before resuming sexual activity, avoid sex w/ anyone other than your usual partner, postpone 2 to 3 hr after heavy meals |
| Peripheral vascular disease | disorders that affect blood vessels distant from large central blood vessels |
| Raynaud's disease | brief spasms of the arteries and arterioles in fingers, temp ischemia, patchy areas of necrosis |
| Raynaud's disease S/S | numbness & tingling common after exposure to cold; vasospasms relieved, flushing swelling & throbbing pain follows |
| Raynaud's disease treatment | avoid factors that precipitate attacks (cold exposure), smoking contraindicated |
| Raynaud's nursing interventions | warm hands in water, clients swing arms behind & then in front rapidly, advise that injuries heal slowly |
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