NP2 test 2_CAD and Angina.txt

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Author:
britsands
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151275
Filename:
NP2 test 2_CAD and Angina.txt
Updated:
2012-04-30 21:14:59
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brittany
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Description:
cad angina
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  1. Collateral Circualation
    the body compensate for atherosclerosis
  2. Homocysteine level
    • family predisposation for plaque development
    • b vitamin help reduce
  3. A1c should be below what?
    7
  4. Echocardiogram
    Ultrasound, looks at valves and blood flow
  5. Beta Blockers should be contridicted in patients with what?
    Asthma
  6. Cardiac Catheterization diagnostic
    • Allergic to shellfish?
    • Informed consent
    • check creatine level
    • After:
    • Check BP, HR, bleeding
    • Legs straight for 46 hours
  7. Carry's Lipids away from vessels (GOOD)
    HDL'S
  8. More Cholesterol and carry to vessels (Bad)
    LDL'S
  9. Carry both bad and triglycerides (very bad)
    VLDL'S
  10. Atrovastiatin
    prevastatin
    simvastatin
    rosuvastatin
    Statins
  11. What do statins do?
    Side effects
    Nursing considerations
    • Block the sythesis of cholesterol and increase LDL receptors in the liver
    • Decreases LDL
    • Decreases Triglycerids
    • Increases HDL


    Rash, GI disturbances, elevated liver enzymes

    Monitor liver enzymes and creatine kinase 3-6 months LFT if increased liver enzymes.
  12. Niacin
    What does it do?
    Side effects
    Nursing considerations
    • Water soluable B vitiams inhibits synthesis and secretion of VLDL and LDL
    • Decreases LDL and Triglycerides
    • Increases HDL

    Flushing and pruitius in upper torso and face, GI disturbances, N&V, Can elevate homocysteine levels


    • Take NSaid or aspirin 30-60 min before given to reduce redness and take with food
    • Treat elevated homocysteine levels with folic acid
  13. Cholestyramine (questran)
    What type is it?
    What does it do?
    Side effects?
    Nursing considerations?
    • Bile-Acid Sequstrants
    • eliminates cholesterial via bile, decreases ldl and cholesterol

    Unpleasant taste, gi disturbances

    • interferes with absorption of digoxin, tthiazide diuretics, warfarin, some antibodics
    • Don't take with Coumadin!
  14. Primary reason for stable angina
    insufficient blood flow is narrowing of coronary arteries by atherosclerosis
  15. For ischemia to occur in the heart, how much stenosis is in the coronary artery disease?
    75%
  16. What factors would determine a MI instead of stable angina?
    • accompanied by N&V
    • If more than 3-5 min
    • EKG change
  17. Medical Management of Stable angina
    ABCDE
    • A- Aspirin and Anti-anginals
    • B- Beta blocker and blood pressure
    • C-Cholesterol and Cigerettes
    • D- Diet and Diabetes
    • E-Education and Exersice
  18. Antiplatelet agent
    Aspirin
  19. Adenosine Diphosphate Receptor antagonists
    • Clopidogrel (Plavix)
    • Agrivates platelet formation
    • Alternative to Aspirin
  20. Nitrates
    • Vasodialation
    • Decreases preload and afterload
    • Watch for othostatic hypotension
  21. Atenolol
    carvedilol
    Metoprolol
    What are they?
    Action?
    Side effects?
    Nursing considerations
    • Beta-blockers
    • Inhibits sympathetic nervous stimulation of the heart, reduce both HR and Contractility, Decreases afterload
    • Watch for hypotension because masks signs, bradycardia, hypotension, wheezing, GI, ED
    • Don't give to a patient with asthma
  22. Norvasc
    Cardizem
    Calan/Isoptin
    Classification
    Action
    Side effect
    Consideration
    • Calcium channel blockers
    • Prevnts calcium entry into vascular smooth muscles cells
    • Conronary and peripheral vasodilation
    • Decreases HR and Contractility
    • Monitor digoxin levels because it could lead to toxticity
  23. Catopril
    Enalapril
    -ril's
    • Ace inhibitor
    • Decreases endothelial dsyfunction


    Hypotension, dizziness, hyperkalemia, acute renal failure, angioedema

    Aspirin and NSAIDs may reduce drug effectivness. Dont use with k+ sparing diuretics
  24. Heparin
    Classification
    Action
    • Unfractionated heparin
    • Prevent converision of fibrinogen to fibrin and prothrombin to thrombin
  25. Lovenox
    • Low-molecular-weight heparin
    • enhances effect of antithrombin III
    • Inactivates activated factor x ant thrombin
    • prevents fibrinogen conversion into fibrin
  26. Tissue plasminogen activator (tPA; alterplase (Activase))
    • Fibrinolytic therapy
    • breaks up fibrin meshwork in clots
    • used only in st-segment-elevation MI
  27. Post stent
    Nursing intervention
    • bedrest anywhere 6-24 hours
    • Will be on anticoagulants or rheomacrodex
    • Monitor vitials including cardiac monitoring
    • assess for kidney function because dye
    • avoid showering for 24 hours and bath for a few days
  28. Guidelines for nitrates
    Take one then in 5 min take 2nd in 5 min take 3rd if no relief call 911.

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