WorksheetsTHE PATIENT WITH CORONARY HEART DISEASE
Total questions: 56
Worksheet time: 48mins
Affects 16.3 million people in the U.S.
(a)
coronary heart disease can lead to?
Angina pectoris (chest pain)
Acute coronary syndrome (heart problems)
Myocardial infarction
Dyspnea
coronary heart disease can lead to?
Dysrhythmias
Heart failure
Sudden Death
tachycardia
○ Supplies the right ventricle
○ Posterior descending artery
(a)
○ Anterior descending artery
○ Circumflex artery
(a)
● Blood flow regulated by aortic pressure
● Collateral channels
(a)
○ Develop between small arteries
○ Providing alternative routes for blood flow
(a)
● Causes unknown, appear to be:
○ Abnormal lipid metabolism
○ Injury or inflammation of the endothelial cells
(a)
● Results in blood flow obstruction, weakened arterial walls
● Major cause of aneurysms in aorta and iliac arteries
(a)
● Most common factor why patients develops coronary artery disease (CAD)
○ Hypertension
○ Chest pain
(a)
● Results from inadequate oxygen supply to the heart muscles
(a)
Categories of coronary heart disease
Chronic ischemic heart disease
Right coronary artery
Left main coronary artery
Acute coronary syndrome
■ Stable and vasospastic angina
■ Silent myocardial ischemia
(a)
■ From unstable angina to myocardial
infarction
(a)
Leading cause of death for all U.S. ethnic groups except
Asian females
(a)
Mortality rates declining 3.3% per year due to increased
public awareness
(a)
Highest incidence in White males ages 45 and older
(a)
Non-modifiable risk factors for coronary heart disease
age
gender
hereditary
obesity
Modifiable risk factors for CORONARY HEART DISEASE
hypertension
diabetes
Abnormal blood lipids
race
non modifiable risk factors for coronary heart disease
Cigarette smoking
Obesity
Physical inactivity
gender
non modifiable risk factors for coronary heart disease
high sodium and high fat
gender
race
hereditary
diagnosis for coronary heart disease
Total serum cholesterol
C-reactive protein
Ankle-brachial blood pressure index (ABI)
Echocardiography
diagnosis for coronary heart disease
Exercise ECG testing
Electron beam computed tomography (EBCT)
Myocardial perfusion imaging
Hemodynamic monitoring
CORONARY HEART DISEASE Risk factor management for smoking
(a)
CORONARY HEART DISEASE Risk factor management for diet
(a)
CORONARY HEART DISEASE Risk factor management for exercise
(a)
CORONARY HEART DISEASE Risk factor management for Hypertension
(a)
CORONARY HEART DISEASE Risk factor management for Diabetes
weight loss
reduce fat intake
increase exercise
low dose aspirin
Complementary therapies for coronary heart disease
Diet and exercise programs
Supplemental vitamins
Behavioral therapies
Mind-body therapies
what medication is used for drug therapy in coronary heart disease
lower total serum cholesterol
low ldl level
raise hdl level
raise hdl level
Diagnoses, outcomes, and interventions for coronary heart disease
Imbalanced Nutrition: more than body
requirements
Ineffective health maintenace
Risk for Noncompliance
Excess Fluid Volume
continuity of care for coronary heart disease
Cardiac rehabilitation program
Teaching, support for patient management
Reduce myocardial oxygen demand and
improve oxygen supply
Assess readiness to learn
Chest pain resulting from reduced coronary blood flow
(a)
● Imbalance between myocardial blood supply and demand
● Myocardial ischemia
(a)
COURSE MANIFESTATIONS FOR ANGINA PECTORIS
CHEST PAIN
Pain begins beneath sternum and radiates to jaw, neck
shoulder, or arm
Crescendo-decrescendo pattern
Elevated WBC count and temperature
course manifestations for angina pectoris
Dyspnea
pallor, tachycardia
great anxiety
and fear
Vasoconstriction
Women can present with atypical symptoms in angina pectoris, such as?
indigestion
nausea
cool skin
dyspnea
Women can present with atypical symptoms in angina pectoris, such as?
vomiting
upper back pain
pallor
cool skin
How are you going to handle patient with angina pectoris to keep
oxygen demand?
(a)
diagnosis for angina pectoris
Transesophageal echocardiography
(TEE)
Coronary angiography
Creatine kinase (CK) and CK-MB
Cardiac muscle troponins
Gold standard for evaluating
coronary arteries
(a)
goal of medication for angina pectoris
reduce oxygen demand
increase oxygen supply
lower total serum cholesterol
and LDL levels, raise HDL levels
reduce the risk for blood clotting
priority of care for angina pectoris
reduce myocardial oxygen demand
improve oxygen supply
support oxygen supply
deplete myocardial oxygen demand
Diagnoses, outcomes, and interventions for angina pectoris
Ineffective tissue perfusion: cardiac
Risk for ineffective therapeutic regimen
management
Decreased cardiac output
Disturbed thought processes
● Condition of unstable cardiac ischemia
● Might or might not cause significant injury of myocardial
tissue
(a)
course manifestation for acute coronary syndrome
chest pain; Substernal or epigastric radiating to the neck,
left shoulder, and/or left arm
dyspnea
diasphoresis
anxiety
course manifestation for acute coronary syndrome
pallor
cool skin
tachycardia
Elevated WBC count and temperature
course manifestation for acute coronary syndrome
Tachycardia
Hypotension
Nausea
Vasoconstriction
diagnosis for acute coronary syndrome
ecg
Cardiac muscle troponins
Creatine kinase (CK) and CK-MB
Myoglobin
medications for acute coronary syndrome
Fibrinolytic drugs
Nitrates and beta blockers
Aspirn, Heparin, Clopidogrel
Antilipemic agents
medications for acute coronary syndrome
Isosorbide mono nitrate
Intravenous antiplatelet drugs
Vasopressors
Standard or low-molecular weight
heparin preparations
goal of acute coronary syndrome medications?
reduce myocardial ischemia
reduce the risk for blood clotting
lower total serum cholesterol
and LDL levels, raise HDL levels
Reduce oxygen demand, increase oxygen
supply
Revascularization procedures for acute coronary syndrome
Percutaneous coronary revascularization (PCR)
Percutaneous transluminal coronary angioplasty
(PTCA)
Intracoronary stents
Angioplasty
Revascularization procedures for acute coronary syndrome
Atherectomy
Coronary artery bypass grafting (CABG)
Cardiopulmonary bypass (CPB) pump
Off-pump coronary artery bypass (OPCAB)
Cardiogenic shock following
AMI
Diagnoses, outcomes, and interventions for acute coronary syndrome
Decreased cardiac output
Hypothermia
Acute pain
Ineffective tissue perfusion
Diagnoses, outcomes, and interventions for acute coronary syndrome
Ineffective airway clearance/impaired gas
exchange
Risk for infection
Disturbed thought processes
Fear
