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Questions and Answers
What is one of the key nursing interventions for managing a patient's anxiety related to illness?
What action should nurses take to prevent angina due to increased cardiac work?
How should nurses manage a patient's pain related to decreased oxygen supply to the myocardium?
Which of the following is a critical nursing care consideration for a patient experiencing myocardial hypoxia?
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What is an effective method for reducing a patient's anxiety during treatment?
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Which factor is considered modifiable in increasing the risk of atherosclerosis?
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What initial condition characterizes a healthy artery?
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What condition is characterized by chest pain due to myocardial ischemia?
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Which treatment option is generally considered as the first method for managing atherosclerosis?
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What is the primary action of statins in the treatment of atherosclerosis?
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Which of the following factors is least certain in its contribution to the risk of atherosclerosis?
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What is the outcome of a significantly reduced blood supply over an extended period?
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What term describes the thickening and narrowing of arterial walls due to plaque formation?
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Which medication is used to prevent the formation of new blood clots and is administered every 4-6 hours in a hospital setting?
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What is the primary purpose of antiplatelet drugs like Aspirin?
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During the assessment of a patient with angina pectoris, which symptom is essential to analyze?
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What lifestyle modification can contribute to the prevention of angina pectoris?
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What is the recommended dosage range of Aspirin for preventing arterial thrombus development?
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Which nursing intervention is appropriate for a patient experiencing ineffective myocardial tissue perfusion?
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What is an expected outcome of administering oxygen during chest pain episodes?
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What common cardiovascular condition should be monitored and controlled to prevent angina pectoris?
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What blood pressure measurement is classified as hypertension?
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What can occur as a direct result of long-standing elevated blood pressure?
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Which type of angina occurs at rest or with minimal exertion?
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Which symptom is most commonly associated with angina pain?
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What is a common trigger for stable angina?
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Which condition is likely to increase the risk of angina and heart disease?
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What characterizes variant angina?
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Which of the following activities is least likely to trigger angina pain?
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What is referred pain commonly associated with during myocardial ischemia?
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What is the primary purpose of pharmacological therapy in myocardial ischemia management?
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Which diagnostic test utilizes X-ray imaging to evaluate the heart's blood vessels?
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Which medication is known for providing immediate relief during an angina attack?
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What autonomic symptoms may accompany myocardial ischemia?
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Which of the following agents is used to reduce heart rate and decrease myocardial oxygen consumption?
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What condition is indicated by elevated C-reactive protein levels associated with myocardial ischemia?
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Which of the following tests evaluates the heart's structure and function using ultrasound?
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Study Notes
Atherosclerosis
- Atherosclerosis is a buildup of plaque in the arteries, leading to restricted blood flow and potential complications.
- The plaque buildup begins with small deposits on the artery walls, gradually increasing in size.
- High cholesterol levels contribute to plaque formation.
Risk Factors
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Modifiable risk factors:
- Diabetes
- Tobacco smoking (increases risk by 200% after several pack years)
- High blood pressure
- Elevated C-reactive protein levels
-
Nonmodifiable risk factors:
- Advanced age
- Male sex
- Family history of atherosclerosis (e.g., coronary heart disease or stroke)
- Genetic abnormalities (e.g., familial hypercholesterolemia)
-
Lesser or uncertain risk factors:
- Obesity (particularly central obesity)
- Sedentary lifestyle
- High carbohydrate intake
- Elevated triglyceride levels
- Stress
Symptoms
- Symptoms depend on the severity of plaque buildup and blood flow obstruction.
- Inadequate blood supply (ischemia) can lead to:
- Angina pectoris (chest pain due to myocardial ischemia)
- Myocardial infarction (heart attack)
- Myocardium dysfunction (scar tissue replacing damaged myocardium)
- Heart failure
Treatment
-
Non-pharmacological methods:
- Smoking cessation
- Regular exercise
-
Pharmacological methods:
- Statins (e.g., lovastatin, simvastatin, fluvastatin) to block cholesterol synthesis and improve lipid profiles.
- Smoking cessation programs
- Managing hypertension (blood pressure above 140/90 mmHg)
- Hypertension can lead to vessel injury and inflammatory response, increasing the workload of the left ventricle and potentially causing heart failure.
Angina Pectoris
- Definition: Severe chest pain due to heart muscle ischemia caused by coronary artery obstruction.
-
Subtypes:
- Stable angina: Chest discomfort related to myocardial ischemia, typically triggered by exertion and minimal at rest.
- Unstable angina: Worsening or changing angina, including rest angina, severe angina, or crescendo angina.
- Variant angina: Occurs at night, caused by coronary artery spasm, potentially related to hyperactive sympathetic nervous system responses.
- Silent ischemia: May occur with activity or mental stress.
-
Risk factors:
- Physical exertion (increased oxygen demand)
- Exposure to cold (vasoconstriction and increased blood pressure)
- Eating heavy meals (increased blood flow to the mesenteric area for digestion)
- Stress (increased blood pressure and workload)
- Obesity (associated with high cholesterol and high blood pressure)
Symptoms
- Chest discomfort: Pressure, heaviness, tightness, squeezing, burning, or choking sensation.
- Radiating pain: May radiate to the upper central abdomen, back, neck, jaw, or shoulders.
- Other symptoms: Breathlessness, sweating, nausea, weakness, numbness, autonomic symptoms (nausea, vomiting, pallor).
Diagnosis
- Electrocardiogram (ECG): Measures electrical activity in the heart.
- Exercise ECG test: Evaluates heart rhythm during exertion to identify ECG changes.
- Coronary angiogram: X-ray imaging of heart blood vessels to assess blood flow restriction.
- Echocardiography (ultrasound): Evaluates cardiac structure and function, performed at rest or during exercise.
- C-reactive protein: Elevated levels indicate inflammation associated with coronary artery disease.
Medical Management
- Goal: Decrease myocardial demand and increase oxygen supply.
-
Pharmacological therapy:
- Nitroglycerin: Dilates veins and arteries, reducing myocardial work and increasing coronary blood flow.
- Beta-adrenergic blocking agents (e.g., Inderal): Decrease heart rate, blood pressure, and myocardial contractility to balance oxygen supply and demand.
- Calcium channel blocking agents (e.g., Procardia, Vascor): Slow heart rate, relax blood vessels, and increase coronary blood flow.
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Antiplatelet drugs:
- Aspirin: Prevents platelet aggregation and thrombus formation.
- Intravenous antiplatelet drugs (e.g., Reopro): Block platelet activation but have a higher risk of bleeding.
- Heparin (anticoagulant): Prevents new blood clot formation and reduces the risk of myocardial infarction.
- Oxygen administration: Increases oxygen delivery to the myocardium and reduces pain at the onset of chest pain.
Nursing Process
- Assessment: Health history, including chest pain details, cardiovascular disorders, medications, diet, exercise, alcohol intake, smoking history, and physical assessment (vital signs, heart sounds, peripheral pulses, skin color and temperature).
- Prevention: Smoking cessation, monitoring and managing other health conditions, healthy diet and weight, regular exercise, stress reduction, alcohol moderation, and annual flu shot.
Nursing Diagnoses and Interventions
-
Ineffective myocardial tissue perfusion:
- Goal: Improve tissue perfusion and decrease chest pain.
- Nursing care: Rest in semi-Fowler position, assess angina, vital signs, monitor for respiratory distress, provide nitroglycerine, administer oxygen, space activities, educate on prescribed medications.
- Anxiety: Goal: Reduce anxiety.
- Nursing care: Provide information about illness, treatment, and prevention, explore stress reduction methods, allow for emotional expression, and answer questions.
- Pain: Goal: Prevent or reduce pain.
- Nursing care: Assess pain, plan activities according to patient ability, balance rest and activity, keep nitroglycerine readily available.
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Description
This quiz covers key aspects of atherosclerosis, focusing on the buildup of plaque in arteries and its impact on blood flow. It also explores various risk factors, including modifiable and nonmodifiable risks, as well as symptoms associated with the condition. Test your knowledge on how lifestyle choices and genetics influence atherosclerosis.
