Coronary Artery Disease (CAD) quiz 1

Coronary Artery Disease (CAD)

• Atherosclerosis is the most common cause

Lipoproteins and CAD Risk

• High levels of LDL increase CAD risk

Acute Angina Treatment

• Sublingual nitroglycerin is the first-line treatment that provides rapid vasodilation

Myocardial Infarction (MI) Diagnostic Marker

• Troponins are cardiac-specific proteins that that are highly sensitive and specific to myocardial injury

Acute Myocardial Infarction Leading Cause of Death

• Cardiac arrest within the first hour is the leading cause due to fatal arrhythmias

MI-related Pain Relief

• Morphine sulfate is the drug of choice for MI-related pain that is not relieved by nitroglycerin, it also reduces anxiety

Treating Myocardial Ischemia

• Reestablishing perfusion is the primary goal and minimizes myocardial damage and improves outcomes

Stable Angina

• Chest pain with exertion is a classic sign, it resolves with rest

Statins and CAD

• Statins inhibit HMG-CoA reductase, lowering LDL levels and reducing plaque formation

Angina Medication Tolerance

• Long-term use of organic nitrates can lead to tolerance, reducing their effectiveness

Myocardial Ischemia vs Infarction

• Ischemia is potentially reversible, infarction indicates irreversible cell death

Silent MI Symptoms in Women

• Women may experience atypical symptoms like epigastric pain, fatigue, or nausea

Unstable Angina

• Chest pain at rest or worsening frequency indicates unstable angina, a medical emergency

Beta Blockers in Stable Angina

• Beta blockers reduce HR and contractility, lowering oxygen demand of the heart

Non-modifiable CAD Risk Factors

• Age, family history, and gender are non-modifiable; hypertension and smoking are modifiable

Myocardial Ischemia Contributors

• Plaque occlusion, vessel spasm, and low BP can decrease perfusion; high HDL is protective

Aspirin Use in MI

• Aspirin inhibits platelet aggregation, reducing clot formation during MI

C-Reactive Protein (CRP)

• A high level suggests systemic inflammation and is used to detect subclinical CAD

Effective Cardiac Perfusion

• Quick capillary refill (less than 2 seconds) suggests adequate tissue perfusion

Clinical Manifestations of CAD

• Angina, dyspnea, chest pain, and nausea are common symptoms, fever is not typical

Angina Priority Nursing Intervention

• Administer sublingual nitroglycerin as it is the first-line treatment to relieve chest pain caused by ischemia

Atorvastatin

• Liver enzymes should be monitored because statins may cause hepatotoxicity

Discharge Teaching for Stable Angina

• Call EMS if pain is not relieved after 3 doses of nitroglycerin (5 minutes apart)

Nursing Interventions for Cardiac Perfusion

• Encourage rest, keep nitroglycerin accessible, monitor oxygen saturation, and instruct on medication compliance to optimize oxygen delivery and adherence to treatment

Prophylactic Nitroglycerin

• Take before known triggers like exercise or stress

Post-MI Patient Assessment

• HR 48 bpm in a patient prescribed metoprolol requires immediate follow-up because metoprolol can cause bradycardia

Nitroglycerin Teaching Points

• Store in a cool, dry place, sit or lie down when taking, replace tablets every 6 months, and it may cause headache, it can cause hypotension and must be stored properly and replaced regularly

CAD Discharge Teaching

• Further teaching is needed if the patient says they can stop taking their meds once they feel better as medications must be taken consistently to avoid serious complications

Telemetry Strip Showing ST Elevation

• The priority is to alert the provider immediately because ST elevation may indicate an acute MI where rapid intervention is critical to restore perfusion.

Interventions for Chest Pain Episode

• Apply oxygen, raise the head of the bed, administer sublingual nitroglycerin, and monitor ECG as these are standard interventions for angina

Signs of Acute MI

• Report of chest pain radiating to the left arm and jaw, client appears pale and diaphoretic and the priority is to notify rapid response/emergency team

Elevated Troponin Levels and Normal ECG

• The nurse should suspect a silent MI as elevated troponins indicate cardiac cell injury and it can occur without symptoms, specifically in older adults or women

Silent MI Likelihood

• Increased with diabetes, female gender, and age over 65 because they often have atypical or silent MI presentations

Older Adult with Confusion, Mild SOB, and Fatigue

• Assess cardiac enzymes first because atypical symptoms may signal an MI, labs like troponins can confirm cardiac involvement

Cardiac Patient Assessment Priority

• A patient reporting new-onset crushing chest pain because severe chest pain suggests an acute MI and needs immediate evaluation

CAD Patient Refusing Medications

• Assess their cultural beliefs, financial concerns, and understanding of the disease because nonadherence may stem from personal, cultural or financial barriers

ST Depression and T-Wave Inversion on ECG

• Call the provider because these ECG changes may indicate myocardial ischemia

Angina Patient Taking Nitroglycerin

• If they report dizziness and lightheadedness, check blood pressure, because hypotension is a common side effect of the drug

Poor Perfusion Post-MI

• Confusion, cap refill > 3 seconds, cool, clammy skin, and hypotension

Post-CABG Patient Care

• Monitor cardiac output and perfusion for the first 24 hours, because immediate post-op priorities include maintaining hemodynamic stability and tissue perfusion

Key Assessment Finding Post-CAD

• Chest pain unrelieved after rest and nitroglycerin requires immediate attention and may indicate unstable angina or MI

Decreased Cardiac Output Post-MI

• Urine output of 15 mL/hr, pale skin, crackles in lungs, and restlessness indicate impaired perfusion

Anxious Post-MI Patient

• Provide emotional support and stay with the patient because addressing emotional distress through presence and reassurance is therapeutic and reduces oxygen demand from anxiety

New Arrhythmia in Post-MI Patient

• Assess the patient's clinical status so that the provider knows is it symptomatic and requires emergency response

Cardiac Rehab Adherence Strategies

• Involve family in education, emphasize long-term benefits, and address transportation barriers

Patient Lightheaded and Dizzy After IV Nitroglycerin

• Stop the infusion and assess BP as hypotension is a known adverse effect of nitro

CAD Patient Understanding of Discharge Teaching

• Correct understanding shown when the patient states to carry nitro at all times, avoid activities that cause chest pain and call their provider if they feel chest pain that doesn't go away because meds should not be skipped or altered

76-Year-Old Woman with Fatigue, Nausea, and Confusion

• Call for an ECG and troponin test, because atypical symptoms in older women may be early signs of MI and prompt testing is essential

Post-MI Beta-Blocker Teaching

• A patient must check their heart rate before taking, as beta-blockers can cause bradycardia

Post-CABG Assessment

• Immediate intervention is required if urine output is at 20 mL/hr, chest tube output is at 150 mL/hr, or LOC changes because low urine output, excessive chest tube drainage, and neurological changes are signs of post-op complications