NCM 110 Quiz Reviewer PDF

QUIZ REVIEWER INVASIVE PROCEDURES  Cardiac catheterization  CVP  PAP  Intra-arterial blood pressure monitoring...

QUIZ REVIEWER INVASIVE PROCEDURES  Cardiac catheterization  CVP  PAP  Intra-arterial blood pressure monitoring  Pacemaker PULMONARY CAPILLARY WEDGE PRESSURE CENTRAL VENOUS PRESSURE  Pulmonary capillary wedge pressure (PCWP) provides an indirect estimate of left atrial  Central venous pressure, which is a measure of pressure in the vena cava, can be used pressure (LAP). as an estimation of preload and right atrial pressure.  Although left ventricular pressure can be directly measured by placing a catheter within  Central venous pressure is often used as an assessment of hemodynamic status, the left ventricle, it is not feasible to advance this catheter back into the left atrium. particularly in the intensive care unit  LAP can be measured by placing a special catheter into the right atrium then punching  The central venous pressure can be measured using a central venous catheter advanced through the interatrial septum. via the internal jugular vein and placed in the superior vena cava near the right atrium.  A normal central venous pressure reading is between 8 to 12 mmHg. This value is altered by volume status and/or venous compliance CVP LINES INDICATION:  Volume resuscitation.  Emergency venous access.  Nutritional support.  Administration of caustic medications (e.g., vasopressors)  CVP monitoring.  Hemodialysis CENTRAL VENOUS CATHETER TRANSDUCER  Devise that convert’s one form of energy to another.  The transducer converts the pressure signal to an electrical signal then sends it on to the monitor.  The monitor amplifies the signal and displays digital readings and/or a waveform Cyra Joy P. Sarmiento NCM 110  INTRA-AORTIC BALLOON PUMP (IABP) PACEMAKER  An intra-aortic balloon pump (IABP) is a mechanical device that helps the heart pump  An electronic device used to pace the heart when the normal conduction pathway is blood. damaged or diseased.  This device is inserted into the aorta, the body's largest artery. It is a long, thin tube called a catheter with a balloon on the end of it.  It is thread the IABP through the femoral artery in your leg into your aorta  The doctor will use an X-ray machine during this procedure to help accurately position the IABP. INDICATIONS  Acute congestive heart failure exacerbation with hypotension  As prophylaxis or adjunct treatment in high risk percutaneous coronary intervention  Myocardial infarction with decreased left ventricular function leading to hypotension  Low cardiac output state after coronary artery bypass grafting surgery HOW PACEMAKER WORKS?  Intractable angina or myocardial ischemia, refractory heart failure, or intractable  The generator contains the battery and the information to control the heartbeat ventricular arrhythmias  The leads are wires that connect the heart to the generator and carry the electrical messages to the heart.  A pacemaker is implanted under the skin, a small incision (cut) is made.  The cut is on the left side (if you are right handed) of the chest below your collarbone.  The pacemaker generator is then placed under the skin at this location. PERMANENT PACEMAKER  Implanted totally in the body.  Powersource is implanted subcutaneously over the pectoral muscle on the patient non dominant side  It has sensors that that detect changes in the patient physical activity and automatically adjust the pacing rate to fulfill the body’s metabolic needs. Cyra Joy P. Sarmiento NCM 110  TYPES OF PACEMAKERS ASYNCHRONOUS PACEMAKER An implanted pacemaker that delivers stimuli at a fixed rate, independent of any atrial or ventricular activity DEMAND PACEMAKER An artificial pacemaker that activates only when it receives sensations indicating a lack of adequate spontaneous rhythm by the heart. It thus avoids competition with the patient's own natural pacemaker INDICATIONS FOR PACEMAKERS  Sinus Node Dysfunction  Acquired Atrioventricular (AV) Block.  After Acute Phase of Myocardial Infarction.  Neurocardiogenic Syncope and Hypersensitive Carotid Sinus Syndrome.  Post Cardiac Transplantation  Hypertrophic Cardiomyopathy (HCM)  Different arrtyhmias CARE OF PATIENT WITH PACEMAKER 1. Immobilize the affected part and keep on supine position but allow movement of fingers and ankle joint 2. Monitor heart rate and rhythm 3. Monitor vital signs and level of consciousness of patient 4. Prevent infection-watch for signs –redness, swelling on dressing Instruct patient to carry pacemaker information card at all times 5. Watch out for complication- hematoma, pneumothorax, ventricular atrophy, cardiac perforation ELECTROCARDIOGRAM  a record of the electrical activity of the heart over a period of time INDICATIONS ELECTRODE ECG MACHINE  Chest pain. a conductor that is used to make contact with a non-metallic part of a  Dizziness, light-headedness or confusion. circuit  Heart palpitations.  Rapid pulse.  Shortness of breath.  Weakness, fatigue or a decline in ability to exercise. Cyra Joy P. Sarmiento NCM 110  ELECTRODE PLACEMENT IN 12 LEAD ECG ELECTRODE PLACEMENT ELECTRODES AROUND THE HEART 6 are CHEST ELECTRODES FOR THE CHEST ELECTRODES  Called V1-6 or C1-6 V1: 4th intercostal space right sternal edge V2: 4th intercostal space left sternal edge 4 are LIMB ELECTRODES  To find the 4th space, palpate the manubriosternal angle of  Right arm: Ride Louis  Left arm: Your  Directly adjustments is the 2nd rib, with the 2nd intercostal space  Left leg: Green below. Palpate inferiorly to find the 3rd and then 4th space  Right leg: Bike V4: over the apex (5th ICS mid clavicular line V3: halfway between V2 and V4 Remember: V5: at the same level as V4 but on the anterior axillary line  The right leg electrode is a neutral or dummy V6: at the same level as V4 and V5 but on the mid axillary line LEADS AND WHAT THEY TELL YOU LIMB LEADS CHEST LEADS Limb leads look at the heart in the coronal plane Each lead can be thought of as looking at an area of myocardium aVL, I, II = lateral II, III, aVF = inferior V1 to V6 look at the heart on the transverse plain aVR = right side of the heart V1 and V2: look at the anterior of the heart and R ventricle V3 and V4: anterior and septal V5 and V6:lateral and left ventricle ELEMENTS OF THE TRACE ECG DEFLECTIONS ELECTRICAL CONDUCTION SYSTEM OF THE HEART ELECTRIC IMPULSES 4 Steps of Cardiac Conduction  The electrical impulse travels from the sinus node to the atrioventricular node (also called Step 1: Pacemaker Impulse Generation.SA node AV node). Step 2: AV Node Impulse Conduction  There, impulses are slowed down for a very short period, then continue down the Step 3: AV Bundle Impulse Conduction conduction pathway via the bundle of His into the ventricles. Step 4: Purkinje Fibers Impulse Conduction  Each contraction of the ventricles represents one heartbeat. Cyra Joy P. Sarmiento NCM 110  OTHER PROBLEMS WITH THE ECG ARTIFACT ELECTRICAL INTERFERENCE MUSCLE TREMOR WANDERING BASELINE  electrocardiographic alterations, not related to cardiac electrical activity NORMAL ECG A normal ECG contains waves, intervals, segments and one complex WAVE INTERVAL SEGMENT Complex A positive or negative deflection from baseline that indicates The time between two specific ECG The length between two specific points The combination of multiple waves a specific electrical event. The waves on an ECG include the events. The intervals commonly on an ECG that are supposed to be at grouped together. The only main P wave, Q wave, R wave, S wave, T wave and U wave. measured on an ECG include the PR the baseline amplitude (not negative or complex on an ECG is the QRS interval, QRS interval (also called QRS positive). The segments on an ECG complex. duration), QT interval and RR interval. include the PR segment, ST segment and TP segment. DEPOLARIZATION REPOLARIZATION  The change in the resting membrane potential to a more positive value.  The event through which the membrane potential is reconverted into the  The resting membrane potential is the potential across the cell membrane at rest, which is -70 mV. resting membrane potential, following the depolarization of the cell membrane.  This means the cell interior is more negatively-charged when compared to the cell exterior.  Following depolarization, the sodium channels, which cause the less negative charge inside, are closed while the potassium channels are opened due to the presence of more positive ions inside.  This results in the movement of potassium ions out of the cell, making the cell interior more negative.  Finally, the repolarization process restores the resting membrane potential.  When an action potential wants to fire, a depolarization current is generated by the opening of sodium channels, which allows more sodium ions to enter into the cell. This results in the decrease of the negative charge in the cell interior. Cyra Joy P. Sarmiento NCM 110  ECHOCARDIOGRAPHY/ECHOCARDIOGRAM HOLTER MONITORING  An ultrasound of the heart. It is a type of medical imaging of the heart, using standard ultrasound  A type of portable electrocardiogram (ECG). or Doppler ultrasound.  It records the electrical activity of the heart continuously over 24 hours or longer  Technician (sonographer) spreads gel on a device (transducer). while you are away from the doctor's office.  The sonographer presses the transducer firmly against your skin, aiming an ultrasound beam  A standard or "resting" ECG is one of the simplest and fastest tests used to through your chest to your heart. The transducer records the sound wave echoes from your heart evaluate the heart.  To evaluate chest pain that can't be reproduced with exercise testing.  To evaluate other signs and symptoms that may be heart-related, such as tiredness, shortness of breath, dizziness, or fainting. TERMINOLOGY ARRHYTMIA Irregular heart beat TACHYCARDIA Rapid heart beat BRADYCARDIA Slow heart beat MURMUR Blowing, whooshing, or rasping sound heard during a heartbeat. FIBRILLATION Muscular twitching involving individual muscle fibers acting without coordination Very rapid irregular contractions of the muscle fibers of the heart resulting in a lack of synchronism between heartbeat and pulse. FLUTTER Type of heart rhythm disorder in which the heart's upper chambers (atria) beat too quickly. REGURGITATION Condition in which your heart's mitral valve doesn't close tightly, allowing blood to flow backward in your heart. ISCHEMIA Inadequate blood supply INFARCTION Death of tissue Cyra Joy P. Sarmiento NCM 110  ARRHYTMIAS  An irregular heartbeat. Heart rhythm problems (heart arrhythmias) occur when the electrical signals that coordinate the heart's beats don't work properly.  The faulty signaling causes the heart to beat too fast (tachycardia), too slow (bradycardia) or irregularly.  Tachycardia -fast heart. The resting heart rate is greater than 100 beats a minute.  Bradycardia -is a slow heartbeat. The resting heart rate is less than 60 beats a minute SINUS TACHYCARDIA SINUS BRADYCARDIA SICK SINUS ATRIAL FIBRILLATION (A-FIB) A regular cardiac rhythm in which the heart Heart rate slower than 60 beats per minute. A group of abnormal heart rhythms resulting A rapid, uncoordinated heart rate. The beats faster than normal and results in an Caused by some medical conditions like heart from the malfunction of hearts primary condition may be temporary, but some A-fib increase in cardiac output. Ex. compensatory system pacemaker, sinus node. This results in low episodes may not stop unless treated. A-fib is response to exercise or stress pulse rate and fainting associated with serious complications such as stroke. ATRIAL FLUTTER NORMAL SINUS RHYTHM (NSR) VENTRICULAR TACHYCARDIA( VTACH) VENTRICULAR FIBRILLATION Similar to A-fibrillation, but heartbeats are Ventricular tachycardia is a heart rhythm Serious heart rhythm problem in which the more organized. Atrial flutter is also linked to disorder (arrhythmia) caused by abnormal heart beats faster and out of rhythm. stroke electrical signals in the lower chambers of the heart (ventricles). This condition may also be Atrial flutter is a type of heart rhythm disorder called V-tach or VT. (arrhythmia) caused by problems in your The chaotic heartbeats prevent the heart heart's electrical system. People with atrial chambers from properly filling with blood. As flutter have a heart rhythm that's more a result, your heart may not be able to pump organized and less chaotic than that of atrial enough blood to your body and lungs. fibrillation. Sometimes you may have episodes of both atrial flutter and atrial fibrillation. Cyra Joy P. Sarmiento NCM 110  MANAGEMENT ELECTRICAL CARDIOVERSION DEFIBRILLATION AUTOMATED EXTERNAL DEFIBRILLATOR( AED)  A procedure used to restore your heart’s rhythm to a  A process in which an electronic device sends an electric  An automated external defibrillator is electronic device a normal, or regular pattern. shock to the heart to stop an extremely rapid, irregular portable that automatically diagnoses the life-threatening  To do this, a low-voltage electrical current is used to heartbeat, and restore the normal heart rhythm. cardiac arrhythmias of ventricular fibrillation and pulseless contract all four chambers of the heart cell at the same  It is performed to correct life-threatening fibrillations of the ventricular tachycardia. time. heart, which could result in cardiac arrest.  Once this occurs, all four chambers can then begin  It should be performed immediately after identifying that working in synchrony, thus restoring the rhythmic pattern the patient is experiencing a cardiac emergency, has no of your heart. pulse, and is unresponsive.  This procedure is used to treat abnormal heart rates or rhythms (known as arrhythmias), such as atrial fibrillation A. Anterolateral paddle placement for external countershock. or flutter. External paddles are placed at the second right intercostal space and at the anterior axillary line in the fifth left intercostal space. B. Ventricular fibrillation converted to normal sinus rhythm with external countershock  An electrical device used to counteract fibrillation of the heart muscle and restore normal heartbeat by applying a brief electric shock.  An electronic device that administers an electric shock of preset voltage to the heart through the chest wall in an attempt to restore the normal rhythm of the heart during ventricular fibrillation CARDIOVERSION VS. DEFIBRILLATION MEDICATIONS FOR CARDIAC ARRYTHMIAS DRUGS FOR ARRHYTMIAS  Amiodarone (Cordarone, Pacerone)  Flecainide (Tambocor)  Ibutilide (Corvert), which can only be given through IV.  Lidocaine (Xylocaine), which can only be given through IV.  Procainamide (Procan, Procanbid)  Propafenone (Rythmol)  Quinidine (many brand names)  Tocainide (Tonocarid) Cyra Joy P. Sarmiento NCM 110  CRASH CART/ CODE CART DEFINITION FUNCTION POLICY ARRANGEMENT OF CRASH CART  A means of storing and transporting  The function of a crash cart is to provide a  Crash cart must be checked by head nurse, staff  Top shelf vital equipment and drugs which may mobile station within the hospital that nurse every shift and document in checklist.  Defibrillator be required during a code blue contains everything needed to treat a life-  Standarization must be maintained.  Spo2 Probe (cardiac emergency) to the location of threatening situation.  Defibrillator will be checked by biomed  ECG strips the emergency.  The advantage of mobility is that it allows department regularly or as necessary.  Ultrasound Jelly for DC shock  The crash cart should be kept in an the treatment to come to the patient when  Crash cart items must be checked monthly for  Ambubag Adult with mask easily accessible position which is needed. expiry dates.  Ambubag pedia with mask central to the patient care areas.  The arrangement of the equipment in the  Each unit will have crash cart placed in an easily crash carts should be standardized place accessible location. throughout the institution. DEFIBRILLATOR AMBU BAG (ARTIFICIAL SUCTION CATHETHER MANUAL BREATHING UNIT) An apparatus used to control heart A bag used to give rescue breaths fibrillation by application of an for victims of cardiac arrest, used electric current to the chest wall or along with a face mask (bag and heart mask ventilation). It is an integral part of any emergency kit. EMERGENCY DRUGS First Drawer ADRENALIN Also known as epinephrine, is a hormone and medication which is involved in regulating visceral functions (e.g., respiration).it is used to treat a number of conditions including anaphylaxis, cardiac arrest, and superficial bleeding. ATROPINE An antimuscarinic medication used in ACLS to treat Bradycardia by reversing cholinergic-mediated slowing of the heart rate AMIODARONE An antiarrhythmic medication used to treat and prevent a number of types of irregular heartbeats. VERAPAMIL Use to treat supraventricular tachycardia ADENOSINE Decreased coronary artery perfusion pressure. DIGOXIN Increases the force of contraction of the muscle of the heart by inhibiting the activity of an enzyme DOPAMINE Increased myocardial contractility and increased heart rate DOBUTAMINE Primarily increases stroke volume and cardiac output LEVOPHED Use to treat low blood pressure CALCIUM Used to manage hypocalcemia, cardiac arrest, and cardiotoxicity due to hyperkalemia or hypermagnesemia GLUCONATE LASIX Diuretic / treat high blood pressure HYDROCORTISON Hydrocortisone treatment during resuscitation, particularly when administrated within 6 minutes of ED arrival, may be associated with an improved ROSC (Returned of E Spontaneous circulation) of OHCA( out of hospital Cardiac Arrest) DILANTIN It has antiarrhythmic effect Cyra Joy P. Sarmiento NCM 110  ASSESSMENT ON ALTERED TISSUE PERFUSION SUBJECTIVE DATA OBJECTIVE DATA NURSING ASSESSMENT FOR NURSING DIAGNOSES INEFFECTIVE PERIPHERAL TISSUE PERFUSION  Numbness Peripheral  Monitor/ check distal pulses frequently.  Activity intolerance related to insufficient  Pain Weak/absent peripheral pulses  Brachial oxygen for ADL  Altered sensation in extremities Cool skin temperature  Radial  Anxiety related to breathelessness headaches Prolonged capillary refill  Dorsalis Pedis  Imbalanced nutrition less than body  Chest pain Thickened nails  Posterior tibialis requirements  Nausea Shortness of breath Loss of hair on legs/ shiny shins  Monitor the color, temperature, and  Related to nausea, anorexia, secondary  Feeling of impending doom/death Pallor on elevation/ rubor when dependent  Sensation of all extremities. to venous congestion Dizziness Lightheadedness fatigue Prolonged wound healing  Impaired peripheral tissue perfusion  Color of extremities should be usual for  Gastrointestinal -sudden sharp ethnicity. Pallor, cyanosis, or mottled related to abdominal pain Cerebral  Venous congestion skin color indicate a blockage in LOC changes: restlessness, irritability,   Renal-Altered fluid intake and output perfusion to the extremity. Disturbed sleep pattern related to agitation nocturnal dyspnea Nausea/ vomiting  Powerlessness related to progressive Motor weakness nature of condition Slurred speech/dysphagia  High risk for ineffective treatment Fever regimen  Management related lack of knowledge Gastrointestinal Decreased/absent bowel sounds  Pain related to impaired circulation Nausea/ vomiting  Recognize myocardial ischemia Electrolyte imbalance  Relieve chest pain Acid-base imbalance  Maintain a calm environment Abdominal distention  Balance of myocardial oxygen supply and demand Renal  Optimize cardiopulmonary function Decreased urine output  Promote comfort and emotional support Abnormal renal values  Monitor effects pharmacological therapy  Patient education Cyra Joy P. Sarmiento NCM 110  ALTERATIONS IN PERFUSIONS 1.Acute coronary syndrome-(ACS)/Acute ischemic heart disease Acute coronary syndrome refers to a group of diseases in which blood flow to the heart decreases. Ex. STEMI (ST Elevation Myocardial Infarction), unstable angina MYOCARDIAL INFARCTION  Described as the irreversible necrosis of heart muscle emerging from a drop in blood supply to the heart due to coronary artery occlusion  Reduction in blood supply to the anterior wall of the heart is related to anterior myocardial infarction. ISCHEMIA Inadequate blood supply to an organ or part of the body, especially the heart muscles ANGINA Type of chest pain caused by reduced blood flow to the heart INFARCTION Tissue death (necrosis) due to inadequate blood supply to the affected area. It may be caused by artery blockages, rupture, mechanical compression, or vasoconstriction. The resulting lesion is referred to as an infarct. CARDIOMYOPATHY Any disorder that affects the heart muscle CLINICAL MANIFESTATIONS MANAGEMENT 1. Chest pain radiating to the left shoulder, jaw, DIAGNOSTIC TEST 2. Nausea 1. ECG 3. Sweating 2. Chest X-ray 4. Cold clammy skin 3. Blood test – cardiac enzymes; troponin 5. Chest pain not relieved by rest 4. Coronary CT angiography 6. Tightness over the chest 7. Shortness of breath MEDICATION 8. Palpitations 1. Aspirin 9. Sense of impending doom ( anxiety) 2. Thrombolytics- chlopidogrel 3.primary Coronary Angioplasty ( PCA) 4. Morphine 5. Oxygen 6. Nitroglycerine HYPERTENSIVE CRISIS  A hypertensive crisis is a severe increase in blood pressure that can lead to a stroke.  Extremely high blood pressure — a top number (systolic pressure) of 180 millimetres of mercury (mm Hg) or higher or a bottom number (diastolic pressure) of 120 mm Hg or higher — can damage blood vessels.  Hypertensive crisis occurs when a person’s blood pressure surges to an unusually high level. This condition can cause damage to blood vessels and major organs. Cyra Joy P. Sarmiento NCM 110  CAUSES CLINICAL MANIFESTATION MANAGEMENT HOME REMEDIES  having overweight or obesity  severe headache or migraine Medications  Managing stress  eating an unhealthful diet that is high in  dizziness Conventional drugs for treating high blood pressure  Quitting smoking salt  confusion include:  Eating healthfully  not getting very much physical activity  severe anxiety 1) ANGIOTENSIN CONVERTING ENZYME  Getting exercise  smoking  nausea or vomiting INHIBITORS  Following any treatment plan the doctor  having a history of cardiovascular  chest pain Angiotensin converting enzyme (ACE) inhibitors prescribes disease  changes in vision block the actions of some hormones that regulate  Regular exercise  having an underlying health condition, blood pressure, such as angiotensin II.   shortness of breath Losing weight such as diabetes or kidney disease Angiotensin II causes the arteries to constrict and  nosebleed  Sleep increases blood volume, resulting in increased  fits or seizures  Natural remedies-meditation, yoga blood pressure. ACE inhibitors can reduce the blood supply to the kidneys, making them less effective. As a result, it is necessary for people taking ACE inhibitors to have regular blood tests. 2. CALCIUM CHANNEL BLOCKERS Calcium channel blockers (CCBs) aim to decrease calcium levels in the blood vessels. This will relax the vascular smooth muscle, causing the muscle to contract less forcefully, the arteries to widen, and blood pressure to go down. 3. THIAZIDE DIURETICS Help the kidneys get rid of sodium and water. This lowers blood volume and pressure 4. BETA-BLOCKERS Cyra Joy P. Sarmiento NCM 110  Beta-blockers slow the heart rate and reduce the force of the heartbeat, causing a drop in blood pressure 5. RENIN INHIBITORS ALISKIREN (TEKTURNA, RASILEZ) Reduces the production of renin, an enzyme that the kidneys produce. Renin helps produce a hormone that narrows blood vessels and raises blood pressure. Reducing this hormone causes the blood vessels to widen and blood pressure to fall HEART FAILURE A clinical condition in which the heart loses its ability to pump blood efficiently throughout the body SIGNS AND SYMPTOM CAUSES RISK FACTORS  Shortness of breath with activity or  High blood pressure 1. Hypertension when lying down.  Heart problem 2. Hyperlipidemia  Fatigue and weakness.  Valvular conditions 3. Diabetes  Swelling in the legs, ankles and feet.  Arrhythmias Coronary heart disease 4. Obesity  Rapid or irregular heartbeat.  Lung problems 5. Smoking.  Reduced ability to exercise.  Poor blood supply ,  Persistent cough or wheezing with  Lung disease, white or pink blood-tinged mucus.  Airway problem  Swelling of the belly area (abdomen)  Lifestyle Failure to take preventive  Chronic lack of energy measures  Difficulty sleeping at night due to  Diet breathing problems  Alcohol misuse  Cough with frothy sputum  Increased urination at night  Confusion/impaired memory Cyra Joy P. Sarmiento NCM 110  TREATMENT DRUG USED MEDICAL /SURGICAL MANAGEMENT Upright position 1.RECANALIZATION Nitrates Restoration of a lumen in a blood vessel following thrombotic occlusion, by Lasix organization of the thrombus with formation of new channels Oxygen ACE inhibitors PALLIATIVE CARE FOR END STAGE Digoxin  Adequate pain and symptom management,  Avoidance of inappropriate prolongation of dying, Fluids (decrease)  Achievement of a sense of control Afterload(decrease)  Relief of the burden on others Sodium restriction  Strengthening of relationships with loved one Test (digoxin level, ABG, Potassium level PTCA PERCUTANEOUS TRANSLUMINAL CORONARY ANGIOPLASTY (PTCA)  also called percutaneous coronary intervention  (PCI) is a minimally invasive procedure to open blocked or stenosed coronary arteries allowing unobstructed blood flow to the myocardium.  The blockages occur because of lipid-rich plaque within the arteries, diminishing blood flow to the myocardium; STENT Tiny, expandable metal mesh coil. It is put into the newly opened area of the artery to help keep the artery from narrowing or closing again. ABLATION Cardiac ablation is a procedure that scars tissue in your heart to block abnormal electrical signals. It's used to restore a normal heart rhythm. Long flexible tubes (catheters) are threaded through blood vessels to your heart. Cyra Joy P. Sarmiento NCM 110  CABG CORONARY ARTERY BYPASS HEART TRANSPLANT TYPES OF CARDIAC DRUGS GRAFT SURGERY (CABG) A procedure used to treat coronary artery Heart transplant is surgery that removes a diseased  Anti-coagulants disease. Coronary artery disease (CAD) is the heart and replaces it with a healthy heart from a  ACE Inhibitors narrowing of the coronary arteries – the blood deceased donor to improve your quality of life and  Angiotensin II Receptor Blockers vessels that supply oxygen and nutrients to increase your lifespan.  Angiotensin Receptor-Neprilysin the heart muscle. Inhibitors CAD is caused by a build-up of fatty material  Beta Blockers within the walls of the arteries. This build-up  Calcium Channel Blockers narrows the inside of the arteries, limiting the  Cholesterol-lowering medications supply of oxygen-rich blood to the heart  Digitalis Preparations muscle  Diuretics  Vasodilators PHARMACOLOGICAL MANAGEMENT  Complimentary / alternative therapies  Fish oil / omega 3  Fatty acids  Hawthorn  Gingko biloba/Ginseng / garlic  Patient education Cyra Joy P. Sarmiento NCM 110