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CAD and ACSMedical Surgical Nursing

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Question Answer
How much of an artery needs to be occluded before angina occurs?
Show Answer
75%
How long can cardiac cells be ischemic before damage occurs?
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20 minutes
What is the PQRST assessment of angina?
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P-precipitating event (like exercise, stress, etc.) Q-quality of pain (pressure, aching, dull, etc.) R-Radiation of pain (back, arms, teeth, legs, back) S-Severity T-timing (when did it begin, happen before, changes?)
How long do episodes of angina typically last?
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3-5 minutes
What finding on an ECG would indicate ischemia?
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A depressed ST segment (transient)
Who is most likely to have silent ischemia and why?
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People with diabetes. It is thought diabetic neuropathy prevents the pain signal from being perceived. Patients who have undergone a heart transplant will also experience silent ischemia.
T/F Nocturnal angina occur only and night when a person is sleeping or in the recumbent position.
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False, it occurs at night but the position doesn't matter
______ is chest pain that occurs when a person is lying down and is relieved by standing or sitting up.
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Angina decubitus
_______ angina occurs at rest and is usually in response to a spasm of a major coronary artery. It is common in patients with a history of migraines.
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Prinzmetals angina
What activities can cause exertional angina?
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Isometric activities like raking, weightlifting, shoveling
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T/F Extreme temperatures can cause angina due to the reflex constriction and dilation of blood vessels.
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TRUE
When are manifestations of CAD most likely to occur?
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In the morning, after awakening
What are non-cardiac related causes of increased oxygen demand of the heart?
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Anxiety, cocaine use, hypertension, hyperthermia, hyperthyroidism, physical exertion
What are non-cardiac related causes of decreased oxygen supply to the heart?
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Anemia, Hypoxemia, Pneumonia, Asthma, COPD, low plasma blood volume
What is the most common treatment for chronic stable angina?
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Nitrate therapy
How long does it take for a short acting nitrate like Nitroglycerine to work?
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3 minutes. If symptoms are unchanged or worse in 5 minutes they need to go to the ER
Nitroglycerin sprays and tablets have special administration instructions, what are they?
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One spray or tablet under the tongue, if no relief within 5 minutes, go to the ER, don't take with ED drugs. Purchase a new supply every 6 months. Take 5-10 minutes in advance of an activity known to cause pain.
How is tolerance to long-acting nitrates avoided?
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The patient takes an 8 hour break from nitrates every day unless they have nocturnal angina
Nitropaste is a topical ointment dosed by _______. It is placed on a skin surface that is smooth and free of hair/scars like the upper arm and is useful for treating nocturnal or unstable angina.
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Dosed by inch
_________ are a group of drugs that have been found to decrease morbidity and mortality in patients with CAD, especially following an MI.
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Beta blockers
________ is a drug used to treat chronic angina that prolongs the QT interval. For this reason it should only be used after other meds have been unsuccessful and in conjunction with beta blockers, nitrates or amlodipine.
Show Answer
Ranolazine
  
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