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Altered cardiac perfusion (CAD) Questions and Answers Fully Solved
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Altered cardiac perfusion (CAD)
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Altered cardiac perfusion (CAD)What are the major complications of MI? - answer Arrythmias & HF
What happens when a patient has an MI? - answer A portion of the heart muscle dies
How do you treat a patient with an aortic stenosis as it relates to pain resulting in
decreased coronary blood flow? - answer allow them to rest to decrease myocardial
oxygen demand
What does MONA stand for in the treatment of an acute MI and the purpose of each
What does MONA stand for in the treatment of an acute MI and the purpose of each? -
answer Morphine, Oxygen, Nitrates, and Aspirin
• Morphine relieves severe anginal pain - MI pain activates sympathetic nervous sys, &
morphine is great for this. (morphine can cause N/V, hypotension, & resp depression so
monitor pt)
• Oxygen (keep O2 sat btw 94-99%),
How do you treat cardiogenic shock as it relates to low cardiac output? - answerTx w/
vasopressor (DOBUTAMINE preferably, dopamine) bc of low CO
Where do you listen to the aortic area of the heart? - answer2nd rib, pt's R side of
sternum
Where do you listen to the pulmonic area of the heart? - answer2nd rib, pt's L side of
sternum
Where do you listen to the tricuspid valve? - answer5th intercostal sp on L side of
sternum
Where do you listen to the mitral valve? - answer6th rib on L side
When is it important to start teaching a patient and loved ones about MI? - answerwhile
still in the acute unit, such as telemetry or ICU.
What is the first line of drug therapy for angina/MI? - answerASPIRIN
How do you monitor a patient for renal function post CABG, include interventions and
labs? - answerstrict I/O hourly, check BUN/Cr, & potassium levels
What type of diet the patient should be on in order to avoid further blockage w/ CAD? -
answerInclude in diet:
, Fresh fruits and vegetables; Whole grains: brown rice, high fiber cereals, oatmeal;
Healthy fats: olive oil, flax seed, avocados, cholesterol-lowering margarine; Lean
proteins; Other healthy protein sources: soy beans, peas and lentils, skinless poultry,
salmon...
Avoid in diet:
Butter; Gravy; Fried foods; Pastries; Junk foods - potato chips, cookies, pies, and ice
cream; High sodium foods which can worsen HTN and contribute to CAD
When do you call 911 when taking Nitroglycerin? - answerIf no relief in 5 minutes, call
EMS; if some relief, repeat every 5 minutes for maximum 3 doses
• After 3 doses & NO RELIEF (angina continues), call 911
What is the main action of a beta adrenergic blocker medication? - answer• Beta
blockers slow HR. common side effect is dizziness or fatigue. In high doses, can worsen
HF. They work by blocking adrenaline (epinephrine) from binding to beta receptors.
Alpha blockers work on blood muscle to open blood vessels while beta blockers ease
bloodflow
What are the 4 major modifiable risk factors for CAD? - answer^ serum lipids >200,
HTN, tobacco use & physical activity
Nonmodifiable risk factors for CAD - answer- Age - plague builds up overtime
- Gender - risk for women increases at age 55; men at age 45
• White men between the age of 35 to 44 are about 6 times more likely to die of CAD
than white women in that same age group
- Ethnicity
• African Americans are 30% more likely to die of heart disease including CAD
• Non-Hispanic white men and women have a significantly higher rate of death from
heart disease than American Indians and Alaskan Natives.
- Family history
• Further increased if a father or brother was diagnosed with heart disease before the
age of 55, or if a mother or sister, before age 65.
- Genetic predisposition
• May also inherit a preponderance toward developing type 1 or 2 diabetes or some
other disease or trait that increases your risk for CAD.
Bile Acid Sequestrants - answerCholestyramine, Cholestipol - lower serum cholesterol
levels by increasing conversion of cholesterol to bile acids
What meds are given for severe fluid overload? - answer• Furosemide, bumetanide,
digoxin
What lab test is most diagnostic when determining if a patient had an MI? -
answerTROPONIN
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