Term
UNSTABLE ANGINA
(acute angina) |
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Definition
Increase in severity,frequency, & duration of discomfort/pain
Angina discomfort when resting or wakes from sleep
Increasing ischemia
Pain lasts 15-20mins or more |
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Term
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Definition
Angina caused by O2 deficiency
Causes of O2 deficiency:
Ishemia
Decreased O2 carrying capacity of the blood
Increased O2 needs of the heart in high C.O. conditions
Common causes of ANGINA:
Atherosclerosis or CAD
Vasospasm
AORTIC stenosis
Activity or disease that increases metabolic demand
How ANGINA happens:
Plaque accumulation causes narrowing of the coronary arteries
Obstruction of blood flow diminishes myocardial O2 supply
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Term
VARIANT
(PRINZMETAL'S)
ANGINA |
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Definition
Pain that occurs @REST
Discomfort similar to classic angina, but lasts longer & occurs at rest
Unrelated to exertion
May be result of spasm if CORONARY ARTERY |
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Term
STABLE ANGINA
(exertional, chronic, classical effort) |
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Definition
TRANSIENT chest pain
Triggered by predictable degree of exertion & emotion
Consistent symptoms w/pain relieved by rest.
Occurs intermittenly over long peroid of time
Usu. relieved by restricitng activity or by nitrates |
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Term
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Definition
Heaviness
Tightness
Choking
Suffocating
Pressure
Constrictive
Burning
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Term
ADDITIONAL
CLIENT SYMPTOMS
of
ANGINA |
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Definition
Dyspnea
Diaphoresis
N/V
Increased need to void
Brady or Tachycardia
Pallor
Increased RR
Increased B/P
*ST segment depression
T wave inversion |
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Term
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Definition
Exercise Stress Test
Nuclear Imaging (Thallium Stress Test, Persantine Thallium Stress Test)
Cardiac Catherization
DX acute anginal pain:
ECG: ST segment depression
T wave inversion |
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Term
DX test findings for ANGINA
ST SEGMENT DEPRESSION |
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Definition
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Term
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Definition
A test done to examine how well the client's heart works.
Usu. done on a treadmill.
Performed by doctor.
Eval the amount of stress client's heart can handle before having abnormal rhythms or eveidence of ishemia (not enough blood flow to the heart muscle). |
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Term
PHARMACOLOGICAL
THERAPY
of
ANGINA |
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Definition
NITRATES
Decrease PRELOAD
Decrease AFTERLOAD
Decrease SYSTOLIC B/P
Decrease in PERIPHERAL RESISTANCE
O2 therapy
PTCA
Analgesics
Beta-adrenergic blockers
Ca+ channel blockers
ACE inhibitors |
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Term
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Definition
ONSET & DURATION:
Gradual or sudden onset; pain usu. lasts <15mins & not >30mins (AVG 3mins).
LOCATION & RADIATION:
Substernal or anterior chest pain, not sharply localized; radiation to back, neck, jwas, upper abd., fingers
S/SX:
N/V
apprehension
dyspnea
diaphoresis
increased or decreased pressure: gallop heart sound
epigastric distress
Precipitating factors:
Occurence at rest or during physical exertion or emotional stress. |
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Term
KEY NSG INTERVENTIONS
FOR
ANGINA |
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Definition
Assess pain level
Assess cardiovascular status
Assess for chest pain
Obtain an ECG reading during aginal episode
Administer O2 & meds. as prescribed
Monitor VS, hemodynamic variables, I/O, labs
encourge pt to express fears
Advise to rest if in pain
Keep in semi-fowler's
maintain diet
Potential complications:
Arrhythmias
Heart Failure
MI
Possible surgical intervention:
CABG |
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Term
MEDICAL MANAGEMENT
OF
ANGINA |
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Definition
DIET: low in cals, Na+, Cholseterol
O2 therapy
Monitoring VS, ECG, hemodynamic variables, I/O, neurovascular checks
LABS: ABGs, Na+, K+, CK w/isoenzymes, LD w/isoenzymes, troponin I, troponin T, and AST.
PTCA: percutaneous transluminal coronary agioplasty/stent replacement
NITRATES: nitroglycerine, Isodril
Analgesics: morphine, demerol
BETA adrenergic BLOCKERS: propranolol, atenolol,, metroprolol.
Ca+ channel blockers: verapamil, diltiazem,
ACE inhibitors: captopril, enalapril, lisinopril
CARDIAC glycoside: Digoxin
Antidysrhytmics: amiodarone, promcainamide, adenosine |
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Term
BETA BLOCKERS
Propanolol (Inderal)
Metroprolol (Lopressor, Toprol XL)
Nadolol (Corgrad)
Atenolol (Tenormin)
Esmolol (Brevibloc)
Acebutolol (Sectral) |
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Definition
Action:
Decrease AFTER LOAD
Decrease HR
Decrease B/P
Decrease myocardial contractility
**DO NOT stop taking abruptly
(may worsen ANGINA)
USES:
Cardiac dysrhytmias= PVC, tachycardias
ANGINA
Improve survival after MI
Hypertension
Migraine HA prevention
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Term
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Definition
SE:
Hypotension
Bradycardia
CHF
Asthma, wheezing, bronchospasms
wt loss
depression
GI complaints
Sexual dysfunction, impotence |
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Term
Ca+ channel blockers
Nifedipine (Adalat, Procardia)
Nicardipine (Cardene)
Bepridil (Vascor)
Felodipine (Plendil)
Amlodipine (Norvasc)
Diltiazem (Cardizem)
Verapamil (Calan, Isoptin) |
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Definition
ACTION:
Neg. inotropic
Neg. chronotropic
Decrease AFTER LOAD (vasodilatory effect)
USES:
ANGINA
Tx certain abnormally rapid heart rhythms (A-Fib)
Post MI- esp if cannot tolerate beta blocker
Hypertension |
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Term
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Definition
SE:
Constipation
Nausea
HA
rash
edema
hypotension
drowsiness
dizziness
*worsening s/sx of heart failure |
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Term
INVASIVE CORONARY ARTERY PROCEDURES |
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Definition
CABG= purpose to increase blood flow to myocardium
PTCA= agioplasty/stent
IABP= Intra aortic balloon pump
Athrectomy= procedure to remove plaque from arteries |
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Term
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Definition
Risk for Ineffective Health maintenance
Anxiety, Fear
Activity Intolerance
Risk for ineffective therapeutic regimen
Disturbed sleep pattern
Risk for constipation
Risk for impaired home maintenance
Risk for ineffective sexuality patterns |
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