NUR 245 EXAM 1 QUESTIONS AND ANSWERS
CAD - CORRECT ANSWER✅✅Chronic and progressive disease
Impaired CO= decreased perfusion
-not pumping enough blood to perfuse tissue/organs
-blood vessel disorder due to Atherosclerosis
Atherosclerosis - CORRECT ANSWER✅✅Major cause of CAD
soft deposits of fat that harden with age
endothelial injury and inflammation play role
endothelial injury occurs causing
1) fatty streaks- earliest lesions appear yellow starting at age 20
2. Fibrous plaque- by age 30, begins to harden and be coated with collagen (grayish/white)
3. Complicated lesion- fibrous plaque continues to grow causing plaque instability= risk of rupture
(thrombus)
collateral circulation - CORRECT ANSWER✅✅"bridges" occurs over time
-plaque block blood flow
causing build of new branches around plaque
-allows heart muscle to still receive adequate amount of blood and oxygen except during increased
workload of heart (exercise)
-the older the person the more collateral circulation
younger=worse prognosis
Nonmodifiable risk factors for CAD - CORRECT ANSWER✅✅Age: middle aged MEN (over age 45)
Gender- Male
women- estrogen may protect, symptoms are atypical (fatigue, SOB, upper back pain, indigestion,
weakness, sleep problems, palpitations, anxiety)
-Genetics
-ethnicity (Caucasian men)
,Modifiable risk factors for CAD - CORRECT ANSWER✅✅DO patient teaching
High serum lipids
Diabetes
tobacco use
obesity
physical inactivity
Hypertension BIGGEST RISK FACTOR
stress
high homocysteine levels
substance abuse
High serum lipids - CORRECT ANSWER✅✅total serum cholesterol >200
LDL > 130
HDL men: <50, Women: <40
fasting triglycerides; >150
-physical activity. eating healthy fats, losing weight, moderate alcohol intake, quitting smoking increase
HDLS
-reduce total fat intake
-reduce sat fats
-take prescribed drugs
-engage in physcial activity
-adjust caloric intake
Hypertension - CORRECT ANSWER✅✅increased risk for CAD, stroke, PVD, HF
>120/80
-causes endothelial injury increasing atherosclerosis= narrows vessels
-results in left ventricular hypertrophy and decreased stroke volume
,Monitor BP, obtain regular checkups, take prescribed drugs
-reduce salt intake
-control weight
-perform physcial activity
stop smoking
Tobacco use - CORRECT ANSWER✅✅releases catecholamines which increase HR/BP= increase heart
workload
-increases lDL/ decreased HDL
-releases toxic O2 radicals (carbon monoxide) which affects hemoglobins O2 carrying capacity
-increases heart workload and decrease O2
-irritates vessels causing endothelial injury and inflammation
DO smoking cessation
Physical inactivity CAD - CORRECT ANSWER✅✅may cause venous stasis (heart works harder)
educate on 30-60 mins 5 days per week
-increases HDLs
-decreases hearts workload
-reduces risk of thrombus
Obesity - CORRECT ANSWER✅✅BMI >30
waist circumference men: >40 inches, women: 35 inches
-have increased levels of LDLs/ triglycerides= atherosclerosis
-apple figure
Diabetes - CORRECT ANSWER✅✅endothelial dysfunction
-high cholesterol and triglycerides
, Lifestyle changes and drug therapy
A1c less than 7%
metabolic syndrome - CORRECT ANSWER✅✅cluster of risk factors for CAD
-central obesity
-hypertension
-abnormal serum lipids
-high fasting blood glucose
psychologic status - CORRECT ANSWER✅✅Type A personality
-due to stress and overworking
-depression
-stress (increases HR, increases O2 demand causing increase workload of the heart)
-can cause elevated lipid and glucose levels = atherosclerosis
homocysteine levels - CORRECT ANSWER✅✅damage innerlining of blood vessels
-promote plaque build up
-make clots more likely to occur
Substance abuse - CORRECT ANSWER✅✅cocaine/ methamphetamine
-produce coronary artery spasms causing myocardial ischemia and chest pain
Health promotion CAD - CORRECT ANSWER✅✅-prevention and early treatment
-ongoing lifestyle changes
-identify high risk
-manage high risk
CAD - CORRECT ANSWER✅✅Chronic and progressive disease
Impaired CO= decreased perfusion
-not pumping enough blood to perfuse tissue/organs
-blood vessel disorder due to Atherosclerosis
Atherosclerosis - CORRECT ANSWER✅✅Major cause of CAD
soft deposits of fat that harden with age
endothelial injury and inflammation play role
endothelial injury occurs causing
1) fatty streaks- earliest lesions appear yellow starting at age 20
2. Fibrous plaque- by age 30, begins to harden and be coated with collagen (grayish/white)
3. Complicated lesion- fibrous plaque continues to grow causing plaque instability= risk of rupture
(thrombus)
collateral circulation - CORRECT ANSWER✅✅"bridges" occurs over time
-plaque block blood flow
causing build of new branches around plaque
-allows heart muscle to still receive adequate amount of blood and oxygen except during increased
workload of heart (exercise)
-the older the person the more collateral circulation
younger=worse prognosis
Nonmodifiable risk factors for CAD - CORRECT ANSWER✅✅Age: middle aged MEN (over age 45)
Gender- Male
women- estrogen may protect, symptoms are atypical (fatigue, SOB, upper back pain, indigestion,
weakness, sleep problems, palpitations, anxiety)
-Genetics
-ethnicity (Caucasian men)
,Modifiable risk factors for CAD - CORRECT ANSWER✅✅DO patient teaching
High serum lipids
Diabetes
tobacco use
obesity
physical inactivity
Hypertension BIGGEST RISK FACTOR
stress
high homocysteine levels
substance abuse
High serum lipids - CORRECT ANSWER✅✅total serum cholesterol >200
LDL > 130
HDL men: <50, Women: <40
fasting triglycerides; >150
-physical activity. eating healthy fats, losing weight, moderate alcohol intake, quitting smoking increase
HDLS
-reduce total fat intake
-reduce sat fats
-take prescribed drugs
-engage in physcial activity
-adjust caloric intake
Hypertension - CORRECT ANSWER✅✅increased risk for CAD, stroke, PVD, HF
>120/80
-causes endothelial injury increasing atherosclerosis= narrows vessels
-results in left ventricular hypertrophy and decreased stroke volume
,Monitor BP, obtain regular checkups, take prescribed drugs
-reduce salt intake
-control weight
-perform physcial activity
stop smoking
Tobacco use - CORRECT ANSWER✅✅releases catecholamines which increase HR/BP= increase heart
workload
-increases lDL/ decreased HDL
-releases toxic O2 radicals (carbon monoxide) which affects hemoglobins O2 carrying capacity
-increases heart workload and decrease O2
-irritates vessels causing endothelial injury and inflammation
DO smoking cessation
Physical inactivity CAD - CORRECT ANSWER✅✅may cause venous stasis (heart works harder)
educate on 30-60 mins 5 days per week
-increases HDLs
-decreases hearts workload
-reduces risk of thrombus
Obesity - CORRECT ANSWER✅✅BMI >30
waist circumference men: >40 inches, women: 35 inches
-have increased levels of LDLs/ triglycerides= atherosclerosis
-apple figure
Diabetes - CORRECT ANSWER✅✅endothelial dysfunction
-high cholesterol and triglycerides
, Lifestyle changes and drug therapy
A1c less than 7%
metabolic syndrome - CORRECT ANSWER✅✅cluster of risk factors for CAD
-central obesity
-hypertension
-abnormal serum lipids
-high fasting blood glucose
psychologic status - CORRECT ANSWER✅✅Type A personality
-due to stress and overworking
-depression
-stress (increases HR, increases O2 demand causing increase workload of the heart)
-can cause elevated lipid and glucose levels = atherosclerosis
homocysteine levels - CORRECT ANSWER✅✅damage innerlining of blood vessels
-promote plaque build up
-make clots more likely to occur
Substance abuse - CORRECT ANSWER✅✅cocaine/ methamphetamine
-produce coronary artery spasms causing myocardial ischemia and chest pain
Health promotion CAD - CORRECT ANSWER✅✅-prevention and early treatment
-ongoing lifestyle changes
-identify high risk
-manage high risk
