NUR 245 EXAM 1 COMPLETE
QUESTIONS AND VERIFIED
ANSWERS
CAD - answer- Chronic and progressive disease
Impaired CO= decreased perfusion
-not pumping enough blood to perfuse tissue/organs
-blood vessel disorder due to Atherosclerosis
Atherosclerosis - 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 - 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 - 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 - 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 - 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 - 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 - 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 - 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 - answer- BMI >30
waist circumference men: >40 inches, women: 35 inches
-have increased levels of LDLs/ triglycerides= atherosclerosis
-apple figure
Diabetes - answer- endothelial dysfunction
-high cholesterol and triglycerides
Lifestyle changes and drug therapy
A1c less than 7%
metabolic syndrome - answer- cluster of risk factors for CAD
-central obesity
-hypertension
-abnormal serum lipids
-high fasting blood glucose
QUESTIONS AND VERIFIED
ANSWERS
CAD - answer- Chronic and progressive disease
Impaired CO= decreased perfusion
-not pumping enough blood to perfuse tissue/organs
-blood vessel disorder due to Atherosclerosis
Atherosclerosis - 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 - 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 - 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 - 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 - 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 - 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 - 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 - 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 - answer- BMI >30
waist circumference men: >40 inches, women: 35 inches
-have increased levels of LDLs/ triglycerides= atherosclerosis
-apple figure
Diabetes - answer- endothelial dysfunction
-high cholesterol and triglycerides
Lifestyle changes and drug therapy
A1c less than 7%
metabolic syndrome - answer- cluster of risk factors for CAD
-central obesity
-hypertension
-abnormal serum lipids
-high fasting blood glucose
