Ch. 25
The American Heart Association now suggests the term acute _____ _____ to describe any group of clinical symptoms compatible with acute myocardial ____ (impaired oxygenation).
coronary syndrome ischemia
The most common cause of MI is ______ _____, the consequence of a blood clot located within the coronar yartery.
coronary thrombosis
When the clot develops in a coronary artery, the resulting condition is called ________ _______.
coronary thrombosis
As disorder worsens, some affected individuals mat develop _____ _____ ischemia, a complication characterized by open sores or infections that do not resolve, become gangrenous, and threaten the viability of the limb, making _____ necessary.
critical limb amputation
Numbness, tingling, awkwardness/fumbling, especially when attempting fine movements. After initial pallor, hands, especially fingers become deeply ____ and begin to ache.
cyanotic
The skin may be slightly ____ in the areas of impaired circulation.
darker
Beta-adrenergic blockers, which ______ oxygen consumption of myocardial oxygen by reducing heart rate, also are used.
decrease
If an artery is completely occluded, treatment cannot be _____. The doctor may order an immediate IV bolus of ____ followed by continuous infusion or multiple high doses of heparin administered subcutaenously to prevent development of further clots or extension of those already present.
delayed, heparin
At rest, ample blood flow may be maintained _____ considerable CAD.
despite
Obese people with metabolic syndrome who are prone to _____ tend to have _____ levels of leptin, which regulates energy metabolism, and adiponectin a protein with anti inflammatory effects
diabetes lower
A few clients, such as older adults and ____, experience little or no pain and may never ____ that they had an MI until an ECG detects it weeks, months, or years later.
diabetics know
Blood tests that reveal elevated total cholesterol, high LDL, and above normal triglycerides, and increased homocysteine contribute to _____.
diagnosis
Some cardiologists indicate a relationship between a _______ crease in the earlobe and the risk for CAD.
diagonal
An infarct is an area of tissue that ______ (necrosis) from inadequate ______.
dies oxygenation
Each coronary artery supplies oxygenated blood to a ____ area of the myocardium.
different
Pedal and tibial pulses may be difficult to _____ because of the _____ of venous fluid
difficult, congestion
Atherosclerotic vessels cannot produce endothelial derived relaxing factors, which impairs the ability of the walls to _____.
dilate
The vessels then _____ widely, apprentely to compensate for the ____.
dilate, restriction
Vericose veins or varicosities are _____ tortuous veins. Both men and women suffer equally from this.
dilated
Superficial veins are ____ and obvious during inspection. Skin color is ____ uniform.
dilated not
The client may say that ____ or _____ of the legs relieves the discomfort.
activity, elevation
When removing a patch, close the _____ edges together, preventing accidental ______ to others. Teach clients to dispose of patches away from ______ and ______.
adhesive exposure children, pets
Thermal underwear, socks, gloves, and blankets are ______ to electric blankets and heating pads.
alternatives
Aminocaproic acid is suggested as an ____ to control excessive _______ when thrombolytics are administered.
antidote, bleeding
The use of _____ stockings and regular performance of foot and leg _____ help to prevent thrombus formation. _____ meds and anticoags also are prescribed.
antiembolism exercises antiplatelet
Ubiquinone, aka Co-Q10, is a nutraceutical (dietary supplement that provides health benefits). Is an ______ synthesized from _____ sources to produce mitochondrial ATP production in all cells, especially muscle tissue.
antioxidant food
Aneurysms of the ______ are the most common, but aneurysms can be found in other arteries, such as those in the legs and brain.
aorta
An obese person with an _____-shaped body (carries most weight in the abdomen) is at ______ risk for CAD than one with a _____-shaped body (carries most weight below hips).
apple higher pear
PVD includes disorders that affect ____ or ____.
arteries or veins
The most common cause of occlusive vascular diseases are ______, ______, ______ formation, and vascular _______.
arteriosclerosis atherosclerosis clot formation vascular spasm
Coronary artery disease refers to ________ and _______ changes in the coronary arteries supplying the myocardium.
arteriosclerotic, atherosclerotic
Treatment depends on whether an _____ or ____ is occluded and the degree of occlusion (partial or complete)
artery, vein
In mild CAD, clients are _______ or complain of ______
asymptomatic fatigue
Clients whose atherosclerotic plaque is no longer soft and pliable may benefit from an ______, or removal of fatty plaque.
atherectomy
The primary cause of PAD is ______ which, like it's counterpathology, CAD is secondary to ____, ____, _____, _____, _____, and in some cases family hx of PAD or other atherosclerotic disease.
atherosclerosis obesity HTN hyperlipidemia diabetes mellitus chronic smoking
Some, especially women, experience more ______ symptoms such as nausea, fatigue, and dizziness, which are often _____ as significant for heart disease and consequently misdiagnosed.
atypical overlooked
Once an area of the myocardium has been damaged and destroyed, the cells in that area lose their special functions of:
automaticity excitability conductivity contractility rhythmicity
Client's should ___ over the counter decongestants, cold remedies, and drugs for symptomatic relief of hay fever because of their _____constrictive qualities.
avoid, vaso
In clients with CAD, the level of LDL, which is sometimes referred to as "_____ _____" because it _____ to the arteries, exceeds recommended amounts.
bad cholesterol sticks
Percutaenous transluminal coronary angioplasty (PTCA), sometimes referred to as ______ ______, is performed for clients who fit specific criteria.
balloon angioplasty
Complete ____ ____ prescribed initially but not recommended for uncomplicated MI's after the first 12 hours.
bed rest
Peripheral vascular disease is a general term for:
disorders that affect blood vessels distant from the large central blood vessels supplying the myocardium or that circulate blood directly in and out of the heart
Testing for pitting is difficult because the congested fluid cannot be ____>
displaced
Cardiac risk can be estimated by diving _____ _____cholesterol level by the ______ level; a result greater than _____ suggests a potential for CAD.
total serum HDL 5
An infarct that extends thru the full thickness of the myocardial wall is called a _______ infarction or Q-wave MI
transmural
AS blood flows thru the vessel, platelets become ____ in the roughened wall and initiate the clotting cascade.
trapped
Hyperlipidemia (high levels of blood fat) _____ atherosclerotic changes.
triggers
Fibric acid agents such as gemfibrozil are used to decrease ______.
triglycerides
Xanthelasma, a raised _____ plaque on the skin of the upper and lower eyelids suggests ______ accumulation.
yellow lipid
The disorder is most common in _____ _____.
young women
If the papillary muscles are involved in an MI and the mitral valve leaflets are compromised, mitral regurgitation may occur. In this condition, blood not only flows _____ into the aorta but _____ into the left atrium thru an incompetent mitral valve.
forward backward
Clots can form in the cavity of the ventricular aneurysm (mural thrombi) or tissue debris can break ____.
free
When a small vessel is occluded, symptoms of ischemia, such as pallor and coldness, occur but are less severe. Unless blood flow is restored, _____ develops.
gangrene
The level of HDL, called "_____ ______" because it _____ cholesterol to the liver for removal, is lower than desireable.
good cholesterol carries
Without adequate circulation, _______ is retarded. Some ulcers may be present for years. The skin is fragile and easily retraumatized in process of healing. Secondary infectious often occur in ulceration.
healing
An MI or ____ ____, occurs when there is prolonged total occlusion of coronary arterial blood flow.
heart attack
The legs feel _____ and tired, particularly after prolonged _____.
heavy, standing
Cardiogenic shock, which has a _____ mortality rate, occurs when ____ % of the left ventricle has lost the ability to pump effectively.
high 40
High-density lipoprotein has a _____ ratio of protein to cholesterol
higher
Hyperhomocysteinemia (increased blood level of homocysteine, an amino acid formed from protein-rich food containing methionine is ____ among those with PAD.
higher
The tentative diagnosis begins with taking a ____ of the client's _____ and examining the ____ extremities.
history, symptoms, lower
If heparin is administered, assess IV infusions ____.
hourly
Neurologic outcomes can be improved by preventing _____.
hyperthermia
h to e American Heart Association and others indicate that maintaining an induced _____ state (89.6 to 93.2) for ____ to _____ hours after resuscitation reduces the brain's oxygen requirements.
hypothermic 12-24
Oxygen is ordered to treat and prevent ______.
hypoxemia
Treatment is directed toward reducing tissue ____, releiving pain, and treating ______ if present, and alleviating arrhythmias if they occur.
hypoxia shock
The underlying cause of Raynaud's disease is not entirely clear. In some it seems ____ (no explainable reason); in others its secondary to ____ tissue diseases (scleroderma, lupus, RA).
idopathic connective
If warming hands in water is impossible, nurse encourages client to _____ warming them in some way such as holding them near a roaring fire. The mind can _____ the physiology of blood flow.
imagine, alter
Serous fluid oozes from the skin when there is no outlet for vascular or lymphatic circulation. Eventually the skin becomes _____.
impaired
A transmyocardial revascularization (TMR) laser procedure which:
improves oxygenation of myocardial tissue, may improve quality of life for clients with chest pain that don't respond to meds and are not candidates for CABG surgery.
Nicotinic acid (niacin) helps ____ HDL and ____ LDL.
increase lower
WBC count, C-reactive protein, and erythrocyte sedimentation rate _____ on about the ____ day following an MI>
increase, third
Cardiac risk _____ when the level of total serum cholesterol is elevated. Another risk factor is an elevation of ________, which are chains of fatty acids.
increases triglycerides
Inflation of the balloon compresses the atherosclerotic plaque against the arterial wall, ____ the diameter of the artery.
increasing
Some describe discomfort other than pain, such as _______ or a burning, squeezing, or crushing tightness in the upper _______ or throat.
indigestion chest
Thrombophlebitis may lead to varicose veins because the ___ process may damage vein valves.
inflammatory
Statins ______ the formation of Co-Q10. When depleted, those taking statins may experience _______ (muscle pain). Supplementing 100-200 mg of Co-Q10 daily while taking a statin is believed to decrease the incidence of muscle pain.
inhibit myalgia
Venous ______ and valvular _______ also foster peripheral vascular disorders.
insufficiency incompetence
People with PAD experience, _____ ____, or pain and cramping in the thigh, calf, or buttock muscle during activity such as walking or climbing stairs.
intermittent claudication
Venous HTN then forces some fluid to move into the ______ spaces of surrounding tissue. Venous congestion and local edema may diminish arterial blood flow, impairing cellular nutrition. Even minor skin or soft tissue injuries easily become infected and ulcerated. The healing of such lesions is slow and uncertain.
interstitial
The hallmark symptoms of arterial insufficiency include:
ischemia pain parasthesia
When the myocardial tissue become ______ (deprived of oxygen), clinical manifestations of CAD, such as ____ ______ (chest pain of cardiac origin) occur. Death of heart muscle does not accompany angina.
ischemic angina pectoris
The third zone is the ____ area that will probably ______.
ischemic survive
It may not be diagnosed until client's are in _____ ____ age or older, but the vascular changes most likely begin much earlier.
late middle
A section from a healthy ____ vein or ___ artery is used to reroute the flow of oxygenated blood from the aorta or a chest artery to below the obstruction in the diseased coronary artery.
leg chest
Some develop skin _____ that are ___ to heal.
lesions
Calcium channel blockers may be used as well, although research has shown that they may be ____ beneficial than beta adrenergic blockers
less
The first line of defense for managing CAD consists of _________ changes such as: (5)
lifestyle smoking cessation weight loss stress management exercise blood glucose regulated
`Surgical treatment for severe or multiple varicose veins consists of vein ____ with or without vein stripping.
ligation
A _____ profile is a group of tests that measure various blood fats.
lipid
Proteins transport ____ in the blood.
lipids (cholesterol)
Clients are encouraged to ____ weight, exercise ___, and cease ____.
lose, daily, smoking
Arteriosclerosis refers to the:
loss of elasticity or hardening of the arteries that accompanies the aging process
Cardiac Risk based on C-Reactive Protein Test: Less than 1.0 mg/L = ______ risk 1.0 - 2.9mg/L = _____ risk Greater than 3 mg/L = ______ risk
low, intermediate, high
Low-density lipoprotein has a _____ ratio of protein to cholesterol
lower
PAD is a condition that affects primarily the blood vessels that supply oxygen to the ____ ____.
lower limbs
The client wears the stockings all the time except when ____ _____.
lying down
CAD results from ______ factors rather than a _____ cause.
many, single
Above normal cholesterol levels also have been linked to a by-product of _________, an amino acid present in meat, called homocysteine.
meat
If clots enter the systemic arterial circulation, they may _____ a peripheral artery.
occlude
Symptoms of MI in ______ adults may include dyspnea, confusion, syncope, epigastric distress, nausea, heartburn, or indigestion. These symptoms may be _______as significant, thus causing delay in treatment.
older unrecognized
Arteriotomy: which is? Embolectomy: which is? may be necessary
opening of an artery removal of an embolus
Such pain or discomfort typically is manifested as sudden pain or pressure that may be centered ______ _____ _____ or under the sternum.
over the heart
Result is reduced volume of __________ blood delivered to organs.
oxygenated
The pain may _______ to the shoulders and arms, especially on the _____ side, or to the jaw, neck, or teeth.
radiate left
They may experience nausea/vomiting or be hypotensive and faint. Pulse is ____ and weak and may be _____. Signs of left sided heart failure: dyspnea, cyanosis, cough, may appear if ____ ventricular pumping is sufficiently impaired.
rapid, irregular left
The congestion stretches the veins. Over time, they cannot _____ and remain chronically distended.
recoil
Vericose veins also may occur in other body parts, such as the _____ and ____.
rectum esophagus
The skin over the leg's appears _____ in a dependent position but returns to normal color in ____ minute when _____.
red 1 elevated
The skin becomes ____ and _____.
red and hot
The entire great saphenous vein, which extends from the groin to the ankle, or the small saphenous vein may be ________.
removed
Lack of _____ impairs the hearts ability to pump effectively. Consequently, cardiomyopathy and heart failure are always _____ potential complications.
resiliency lifelong
The discomfort is relieved after ___ for several minutets.
resting
A second zone of injured cells, which may live if blood supply to area is ______, surrounds the first zone.
restored
When the vascular reconnections are completed, heart function is _______.
restored
An IV infusion is initiated to provide fluid while eating is _______.
restricted
Coronary artery bypass graft surgery is a technique for:
revascularizing the myocardium
Be alert for signs of bleeding and keep protamine sulfate on hand for _____ heparin and keep ____ ____ on hand for reversing oral anticoags.
reversing vitamin K
dyspnea, rapid ____ sided heart failure, and _____ result.
right shock
Ventricular rupture occurs when a soft necrotic area from a transmural or interventricular septal MI ______.
ruptures
An isoenzyme is one of several forms of the ____ enzyme that may exist in cells and is capable of being identified seperately from others.
same
Thrombosis is usually _______ to arteriosclerotic and atherosclerotic changes.
secondary
The condition may go unrecognized, particularly among those with a _______ lifestyle.
sedentary
_______ rather than bathe until the cutaneous catheterization site heals.
shower
Hair and toenail growth are ____.
slow
Percutaneous Transluminal Coronary Angioplasty Discharge teaching.... avoid lifting more than ____ pounds for at least ___ days if the groin was used for cath insertion. Avoid lifting more than ____ pound for at least ___ days if a site in the upper extremity was used.
10, 3 1,3
The procedure is performed thru a ___ to ___ inch midsternal incision, which is closed with _____, _____, or ____.
10-12 wire, staples, sutures
Treatment for hyperlipidemia may begin when the LDL level ranges between ______mg/dL and _____mg/dL, with the goal being a level below _____mg/dL
100 130 100
Nitroglycerin transdermal patches are typically applied for ____ to ____ hours and then removed for the _____ amount of time.
12-14 same
Even if the client is seen within ___ to ____ hours of the onset of the occlusion, reestablishing coronary artery blood flow can reduce the zone of _____.
12-24 necrosis
The spasms last approx ____ minutes and cause temporary ischemia to the tissues.
15
Another technique, called the McIntyre maneuver; while standing, clients swing their arms behind them and in front of their bodies at a rate of about ____ times per minute. The swinging motion ____ blood to the distal areas of the fingers.
180, distributes
Myoglobulin, a biomarker that rises in ___ to ___ hours _____ heart damage. It can be detected prior to the detection of troponin I and T.
2-3, after
Because TMR relieves symptoms only, cardiac rehabilitation requires clients to continue to modify risk factors that caused CAD such as eliminate _____, follow a ____ ____ diet, and incorporate regular, moderate _____.
smoking heart-healthy exercise
Clean the site with ____ and _____; eliminate any dressing.
soap , water
Arterial _____ may also cause an MI.
spasms
Raynaud's disease is characterized by brief _____ of the arteries and arterioles in the ___ (most common site), toes, nose, ears, or chin.
spasms fingers
Varicose veins may be accompanied by a smaller variation called _____ _____, which appear closer to the surface of the skin
spider veins
When chest pain is experienced, it is more severe and last longer than anginal pain. Some describe it as ____ or ______.
squeezing, crushing
Lipid lowering drugs such as HMG-CoA reductase inhibitors are known as _____, and ____ ____ sequestrants may be prescribed.
statins bile acid
A thrombus is a _____ clot.
stationary
Because the artery tends to reocclude in 40-50% of clients who undergo PTCA, a coronary _____ is usually placed in the artery during the procedure, otherwise PTCA may need to be repeated.
stent
The heart is _____ during traditional CABG surgery, but blood is circulated thru a heart-lung ______ so that oxygen continues to be delivered to cells, tissues, and organs while CO2 is removed.
stopped machine
Aneurysm is:
stretching/bulging of an arterial wall.
For better results, vein ______ is performed: the ligated veins are severed and removed.
stripping
A partial-thickness infarct is called a ______ infarction or a non-Q wave MI.
subendocardial
The onset of a pulmonary embolism is usually _____, with chest ____, dyspnea, and cyanosis being the ____ symptoms.
sudden pain first
Men typically experience _____, severe chest pain, which usually is substernal and may _____ to the shoulder, arm, teeth, jaw, or throat.
sudden radiate
The saphenous leg veins are commonly affected because they lack ___ from surrounding muscles.
support
The foot or feet appear ____.
swollen
The severity of the disorder is determined by dividing the ____ BP in the ankle by the systolic pressure in the ____. When quotient is _____ or less, the data support a diagnosis of PAD
systolic, arm, 0.9 or less
Atherosclerosis is a condition in which:
the lumens of arteries fill with fatty deposits called plaque.
High levels of homocysteine are also implicated in ______, ______, and scarring of arterial walls.
thickening, narrowing
Eventually the vasospasm is relieved, and blood rushes to affected part. The skin in the deprived area becomes flushed, swollen, and warm, and the person has sensation of _____ pain.
throbbing
DVT may need surgical removal of the clot _____
thrombectomy
This area of poorly contractile tissue predisposes the heart to failure. Blood trapped in the projection tends to form ___, which may be released into the arterial circulation, or the aneurysm may ___, resulting in hemorrhage and death.
thrombi burst
A "cardiac patch" of collagen fibers begin to form within the first 2 weeks of the infarct, but it takes as long as ____ months for the scar to grow firm. The scar tissue is ____ effective than the myocardium it is replacing. It doesn't ____ and ____ like the original tissue.
3 less stretch, contract
Leukocytosis and slightly elevated body temp follow in ___ to ____ days.
3-7
Frozen blood products take ____ minutes to thaw. Fresh frozen plasma must be obtained from an _____ compatable blood type and preferred for platelets and croprecipitate also.
30 ABO
The stent remains permanently in the enlarged artery, and endothelial tissue is incorporated into the mesh within _____ to ____ weeks.
4-6
Because women younger than ____ years are seven times more likely to be misdiagnosed than men of similar age, they are erroneously discharged and have a higher ____ rate following an MI.
55, mortality
The infarction process can take up to _____ hours. There are ____ zones of tissue damage.
6 3
Symptoms do not occur until at least _____% of the arterial lumen is occluded.
60
Women with family hx of cardiac disease show symptoms _____ years earlier than women with no family history.
7
The following serum cardiac markers are measured initially and every ___ hours for ____ hours to determine elevated levels:
8 24
Clients who are not candidates for thrombolytic therapy should undergo PTCA within ____ minutes from the time they are assessed in the emergency department. Delaying for ___ to ___ hours post infarct correlates with higher incidence of 1 year mortality.
90 2-3
The goal for administering ____ agents, IV drugs that dissolve blood clots, is a "____-to-____" time of ____ minutes but no more than ____ minutes.
thrombolytic, door to needle, 30, 90
Notify the cardiologist immediately if there is pain or ____ in the chest, which could indicate _______ blood flow thru the coronary artery.
tightness obstructed
As cells in the arterial tissue layers degenerate with age, _____ is deposited in the cytoplasm.
Calcium
________ disease is the leading cause of death in the US
Cardiovascular
A current hypothesis is that atherosclerosis is linked to prior infections with _______ _______, a bacterium that commonly causes respiratory infections.
Chlamydia penumoniae
Recently conducted large clinical trials support the C. pneumoniae hypothesis and also suggest connection between atheromatous plaque formation and other infectious microorganisms such as ______ ______, herpes simplex virus, and cystomegalovirus.
H. Pylori
Drugs such as angiotensin converting enzyme inhibitors and diuretics and stress managment are used to control ______.
HTN
Venous thrombosis is treated with ____ rest, _____ of the extremity, local heat, analgesics for _____, and intermittent subq injections or continuous IV _____ therapy followed by oral ______ once heparin has achieved therapeutic effect.
bed, elevation, pain heparin anticoagulants
Cardiac rehab usually begins ____ discharge, but continues on an ____ basis.
before outpatient
The sooner the shock is detected and treatment is instituted, the ____ the client's chances of survival.
better
Refrain from riding a _____, driving a _____, or _____ the lawn for at least ___ days.
bicycle vehicle mowing 3
Report any signs of ____, infection, or impaired ____; fever, swelling, redness, bloody or purulent drainage, acute pain in extremity, and cold or pale skin
bleeding, circulation
Thrombosis is a state in which a thrombus has formed in a ______ _____.
blood vessel
Hemoglobin from blood cells also escapes into the extravascular space, causing the tissue to appear dark ____, deep ____, or black.
brown, purple
A ventricular aneurism is a ____ of the portion of the heart affected by the MI>
bulging
The advantage of EBCT is that it can detect and quantify ____ ____ in the coronary arteries _____ clients who do not fit the usual cardiac risk profile are symptomatic.
calcified plaque before
laboratory tests to diagnose MI include a series of serum _______ _____substances that are released by damaged myocardial cells during an infarct.
cardiac markers
After significant cardiac event such as an MI or heart surgery, clients are encouraged to participate in a medically supervised _______ ______ program, which combines exercise and educational activities to speed recovery and reduce or prevent recurrent episodes.
cardiac rehabilitation
As unoxygenated cells die, they release inflammatory ______ that cause dermatitis, or inflammation of the dermis of the skin.
chemicals
The classical symptom is ______ ______ (angina pectoris) or discomfort during ____ or ______.
chest pain activity, stress
Plaque is chiefly composed of ______, a fatty (lipid) substance.
cholesterol
Major goal of therapy is to promote venous ______.
circulation
When chest pain is controlled, a _____ _____ diet is allowed and progressed to _____ _____ diet therafter.
clear liquid heart healthy
Coronary occlusion is the:
closing of a coronary artery which reduces or totally interrupts blood supply to the distal muscle area
Thrombolytic drugs called ____ _____ are given during this ____ hour window of opportunity to reestablish blood flow and save as much myocardial tissue as possible
clot busters, 6
Thrombophlebitis is an inflammation of a vein accompanied by a ____ or ____ formation.
clot, thrombus
One or both lower limbs feel _____ to touch.
cold
When the condition occurs in the hands, they become ____, blanched, and ___ with perspriation.
cold, wet
Enzymes are:
complex proteins produced by living cells that function as catalysts, substances capable of producing chemical changes without being changed themselves.
Arterial rupture, MI, and abrupt reclosure are _______ of PTCA.
complications
This is accomplished by elastic _____ _____ such as Jobst stockings, that maintain venous pressure at 40mmHg.
compression stockings
Prolonged standing _____ venous return as blood pools distally with gravity
compromises
Obesity and pressure on blood vessels from an enlarging fetus, liver, or abdominal tumor contribute to venous ______.
congestion
When the forward movement of venous blood is affected, venous _______ develops from the accumulating blood volume.
congestion
Troponin and subunits known as troponin T and troponin I, enzymes in myocardial _____ tissue.
contractile
The best method for facilitating hypothermia is the application of several _____ ____ _____ at strategic locations on the body; the pads are connected to a temp management console.
cooling gel pads
Electron beam computed tomography is a radiologic tests that produces xrays of the _____ ______ using an electron beam.
coronary arteries
_____ _____ ______ is the most common cause of death in adults older than 65 years.
coronary artery disease
Refrain from sexual activity for _____ week.
1
Clients remain in the hospital up to ____ week. _____ is restricted for several weeks to allow a safe period of healing.
1 week activity
If untreated, it may last for several hours or ____ to ____ days. Finally it becomes sore or achy before ______ entireley.
1-2 disappearing
Expect to see a bruise which may last ____ to _____ weeks; at the cath insertion site.
1-3
This noninvasive test scan scan the heart in 1/20th of a second using _____ times less exposure to radiation than a CT.
10
The ____-______ test is performed for diagnostic purposes. The client lies flat and elevates the affected leg to empty the veins. A tourniquet is applied to upper thigh, client is asked to stand. If blood flows from the upper part of the leg into the superficial veins when the tourniquet is released, the valves of the superficial veins is considered incompetent.
Brodie-Trendelenburg
The fluid-filled space acts as a barrier between the cells in the surround tissue and their capillary blood supply. Consequently the cells are subjected to accumulating amounts of ____.
Co2
_____ ultrasonography is used to detect abnormalities in peripheral blood flow.
Doppler
One of the simplest tests involves measuring the ankle-brachial index, a comparison of the systolic pressure in the brachial artery with that in the posterior tibial artery using a _____ ultrasound at rest or after _____.
Doppler, exercise
There is a high degree of correlation between the amount of calcium plaque identified by EBCT and the future risk of ______.
MI
An IV infusion of ________ ____ may provide temporary relief.
Prostaglandin E
ECG changes may include _____ wave inversion, _____ segment elevation, and ____ wave.
T, ST, Q
Monitor ____, ____, and _____ labs when concurrent oral anticoag is prescribed.
aPTT, PT, INR
A lipid profile generally consists of measuring: (4)
Total serum cholesterol Low-density lipoprotein (LDL) cholesterol high-density lipoprotein (HDL) cholesterol Triglycerides
Drugs such as streptokinase and recombinant tissue plasminogen activator (tPA) ________ the thrombus occluding the coronary artery, restoring the circulation of oxygenated blood to the myocardium. If administered within the _____ _____ hours after the onset of symptoms, MI can be greatly minimized.
dissolve first 2
The leg veins look ____ and tortuous and can be seen under the skin as dark blue or purple, snakelike elevations.
distended
_____ ultrasound demonstrates a _____ direction of blood flow, indicating valvular incompetence in superficial or deep veins.
doppler, reversed
The term arrhythmia, sometimes called ____, refers to changes from the normal sequence of cardiac impulses resulting in erratic heart rhythms or rates that are too fast or slow.
dysrhythmias
The valves of the veins become incompetent in ____ ____, resulting in varicosities.
earlt adulthood
Increased hydrostatic fluid pressure causes fluid to leave the veins and enter interstitial spaces. Localized ____ is evident. The skin becomes ______ and hard.
edema, shiny
Pericarditis may be mild or severe. The mild form may not require treatment. If pericardial _____ develops, the client is closely observed for signs of cardiac tamponade; pericardiocentesis is done to remove ____ _____.
effusion excess fluid
Calcium causes the arteries to lose _____. The rigid arterial vessels fail to ___ as the left ventricle contracts, sending oxygenated blood from the heart.
elasticity, stretch
Discourage older adults from using _____ ____ devices; burns are more likely to occur because of decreased temperature perception resulting from impaired circulation.
electric heating
The other enzymes can be ____ in response to cardiac or other organ damage.
elevated
Blood glucose level may be ____ because of the body's response to a major _____.
elevated, stressor
When tissues and cells break down, are damaged, or die, great quantities of certain ____ are released into the bloodstream.
enzymes
Men may experience ______ dysfunction.
erectile
During situations that increase myocardial oxygen demand like _____ or __________ stress, the compromised coronary arteries cannot adequately oxygenate the myocardium.
exercise emotional
Treatment of mild varicose veins include ______, losing weight, wearing ____ support stockings, and avoiding _____periods of sitting/standing.
exercising, elastic, prolonged
Treatment involves avoiding _____ that precipitate attacks.
factors
Varicose veins hav e a _____ tendency.
familial
Signs and symptoms of DVT usually include mild ____ and pain, swelling and tenderness in affected _____.
fever, extremity
Venous insufficiency is a peripheral vascular disorder in which the:
flow of venous blood is impaired thru deep or superficial veins or both. Conditions usually affects lower extremities, most often the medial aspect of the leg and around the ankle.
Daily intake of food sources or supplements of folate or ______ acid, vitamin ____, and vitamins _____, reduce homocysteine levels
folic B6 (pyridoxine) B12 (cyanocobalamin)
This complication has been successfully treated with ____, ventricular assist devices, and an intra-aortic _____ pump.
medications balloon
____ are affected more than ____ by PAD in lower extremities.
men, women
Although CAD occurs 10-15 years earlier in _____ than ____, the incidence rises in ________ _______ and becomes similar to that in men thereafter.
men, women postmenopausal
A coronary stent is a small ____ ____ with a meshlike openings placed in the coronary artery during PTCA.
metail coil
Relieve discomfort at the site with a ____ _____ such as acetaminophen; numbness at the site is _______ and not unusual.
mild analgesic temporary
Atherosclerosis is a more ______ contributor than arteriosclerosis to vascular disease.
modifiable
An embolus is a ___ mass (clot) of particles, either ___ or ___, in the bloodstream
moving solid, gas
Troponin is present only in ______ tissue, therefore, it is the _____ standard for determining heart damage in the early stages of an MI.
myocardial gold
Coronary artery disease precedes coronary occlusion, which if untreated, leads to ____ _____, which layperson's refer to as a ____ ______.
myocardial infarction heart attack
The first zone consists of a central area of _____ myocardial cells.
necrotic
If a client experiences cardiac arrest (asystole),____ damage can occur.
neurologic
Meds that produce vasodilation include:
nitrates
Unlike anginal pain, rest and sublingual _____ do not relieve MI pain.
nitrates
Older adults are more sensitive to the hypotensive effects of ______ and _____ _____ _____, probably because of impaired venous valves, diminished baroreceptor reflex, and decreased vascular volume. These drugs are used with caution.
nitrates calcium channel blockers
Upon exertion, many describe feeling ____ in the affected leg(s) accompanied by ______ and fatigue.
numbness, heaviness
Decreasing _____ and body fat stores via exercise, dietary modification, or developing drugs that target proinflammatory proteins may _____ risk factors for heart disease.
obesity heart
Arteriography or venography using a contrast dye identifies the point of _____.
obstruction
Drug therapy includes analgesics for ____, nitrates or other vasodilating drugs to improve ____ _____, diuretics to reduce circulating ____ _____, sedatives to promote ___ and reduce _____, anticoagulants to prevent additional _____ formation, and drugs to treat arrhythmias.
pain blood flow blood volume rest, anxiety thrombus
Pulses in the lower extremities are difficult to _____.
palpate
Raynaud's disease is characterized by:
periodic constriction of the arteris that supply the extremtiies.
PTCA uses sedation and local anesthesia, a balloon-tipped catheter is inserted thru the skin and threaded from a _____ artery into the diseased ______ artery.
peripheral coronary
Common peripheral vascular disorders which reduce blood flow by various mechanisms include: (5)
peripheral artery disease Raynaud's disease thrombosis phlebothrombosis embolisms
Because soy products are classified as ______, plant sources of estrogen, some clients are increasing consumption of soy as a cardioprotective strategy.
phytoestrogens
Hemorrhage associated with thrombolytics may be controlled by infusing ______, fresh frozen ____, or croyprecipitate.
platelets plasma
Hemopericardium (blood in the pericardium) and cardiac tamponade follow. The prognosis is ____, although survival is possible.
poor
A transdermal nitroglycerin patch is for ______ of angina pectoris.
prevention
The stent ______ the buildup of new tissue that reforms in the artery, prevents the artery from _____ shortly after the procedure, and keeps the lumen open for a longer period than traditional PTCA alone.
prevents collapsing
a vein ligation is a :
procedure in which affected veins are ligated (tied off) above and below the area of incompetent valves but the disfunctional vein remains.
_____ areas of necrosis occur with prolonged ischemia.
prolonged
Normally, the action of activity of leg muscles during movement and exercise aids venous return. When valves in veins become ____, blood accumulates rather than being propelled efficiently to the heart.
propelled
One theory explaining vasospasms is impaired release of ______ (chemicals stored in cellular membranes).
prostaglandins
When disease is severe and long standing, cyanosis of fingers persists between attacks and skin changes gradually develop. Painful ____ and superficial _____ may appear at fingertips. The fingers are especially vulnerable to infection. Healing of even minor lesions of ten slow and uncertain.
ulcers, gangrene
In rural areas, this type of equipment is _____. Hypothermia can be induced using an external hypothermia ____ or _____ packs or administering ____ saline thru a peripheral IV cath or endovascular cooling cath.
unavailable blanket ice cold
Sublingual nitroglycerin is placed _______ ______ ______ for acute relief of angina pectoris.
under the tongue
A thrombolytic can be administered within the specified timelines _____ the client is disqualified on the basis of criteria that identify possible concomitant risks for neurologic complications and bleeding.
unless
Women more often than men have more ____ symptoms such as unexplained _____, abdominal pain, and shortness of breath, which often leads to _______ of women in emergency departments.
vague fatigue misdiagnosis
Signs and symptoms ____ between men and women.
vary
some prostaglandins cause _____; others cause ______. The type that accompanies inflammatory response causes ____.
vasoconstriction, vasodilation vasodilation
Drug therapy includes meds that produce arterial _______.
vasodilation
Drug therapy with peripheral ______ such as isoxsuprine, may be attempted.
vasodilators
Venous thrombosis arises mostly in the ____ of the _____ extremities and pelvis.
veins lower
Most pulmonary emboli arise from ______ thrombi in the lower extremities and pelvis. They may also arise from the ____ ventricle after an MI.
venous right
A lesion referred to as a _____ ____ ulcer forms.
venous stasis
Venous insufficiency may be a consequence of: _____ _____ or valvular damage from a previous venous thrombosis.
vericose veins
Placing the affected part in ___ water or going to a ____ area can relieve an attack.
warm, warm
Many older adults have peripheral vascular insufficiency that is manifested in ___ or ___ pedal pulses; cold clammy feet, ______ toenails, and ___ skin on the lower extremities.
weak, absent thickened shiny
An opaque _____ ring about the periphery of the cornea, called arcus senilis, results from a deposit of ____ granules but may be apparent only in older adults.
white fat
Phlebothrombosis is the development of a clot _____ the vein without ______.
within inflammation
