1. Coronary Artery Disease
Ischemic heart disease

2. Angina Pectoris Development of plaques
Vessels narrow or become obstructed
Ischemia
Prolonged deficiency of oxygenated blood

3. Angina “pain in chest”

4. Signs and Symptoms Distribution of pain Sensation of tightening Faint
Dyspneic
Pale

5. Diagnostic Test
ECG (ekg)
Cardiac enzymes
Xray
Medical history

6. Medical and Surgical treatment
Medications
Diet and exercise
Reduction of risk factors
Invasive and intervention procedures

7. Nursing considerations
Teaching
Lifestyle changes
Medications
Compliance

8. Myocardial Infarction
Blockage of coronary arteries
Damage to the myocardium and conduction system
Diminished blood flow
Life threatening dysrhythmias
Ineffective pump

9. Signs and Symptoms Pain Panic Restlessness Confusion Ashen Cold Clammy
Dyspnea
Cyanosis
Rapid thready pulse
Irregular pulse
Drop in BP
Drop in body temp
Sense of impending doom

10. Diagnostic test
ECG
Cardiac enzymes
Xray
BMP
Coagulation studies

11. Medical treatment
Pain relief
Medications
Oxygen
Rest

12. Nursing Considerations acute phase
Assessment
Vital signs
Cardiac monitoring
I/O, daily weight
Lab and xray
Medications

13. Nursing Considerations recovery phase
Bowel movement
Cardiac rehab-exercise
Rest
Diet
Treatment and medications
Risk factors
Compliance

14. Blood Vessel Disorders
Inflammatory disorders and Complications

15. Thrombophlebitis Inflammation Blood clot formation
Deep vein thrombosis
Phlebitis
Coagulability

16. Thrombophlebitis Predisposing factors Venous stasis Pressure
Prolonged inactivity
Prolonged immobilization
Venous stasis
Decrease venous return

17. Signs and Symptoms Pain Redness Swelling Fever Fatigue
Positive Homans’ sign

18. Medical treatment
Imaging studies
Medications
Lab tests
rest

19. Nursing Considerations
Exercise plan
Bed rest
Antiembolism stockings
Medications

20. Embolism Pulmonary embolism Coronary embolism Cerebral embolism
Peripheral embolism

21. Surgical treatment
Ligation (tied off)
Filter placed

22. Peripheral Vascular Disorders
Intermittent claudication
Tingling and numbness
Coldness and difference in size
Lack of new tissue growth

23. Buerger’s disease Thromoangiitis obliterans
Inflammation causes obstruction of blood vessels
Cramps in calf muscle-exercise
Tingling, burning and numbness
Edema-pitting or brawny
Mottled purple red hue- dependent
Pale when elevated
Ulcers-infection-gangrene
Amputation

24. Medical and surgical treatment
Mild exercise- buerger-allen exercises
Medications
Clothing
Diet and fluid intake

25. Raynaud’s Phenomenon Spasmodic constriction of arteries
Blanched cold extremities
Numb-prickly- perspire-blue
Progresses-cyanosis-ulcers
Skin shiny and tight
Avoid cold
Medications to relieve spasms

26. Varicose Veins Weakening valves of the veins Blood pools
Predisposing factors
Heredity
Weakening vein walls
Poor posture
Prolonged standing
Tumors
Hypertension
obesity

27. Signs and symptoms Dark, tortuous superficial veins
Dark protrusions when standing
Pain
Fatigue
Feeling of heaviness
Muscle cramps

28. Medical and Surgical treatment
Elevating legs
Avoiding constriction, standing long periods and restrictive clothing
Measures aimed at promoting venous return
Surgical ligation and stripping of varicose veins
Sclerosing-injection

29. Nursing considerations
Teaching
Measures to promote venous return
Antiembolism stockings
Elevate legs
Ambulation

30. Telangiectasia (spider veins)
Small dilated blood vessels
Treated by scleropathy

31. Aneurysms Outpouching of a blood vessel
Congenital
Trauma
Increased pressure of arteriolosclerosis
Vessel may hemorrhage or rupture
Surgical intervention if in an operable site
Surgical repair-clamping, removal or synthetic graft

32. Cerebrovasular Accident
Stroke
Brain attack

33. Causes of cerebrovascular accident
Contributing factors
Causes of CVA
Cerebral thrombosis
Cerebral hemorrhage or aneurysm
Cerebral embolism

34. Stages of CVA Transient ischemic attack
Reversible ischemic neurological deficit
Stroke in evolution
Completed stroke

35. Signs and Symptoms Dizzy spells Memory loss
Ringing in the ears (tinnitus)
Headache-nausea and vomiting
Loss of consciousness
Face red
Breathing noisy and strained
BP elevated
Pulse slow but full and bounding
Inconsistent behavior
Easily fatigued
Loss of bowel and bladder control
Poor balance
Deep coma

36. Results of CVA Hemiplegia Paralysis of one side of body Flaccid stage
Numbness and weakness
Spastic stage
Muscles contracted, tense and movement difficult
Recovery stage
Therapy and rehabilitation

37. Aphasia and Dysphasia Aphasia Dysphasia Dysphagia
Damage to the brain’s speech center
Unable to speak
Dysphasia
Inability to say what one wishes to say
Dysphagia
Swallowing difficulty

38. Chances of recovery Deficits
Brain Damage
Chances of recovery
Deficits

39. Hemianopsia Blindness in half of the visual field of one or both eyes
Approach from the unaffected side
Teach client to scan to see things

40. Pain Very little pain associated with CVA Secondary health issues
Infection
Kidney
Bladder
Fecal impaction

41. Autonomic Disturbances
Perspiration or “goose flesh” above paralysis
Dilated pupils
High or low blood pressure
headache

42. Personality changes Functional Organic changes
Frustration unable to walk or talk
Useless or helpless
Organic changes
Blockage of blood supply to part of brain

43. Nursing Considerations
Changes in LOC
Documentation
Positioning on unaffected side
Maintain patent airway
Limb support
Monitor vital signs
Communications
Ortho bowel program
Medication and therapy