Medical-surgical Nursing Demystified

CHAPTER 1 Cardiovascular System^9

(PTT) (helps to detect and diagnose bleeding disorders and the effectiveness

of anticoagulants), proBNP (BNP) measures the presence and severity of

heart failure.

• Cholesterol panel to evaluate risk.
  
  
  • Increased risk for coronary artery disease with increased total cholesterol,
    increased low-density lipoproteins (LDL), increased triglycerides and de-
    creased high-density lipoproteins. (HDL).
  
  
  
  

TREATMENT

The goal of treatment is to deliver sufficient oxygen to the heart muscle to meet its
need. When suspecting chest pain, always give oxygen as the first line of defense.
Medications are used initially to treat symptoms and increase blood flow to the
heart muscle. Medications are used for symptom control and cholesterol manage-
ment in the long term. Cardiovascular interventions are used to maintain adequate
blood flow through the coronary arteries.

• 2 to 4 liters of oxygen.


• Administer beta-adrenergic blocker—this class has a cardioprotective effect,
  decreasing cardiac workload and likelihood of arrhythmia.
  
  
  • Drugs like propranolol, nadolol, atenolol, metoprolol.
  
  
  
  


• Administer nitrates—aids in getting oxygenated blood to heart muscle.
  
  
  • Nitroglycerin—sublingual tablets or spray; timed-release tablets.
  
  
  • Topical nitroglycerin—paste or timed-released patch.
  
  
  
  


• Aspirin for antiplatelet effect.


• Analgesic—typically morphine intravenously during acute pain. The medi-
  cine is very fast-acting when given this way and will decrease myocardial
  oxygen demand as well as decrease pain.

The following should be watched separately.

• Percutaneous transluminal coronary angioplasty. This is a nonsurgical pro-
  cedure in which a long tube with a small balloon is passed through blood
  vessels into the narrowed artery. The balloon is inflated, causing the artery to
  expand.


• Coronary artery stent. This is a small, stainless steel mesh tube that is placed
  within the coronary artery to keep it open.


• Coronary artery bypass graph (CABG). This is a surgical procedure in which
  a vein from a leg or an artery from an arm or the chest is removed and