Pathophysiology-Coronary Artery Disease (CAD)

Pathophysiology: Coronary Artery Disease (CAD); Damaged lining of coronary arteries leading to build up of lipids and WBCs forms plaques; Narrows lumen of arteries, can lead to thrombus or emboli
Discharge Planning: F/U with PCP;
Cardiology referral; Smoking cessation
support if needed; Other Support
groups; Assess $$$ to afford meds
Collaborative Care: Dietician; Diabetic
Educator if indicated
Action of meds: Slows production of
cholesterol in the liver; Side Effects of
medication: increased cataract risk,
HA, abdominal pain, diarrhea, SEVERE:
rhabdomyolysis & liver failure
Risk factors: Atheroscelrosis, HTN,
Smoking, Obesity/sedentary,
Hyperlipidemia, Diabetes, Family Hx,
Post-menopausal
Important Points: Contraindicated
w/liver disease, monitor liver enzymes,
no grapefruit products
What to look for: Unstable angina -
chest pain at rest; MI: angina,
diaphoresis, SOB, neck, jaw, or back
pain, etc.; Stroke or TIA: neurological
changes dizziness, weakness or
numbness on one side of body,
dysphasia, drooping on one side of
face
Diagnostic Procedures: Coronary artery
calcium scoring; possible angiography
to look for blockage if symptomatic
Labs: HTN > 140/90; LDL > 160; HDL < 40; total cholesterol > 240; triglycerides > 200; glucose > 200
Patient Teaching: Disease
process; Diet reduced fat &amp;
cholesterol; exercise regular;
medications; Smoking
cessation; Control HTN &amp;
diabetes
Nursing Interventions: Monitor VS and
labs; Assess for S/S of complications;
Administer medications; Referrals;
Patient Teaching
Medications: Atovstatin calcium
(Lipitor) &quot;statins&quot;
Priorities of Care: Monitor for
complications; stabilize and reduce
plaques; Reduce risk factors educate
on diet, meds, &amp; exercise; Address
HTN and/or diabetes if present
Potential Complications: Unstable
angina/MI; Stroke or TIA
Assessment: Often have HTN, Elevated
Lipids/cholesterol, may have elevated
glucose. May have S/S of TIAs
associated with stress/exertion, arterial
bruits
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