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on the patient to see how well they tolerate activity.Phase IVMaintenance phase. Emphasizes the long-term life change.Exercise (no sedentary lifestyle). Diet.CADoRisk Factors: Modifiable vs. Non-ModifiableModifiable:Smoking, hyperlipidemia, hypertension (long term or chronic over 140/90), diabetes, obesity, diet, inactivity, stress, and alcoholNon-Modifiable: Age, gender, family history, and ethnic backgroundoDiagnostic Test TeachingsElectrocardiogram12-lead electrical recording of the heart used to determine areas of ischemia or infarctionHolter MonitorAmbulatory ECG that monitors the patient to see if ischemia is present. Goes directly to the telemonitor nurse. Like a pager looking device. Relates the ischemic episode to what the patient is doingChest X-rayNot diagnostic worthy, but can reveal clues of CADECG Stress TestExercise induced stress test. It evaluates effectiveness of therapies. Shows how exercise is affecting the cardiac systemLabsCreatine Kinase: looks overall if there is muscle damage in the body. It is a marker but is nondistinctive.Troponin: a myocardial protein that is only released in circulation when there is a myocardial injury. It will rise quickly and remain elevated for 2 weeks. STEMI
Exam 3 Concept GuideMore extensive damage, occurs very quickly, usually correlated with prolonged and complete blockageNSTEMIIncomplete blockageoMedications for Treatment(All work by decreasing the workload of the heart and increasing myocardial perfusion)NitratesNitroglycerinoPRNoWatch for hypotension (stand slowly)oCommon/expected side effects: tingling sensations and headacheoAvoid use of Viagra or Cialis because it vasodilates as well so thecombination of both could cause death to occurBeta BlockersAtenolol & MetoprololoDecrease afterload and increase diastolic time to increase coronary perfusionoMonitor for bradycardia, hypotension, SOB, and wheezingIt can also constrict the bronchiolesoDo not give to someone with asthma Calcium Channel BlockersVerapamil, Diltiazem, & AmlodipineoDilate coronary arteries, prevents vasospasms, and decreases preload and afterloadoMonitor for edema, hypotension, bradycardiaoStart prevention attempts for constipation (laxatives)Antiplatelet TherapyAspirinoInhibits blood clots, decreases pain, and decreases the risk of death in elderly patients. oTake with foodoCommon dose: baby aspirin (81 mg/day)HDL vs. LDL Differences and LevelsoLDL (bad cholesterol): main component of atherosclerotic plaque buildup. LDL transportscholesterol to the liver and other organs. oHDL (good cholesterol): Transports plasma cholesterol away from the plaque to be excreted. If HDL goes up the tendency for CAD decreases.ClassificationTotalCholesterol(mg/dl)LDL (mg/dl)HDL (mg/dl)Triglyceride(mg/dl)OptimalLess than orLess than orGreater than orLess than or