hi guys this is your unit 3 part 2 lecture so we're starting off with coronary artery disease so etiology cad that's the abbreviation for coronary artery disease that's the fatty deposit buildup within those coronary arteries um this starts in chapter 27 on page 430 i'm going to be flipping back and forth a little bit between your lecture notes and maybe a little bit on the powerpoint the powerpoint you should just be able to follow along i'll let you know when to refer to the slide um but looking at this here this is a good picture of coronary artery disease so here we have these um coronary arteries right and then we have this fatty deposit buildup in those arteries so you see what happens is when we have that buildup it's gonna impede blood flow right we don't have as you know as greater blood flows we could have so we'll have decreased perfusion and then that part of the heart is going to end up becoming ischemic because it's not getting appropriate blood flow okay looking back here so arthrogenesis that's a buildup of cholesterol and lipids within the artery and then we have risk factors so we've talked about risk factors before there's modifiable so those things that we can modify so hypertension we say modifiable with hypertension in the sense that we could change our diet we could take our medications so meaning we can control the hypertension so modifiable in that aspect smoking talking to the patient about smoking cessation obesity diabetes mellitus so remember we talked about that before in part one really that's just meaning to maintain glycemic control and then dyslipidemia dyslipidemia or hyperlipidemias how you also hear that said that's elevated plasma cholesterol okay so we have um triglycerides and cholesterol those are the two primary forms of lipids in the blood and we use them as an energy source and stored it's stored in fat okay so a couple different types of cholesterol right which you're really going to want to remember there's hdl and there's ldl okay so hdl so we have hdl and ldl hdl is our good right that's our good cholesterol ldl is known as our bad cholesterol so hdl stands for high density lipoproteins and ldl stands for low density lipoprotein so we want more high density lipoproteins than low okay so hdl is your good ldl is your bad physical inactivity we can always become more active so that's modifiable and then diets so diet high in fat or salt and decrease in veggies and fiber can also be modified right to be less salt less fat more veggies more fiber non-modifiable those things that are non-modifiable would be age gender especially males greater than females and then for females pre-menopausal ethnicity caucasian greater than african americans and then genetic predisposition so that'd be if there was family history of heart disease controllable modifiable risk factors so we have lifestyle changes that can occur pharmacologic treatment if the patient stays on their regimen as prescribed smoking sensation physical activity weight control dietary management you're seeing a lot of this stuff is kind of repetitive right um monitoring and managing our blood pressure glucose and lipid control and then as a nurse nursing actions we can assess for risk factors we can assess for compliance right so is the patient following following their regimen as prescribed um are they following their diet have they stopped smoking those types of things are they taking their medicines patient education so especially those things that are modifiable we could be teaching them about right so we should teach them about lifestyle changes teach them about meds compliance and really what is the outcome we're trying to achieve sometimes understanding the horrible or horrific outcomes that occur concur sorry that can occur if we don't follow our medical regimen is more of a shell shock and really a reality check facilitate referral so if they need referrals for weight reduction cardiology or even an endocrinologist if they're diabetic