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BB cardiac
cardiac
| Questions | Answers |
|---|---|
| In the conduction system, what is known as the pacemaker? | The SA node which fires at 60-100 impulses/min. |
| What sends impulses to the ventricles and at what rate? | The AV node, 40-60 impulses/min. |
| The bundle of His is located in the septum and separates what? | The ventricles. |
| What are five important parts of the electrophysiology of the heart? | Automaticity, excitability, conductivity, contractility, and refractoriness. |
| What is cardiac output? | Heart rate x stroke volume. |
| What is preload? | The amount of blood coming into the heart. |
| What is afterload? | The resistance the ventricles have to overcome to eject blood into the vessels. |
| What are some non-modifiable risk factors for CHF? | Age, gender, ethnicity, genetics. |
| What are some modifiable risk factors for CHF? | Smoking, inactivity, obesity. |
| What are some diagnostic tests for CHF? | Serum lipids, C-reactive protein, angiography, EKG, stress test, echocardiograms, hemodynamic monitoring. |
| What does CHF mean? | A less than normal cardiac output. |
| What are the compensatory mechanisms of the heart? | Increase heart rate, increase stroke volume, arterial vasoconstriction, Na and water retention, neurohumoral response, and myocardial hypertrophy. |
| What are signs and symptoms of left-sided heart failure? | Fatigue, weakness, daytime oliguria, angina, tachycardia, palpitations, confusion, restlessness, dizzyness, pallor, weak peripheral pulses, cool extremities, cough, dyspnea, breathlessness, orthopnea, increased respirations, crackles, noctural dyspnea. |
| What are the signs and symptoms of right-sided heart failure? | Jugular vein distention, enlarged liver and spleen, destended abdomen (ascites), anorexia, nausea, dependent edema, noctural polyuria. |
| What drugs are used to treat hear failure? | Digoxin, Beta-blockers, ACE inhibitors, diuretics, vasodilators. |
| What drug is the only commonly used glycoside? | Digoxin |
| What is the action of Digoxin? | It improves the heart's pumping ability and increases contractility. |
| What is the common dose for Digoxin? | 0.125 mg |
| What is angina pectoris? | Chest pain. |
| What are some non-pharmacologic methods for managing angina? | Altering risk factors such as smoking, hypertension, hyperlipidemia, obesity, sedentary lifestyle, stress, and use of drugs that increase cardiac workload. |
| What medications can be used to treat angina? | Organic nitrates, beta-blockers, and calcium-channel blockers. |
| What is the prototype and most widely used nitrate? | Nitroglycerin. |
| What do nitrates do? | Relax smooth muscle in blood vessels, and cause vasodilation in veins, coronary arteries, and arterioles. |
| What does dilation of veins cause? | Decrease in venous return to heart (preload), Decrease in cardiac workload, and a decrease in oxygen demand. |
| What does the dilation of coronary arteries result in? | Increased blood flow to the ischemic areas of the heart. |
| What does dilation of the arterioles cause? | A decrease in peripheral vascular resistance (afterload), a decrease in BP, and a decrease in cardiac workload. |
| What are the names of less commonly used nitrates? | Isosorbide dinitrate (Isordil), Isosorbide mononitrate (Imdur). |
| What are some side effects of nitrates? | Hypotension, dizziness, light-headedness, tachycardia, palpitations, and headache. |
| What do beta-blockers do? | Prevent usual SNS responses. |
| When beta blockers inhibit the SNS, what are the results? | Decrease in HR, BP, contractility, oxygen demand, and cardiac output, bronchoconstriction, decreased aqueous humor in the eye, and decreased angina pain. |
| What is the difference between beta-1 sites and beta-2 sites? | Beta-1 sites have more effect on the heart, whereas beta-2 sites have more effect on the lungs. |
| What letters to most beta-blockers end in? | olol. |
| FWhat are some adverse effects of beta-blockers? | Hypotension, bradycardia, bronchospasm, heart failure. |
| What is the rationale for not stopping beta-blockers abruptly? | It can result in very high blood pressure and angina because the SNS is stimulated. |
| What do calcium channel blocking agents do? | The prevent movement of calcium into the cells which results in dilation of coronary and peripheral arteries. |
| What are the results of calcium channel blockers? | Improved angina, decreased workload (decreases afterload), decreased blood pressure. |
| What are some adverse side effects of calcium channel blockers? | Hypotension, dizziness, lightheadedness, weakness, peripheral edema, headache, heart failure, pulmonary edema, nausea, and constipation. |
| What are the names of some calcium channel blockers? | verapamil, nifedipine, diltiazem. (Very Nice Drugs) |
| What is hypertension? | A sustained elevation of BP with at least three occasions over several weeks above 140/90. |
| What are the two major factors that determine hypertension? | Heart rate and stroke volume. |
| What does hypertension cause? | An increase in heart workload, enargement of the heart muscle, narrowing of arterial lumen, increased risk of thrombosis. |
| What are the "target organs" of hypertension? | Heart, brain, kidneys, and eyes. |
| What are the signs and symptoms of hypertension? | Fatigue, headache, dizziness, palpitations, angina |
| What are some non-pharmacologic treatments for hypertension? | Lifestyle modification, dietary changes (restrict sodium), Limit alcohol to 1oz/day, increase activity (30 min of moderate activity/day), quit smoking, and manage stress. |
| What is the rationale for quitting smoking? | Nicotene use causes vasoconstriction. |
| What risks are associated with hypertension? | Heart attack, stroke, and kidney failure. |
| What medications can be used to treat hypertension? | Angiotensin-converting enzyme inhibitors (ACE), Angiotensin II receptor blockers, anti-adrenergics, calcium channel blockers, diuretics, vasodilators (direct acting). |
| Hypertension medications have what 2 main actions? | Reduction of systemic vascular resistance, and reduction of volume of circulating blood. |
| What do ACE inhibitors do? | They block the enzyme that converts angiotensin I into angiotensin II (strong vasoconstrictor) which results in vasodilation. |
| What effect does vasodilation have? | A decrease in blood pressure. |
| What do most ACE inhibitors end in? | pril. |
| What does anti-coagulent mean? | Prevents the formation of clots. (does not dissolve clots) |
| What does anti-platelet mean? | Inhibits platelet aggregation. |
| What does thrombolytic mean? | Dissolves thrombi. |
| What lab values need to be monitored when heparin is given IV? | PTT (partial thromboplatin time) |
| What is an example of a low molecular weight heparin? | Lovenox (enoxaparin). |
| What is the most commonly used oral anticoagulant? | Coumadin (warfarin). |
| Why would you choose coumadin over heparin? | For long-term therapy. |
| What lab values need to be monitored when Coumadin is given? | PT (prothrombin time), and INR (international normalized ratio) |
| What kinds of foods should people who take Coumadin avoid? | Green leafy vegetables, tomatoes, bananas, fish. (the all contain vitamin K) |
| What is the antidote for heparin? | protamine sulfate. |
| What is the antidote for Coumadin? | Vitamin K. |
| What are some non-pharmacologic ways to treat arteriosclerosis and atherosclerosis? | Diet, exercise, quit smoking. |
| What are some signs and symptoms of peripheral arterial disease? | Pain, intermittent claudication, bruit, trophic skin changes, rubor or blanching, arterial ulcers (start on feet or toes, painful). |
| What are some nonsurgical ways to mange PAD? | Exercise (increase slowly, stop if pain), Positioning, protect feet, decrease weight, stop smoking, avoid tight clothing..crossing legs..cold..direct heat. |
| What are some drugs that treat PAD? | Trental, ASA, Plavix. |
| What are some post-op cares for an arterial revascularization? | Keep leg straight, bedrest first 24 hrs, check extremity, assess pulses and pain. |
| What are the treatments for acute peripheral arterial occlusions? | Heparin, or a trombectomy. |
| What are some signs and symptoms of acute peripheral arterial occlusions? | Severe pain, affected areacould be cool or cold or pulseless or mottled, areas on toes may be black or gangrenous. |
| What could an acute peripheral arterial occlusion cause? | An embolism. |
| What are some of the symptoms of aneurysms? | Pain when supine (pressure on structures), Abd pain, back pain, dyspnea, cough, pulsating abd mass, but some have no symptoms. |
| Why would you want to decrease the blood pressure of someone with an aneurysm? | To lessen the chance of rupture. |
| What are some signs and symptoms of Buerger's Disease? | Burning pain, sensitivty to cold, intermittent claudication, superficial phlebitis, ulcerations and gangrene. |
| What are the treatments for Buerger's Disease? | Stop smoking and all use of tobacco, avoid the cold, vasodilating drugs. |
| What is Raynaud's Phenomenon? | Vasospasm of arterioles and arteries. |
| What are signs and symptoms of Raynaud's Phemomenon? | Blanching, cyanosis, cold, pain, ulcers on tips of fingers. |
| What are the treatments for Raynaud's Phenomenon? | Avoid cold, stress, and trauma to the fingers, stop smoking, avoid caffeine, meds. |
| What is Venous thromboembolism? | A deep vein thrombophlebitis. |
| What are signs and symptoms of a venous thromboembolism? | Edema, difference in size of calves of legs, increased temp, redness of area, tenderness. |
| What is a complication of a venous thromboembolism? | Pulmonary Embolism. |
| How do you threat a venous thromboembolism? | Bedrest, elevation of limb, warm moist packs, anticoagulents, thrombectomy ("umbrella" filter). |
| What are the signs and symptoms of venous insufficiency? | Steady throbbing pain, edema, brown pigmentation of lower legs, ulcers (around the ankle, little pain, superficial, chronic, infection risk). |
| What should a patient with venous insufficiency be encouraged to do? | Elevate legs, wear compression stockings, exercise, avoid long periods of standing, do not cross legs, avoid tightness on legs. |
| How do you treat a venous ulcer? | With an occlusive dressing (hydrocolloid-DuoDerm), unna boot on for 1 week, compression stockings. |
| What causes varicose veins? | Incompetent valves. |
| What are signs and symptoms of varicose veins? | Edema, dull aching, enlarged leg veins. |
| What are the treatments for vericose veins? | Walk, slerotherapy, surgical removal. |
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thisgirl
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