Cardiac

Question 1

What are common side effects associated with Beta Blockers?

Answer 1

Edema Worsening HF Hypotension Fatigue Bradycardia

Question 2

Rhythm?

Treatment?

Answer 2

Asystole

Epinephrine and Atropine

Question 3

Identify Rhythm?

Symptoms?

Tx?

Answer 3

Premature Ventricular Contractions

Lack of cardio output

CPR, ACLS, Epi, Vasopressin, Intubation

Question 4

Identify # 6

Time?

Whats happening?

Answer 4

QT interval

0.34-0.43

Time for entrie electrical depolarization and repolarization of the ventricles.

Question 5

What do diuretics do for cardiac function for the HF patient? Acute

Answer 5

1. Reduces venous pressure, 2. Volume returning to the LV, 3. Increase Cardiac output, 4. decrease pulmonary pressure, 5. improves gas exchange.

Question 6

Why use an ACE-inhibitor for the treatment: Chronic HF 2 reasons

Answer 6

1. They are the drug of choice for blocking the RAAS system in HF patients with systolic failure. 2. Decrease the development of ventricular remodeling by inhibiting ventricular hypertrophy.

Question 7

What benefits are associated with the use of ACE-inhibitors?

Answer 7

Reduction of systemic vascular resistance. Increased CO Diuresis is enhanced

Question 8

Rhythm?

Symptoms?

Treatment?

Answer 8

Sinus Bradycardia

Pale cool skin, hypotension, weakness, agina, dizziness, syncope, SOB, confusion, disorentation

Tx: Atropine if symptomatic

Question 9

What are the common side effects of ACE-inhibitors?

Answer 9

Hypotension intractable cough hyperkalemia angioedema renal insufficiency

Question 10

Why give Vasodilators to the HF patient? Acute

Answer 10

1. They reduce circulating blood volume, 2. dilates coronary arteries. 3. Decreases preload, 4. reduces after load, 5. Increases myocardial oxygen supply.

Question 11

How do you position the Acute decompensated Heart failure patient whose experiencing Dyspnea?

Answer 11

In high fowlers position with feet horizontal or feet dangling at the bedside.

Question 12

Why are diuretics given to the HF patient? Acute

Answer 12

Treatment of fluid volume overload

Question 13

How do Vasodilators Nitrates work?

Answer 13

They cause vasodilation by acting on the smooth muscle of the vessel wall. They promote vasodilation of the coronary arteries.

Question 14

What medication is contradicted with use of Nitrates that could cause systemic hypotension?

Answer 14

Erectile dysfunction medications.

Question 15

What are the problems associated with taking diuretics for treatment for Chronic HF

Answer 15

Reduction of potassium levels ototoxicity allergic reaction from the sulfa

Question 16

Rhythm?

Whats seen?

Treatment?

Answer 16

Ventricular Tachycardia

Rapid HR with wide QRS complexes

Pulse: 150mg Amiodarone

Pulseless: CODE, Amiodarone, Lidocaine, defibrillation,

Question 17

Rhythm?

Symptoms?

Treatment?

Answer 17

PAC

Distorted P-wave

Remove source, beta blockers

Question 18

Identify #1

Time?

What does it mean?

Answer 18

P-wave

0.06-0.12

Atrial depolarization (Contraction) time

Question 19

Rhythm?

Symptoms?

Treatment?

Answer 19

Ventricular Fibrillation

Unresponsive, pulseless, apneic

Tx: CPR, ACLS, Defibrillation, Epi, vasopressin

Question 20

How do ACE-inhibitor work?

Answer 20

They block the enzyme responsible for covering Angiotension-1 to Angiotensin-2. Resulting in Vasodilation and excretion of Sodium.

Question 21

What effects do Positive Inotropes have for treatment of chronic HF?

Answer 21

They increase the force of cardiac contraction They also decrease the HR Allows more complete emptying of the ventricles Reduces volume remaining in ventricle during diastole Increases CO

Question 22

Rhythm?

Symptoms?

Treatment?

Answer 22

Atrial Flutter

Saw toothed p-waves, HR: 75-175

Unstable: cardioversion

Stable: Beata blocker, Ca2+ channel blockers

Question 23

Rhythm?

Symptoms?

Treatment?

Answer 23

Sinus Tachycardia

HR 101-200 BMP

Remove underlying cause, IV beta blockers, Calcium channel blockers

Question 24

Identify # 5

Time?

Whats happening?

Answer 24

T wave

0.16

Time for ventricular repolarization

*should be upright*

Question 25

Why are Diuretics used in treatment for Chronic HF?

Answer 25

They reduce edema, pulmonary pressure, and preload

Question 26

What does Scientific Research indicate to the effects of [Hawthorn] ?

Answer 26

May increase effects of cardiac glycosides, antihypertensives, and cholesterol-lowering drugs.

Question 27

Identify # 4 Time? Whats happening?

Answer 27

ST segment 0.12 The time between ventricular depolarization and repolarization. \*should always be flat\*

Question 28

Why would ARB's be used for treatment: Chronic HF

Answer 28

Those that cannot tolerate ACE-inhibitors

Question 29

When is inotropic therapy recommended?

Answer 29

for short term management of patients with ADHF who have not responded to diuretics, ACE-inhibitors, Morphne

Question 30

Who would benefit from the use of Vasodilators Nitrates?

Answer 30

Patients who cannot tolerate Ace-inhibitors or ARB's And Management of myocardial ischemia related to HF

Question 31

Identify # 3 Time? Whats happening?

Answer 31

QRS Interval \<0.12 Time taken for contraction of both ventricles

Question 32

How is morphine used with the HF patient? Acute pt

Answer 32

Decreases preload and after load Dilates the pulmonary and systemic blood vessels, Decreases pulmonary pressure Decreases myocardial oxygen needs Improves gas exchange Relief from dyspnea and anxiety

Question 33

Name the Rhythm Range of BMP? Treatment?

Answer 33

Normal Sinus Rhythm BPM= 60-100 No Treatment needed

Question 34

How do beta-blockers work for treatment: Chronic HF

Answer 34

They block the negative effects of the Sympathetic nervous system. They reduce the effect of renin The reduce myocardial contractility

Question 35

Identify # 2 Time? Whats happening?

Answer 35

PR Interval 0.12-0.20 Time taken for the impulse to spread through the atria right before ventricular contraction.

Question 36

How do diuretics work? Acute

Answer 36

By decreasing sodium reabsorption within the nephron.