Heart Failure Flashcards by Shaquan Moore

Q

Digoxin

VASOPRESSORS/SHOCK, Cardiac Glycoside, Inodilator

A

Cardiac Glycoside

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Q

Milrinone

VASOPRESSORS/SHOCK, Cardiac Glycoside, Inodilator

A

Inodilator

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Q

Dopamine

VASOPRESSORS/SHOCK, Cardiac Glycoside, Inodilator

A

VASOPRESSORS/SHOCK

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Q

Cardiac Remodeling

Ventricles constrict, hypotrophy, fibrosis, become spherical
or
Ventricles dilate, hypertrophy, fibrosis, become spherical

A

Ventricles dilate, hypertrophy, fibrosis, become spherical

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Q

Cardiac Remodeling

◦Increase wall stress and reduce EF
or
◦Decrease wall stress and induce EF

A

◦Increase wall stress and reduce EF

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Q

Cardiac Remodeling

UNDERACTIVE Sympathetic Nervous System (SNS)
or
OVERACTIVE Sympathetic Nervous System (SNS)

A

OVERACTIVE Sympathetic Nervous System (SNS)

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Q

Cardiac Remodeling

OVERACTIVE Renin Angiotensin Aldosterone (RAAS)
UNDERACTIVE Renin Angiotensin Aldosterone (RAAS)

A

OVERACTIVE Renin Angiotensin Aldosterone (RAAS)

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Q

Cardiac Remodling

Baroreceptor?

desensitization or sensitization

A

desensitization

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Q

Called water pills, are medications designed to increase the amount of water and salt expelled from the body as urine.

Epinephrine or Diuretic

A

Diuretic

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Q

stable/chronic/controlled/home

Decompensated Heart Failure
or
Compensated Heart Failure

A

Compensated Heart Failure

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Q

acute/hospitalization/uncontrolled

Decompensated Heart Failure
or
Compensated Heart Failure

A

Decompensated Heart Failure

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Q

Medications designed to prevent worsening

Decompensated Heart Failure
or
Compensated Heart Failure

A

Compensated Heart Failure

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Q

heart failure exacerbation

Decompensated Heart Failure
or
Compensated Heart Failure

A

Decompensated Heart Failure

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Q

Diuretics•Vasodilators

Decompensated Heart Failure
or
Compensated Heart Failure

A

Decompensated Heart Failure

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Q

Inotropic Support•Kidneys>Heart

Decompensated Heart Failure
or
Compensated Heart Failure

A

Decompensated Heart Failure

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Q

Cardiac Muscle, Contractility

CHRONOTROPIC, INOTROPIC, DROMOTROPIC

A

INOTROPIC

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Q

SA Node, Heart rate

CHRONOTROPIC, INOTROPIC, DROMOTROPIC

A

CHRONOTROPIC

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Q

Conduction Velocity

CHRONOTROPIC, INOTROPIC, DROMOTROPIC

A

DROMOTROPIC

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Q

AV node ,bundle of His, Purkinje Fibers

CHRONOTROPIC, INOTROPIC, DROMOTROPIC

A

DROMOTROPIC

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Q

+ increase/ - Decrease the FORCE of myocardial contraction (STRENGTH)

CHRONOTROPIC, INOTROPIC, DROMOTROPIC

A

INOTROPIC

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Q

+ increase/ - Decrease the RATE of the heart beat

CHRONOTROPIC, INOTROPIC, DROMOTROPIC

A

CHRONOTROPIC

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Q

+ increases/ - Decrease CONDUCTION of electrical impulses

CHRONOTROPIC, INOTROPIC, DROMOTROPIC

A

DROMOTROPIC

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Q

Furosemide

Beta Blockers, Aldosterone Antagonists, Loop Diuretics, ACE-Inhibitors/ARBS

A

Loop Diuretics

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Q

Carvedilol

Beta Blockers, Aldosterone Antagonists, Loop Diuretics, ACE-Inhibitors/ARBS

A

Beta Blockers

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Lisinopril Beta Blockers, Aldosterone Antagonists, Loop Diuretics, ACE-Inhibitors/ARBS

ACE-Inhibitors/ARBS

Spironolactone Beta Blockers, Aldosterone Antagonists, Loop Diuretics, ACE-Inhibitors/ARBS

Aldosterone Antagonists

Eplerenone Beta Blockers, Aldosterone Antagonists, Loop Diuretics, ACE-Inhibitors/ARBS

Aldosterone Antagonists

Valsartan Beta Blockers, Aldosterone Antagonists, Loop Diuretics, ACE-Inhibitors/ARBS

ACE-Inhibitors/ARBS

Increase Sympathetic and RAAS Activity 2 Carvedilol, Furosemide, Lisinopril, Spironolactone Valsartan, Eplerenone Beta Blockers, Aldosterone Antagonists, Loop Diuretics, ACE-Inhibitors/ARBS

Beta Blockers' Carvedilol ACE-Inhibitors/ARBS Lisinopril Valsartan

Sodium or water retention Carvedilol, Furosemide, Lisinopril, Spironolactone Valsartan, Eplerenone Beta Blockers, Aldosterone Antagonists, Loop Diuretics, ACE-Inhibitors/ARBS

Loop Diuretics | Furosemide

Failure to escape from aldorsterone Carvedilol, Furosemide, Lisinopril, Spironolactone Valsartan, Eplerenone Beta Blockers, Aldosterone Antagonists, Loop Diuretics, ACE-Inhibitors/ARBS

Aldosterone Antagonists Spironolactone Eplerenone

treats Heart Failure? Inodilator, Cardiac Glycoside, VASOPRESSORS/SHOCK Digoxin, Dopamine, Milrinone,

Cardiac Glycoside | Digoxin

Treats Atrial Fibrillation Inodilator, Cardiac Glycoside, VASOPRESSORS/SHOCK Digoxin, Dopamine, Milrinone,

Cardiac Glycoside | Digoxin

Cardiac Glycosides: Digoxin + increase or - Decrease the FORCE of myocardial contraction (STRENGTH) CHRONOTROPIC, INOTROPIC, DROMOTROPIC

+ INOTROPIC | + increase the FORCE of myocardial contraction (STRENGTH)

Cardiac Glycosides: Digoxin + increase or - Decrease the RATE of the heart beat CHRONOTROPIC, INOTROPIC, DROMOTROPIC

- CHRONOTROPIC | Decrease the RATE of the heart beat

Cardiac Glycosides: Digoxin + increases or - Decrease CONDUCTION of electrical impulses CHRONOTROPIC, INOTROPIC, DROMOTROPIC

DROMOTROPIC | Decrease CONDUCTION of electrical impulses

Cardiac Glycosides: Digoxin Blocking the Na+/K+ ATPase pump CHRONOTROPIC, INOTROPIC, DROMOTROPIC

+INOTROPIC

Cardiac Glycosides: Digoxin Parasympathomimetic (causes vagal stimulation) and also increases baroreceptor sensitivity CHRONOTROPIC, INOTROPIC, DROMOTROPIC

-CHRONOTROPIC

Cardiac Glycosides: Digoxin Cholinergic activation in atria (AV node), less at Purkinje CHRONOTROPIC, INOTROPIC, DROMOTROPIC

-DROMOTROPIC

Cardiac Glycosides: Digoxin (Improved/ Declined) Cardiac Output and (Increased / Decreased) Renal Perfusion= (Increased / Decreased) Urine Production and (increased / decreased) RAAS activation

Improved Increased Increased decreased

What do a nurse to check before giving Digoxin Heart rate, Blood pressure, or Both Sodium, Magnesium, Cholesterol, Calcium, Potassium, Cortisol Digoxin level or no?

Heart Rate Potassium Yes Dig Levels to avoid tox

Cardiac Glycosides: Digoxin MOA Digoxin competes with ? Calcium, Sodium, or Potassium

Potassium

Cardiac Glycosides: Digoxin MOA Since Digoxin and Potassium competes with other ranges needs to be normal to avoid Dig Tox? Sodium, Magnesium, Cholesterol, Calcium, Potassium, Cortisol

Magnesium Calcium Potassium

Cardiac Glycosides: Digoxin MOA Which results in Dig Tox? (Hyper/ Hypo- kalema,) (Hyper / Hyper - magnesemia,) (Hyper / Hypo - calcemia)

HypoKalema HypoMagnesemia HyperCalcemia

Cardiac Glycosides: Digoxin MOA What are Dig Tox Effects Heart, Muscles, Balancing, GI, GU, CNS, SNS

Heart GI CNS

disturbance to an otherwise normal rhythm arrhythmia, dysrhythmia

dysrhythmia

irregular heartbeat arrhythmia, dysrhythmia

arrhythmia

A fast heart rhythm with a rate of more than 100 beats per minute Bradycardia , Tachycardia

Tachycardia

A slow heart rhythm with a rate below 60 beats per minute. Bradycardia , Tachycardia

Bradycardia

Cardiac Glycosides: Digoxin Tox Effect Heart- arrhythmia or dysrhythmia Bradycardia , Tachycardia

dysrhythmia | Bradycardia

Cardiac Glycosides: Digoxin Tox Effect Heart- Can potassium be hyperkalemia or Hypokalemia or both . If both which is the main concern?

Both | Hypokalemia

Cardiac Glycosides: Digoxin Tox Effect GI- ``` Constipation Diarrhea Vomiting Heartburn Nausea Abdominal Pain Anorexia ```

Vomiting Nausea Anorexia

Cardiac Glycosides: Digoxin Tox Effect CNS related- ``` Severe headaches. Strokes Confusion Blurred vision Weakness. Vision disturbances Seizures Fatigue ```

Confusion Vision disturbances Fatigue Blurred vision

Cardiac Glycosides: Digoxin Tox Effect With Vision disturbances- (yellow or pink) tint, "Melos or Halos)

Yellow tint | Halos

Cardiac Glycosides: Digoxin Tox Effect | Can Digoxin could cause weight gain or loss?

Weight Loss

Cardiac Glycosides: Digoxin Digoxin Normal range= 0.5- 1 ng/ml, 0.5 -2 ng/ml, 0.5 - 3 ng/ml

0.5 - 2 ng/ml

Cardiac Glycosides: Digoxin If Digoxin level are tox is there an antedote? Yes or No

Yes

Cardiac Glycosides: Digoxin - Which is the Antedote? Digifind ®- Digoxin unspecific Antibody Fab fragments Digibind ®- Digoxin specific Antibody Fab fragments Digibind ®- Digoxin unspecific Antibody Fab fragments Digifind ®- Digoxin specific Antibody Fab fragments

Digibind ®- Digoxin specific Antibody Fab fragments

Cardiac Glycosides: Digoxin - Diuretics Is it true that patient who have heart failure are on Diuretics. Yes or No

Yes

Cardiac Glycosides: Digoxin - Diuretics Low potassium will (Increase or Decrease) the risk for digoxin to (induced or inhibit) dysrhythmias

Increase | induce

Cardiac Glycosides: Digoxin - ACE-Inhibitors/ARBs increase K+ and (increase or decrease) digoxin response

Decrease

Cardiac Glycosides: Digoxin - Drugs/ Food Binding Bile Acid Sequestrants- ? Kayexalate, Cholestyramine,

Cholestyramine

Cardiac Glycosides: Digoxin - Drugs/ Food Binding Sodium Polystyrene Sulfate- Potassium Binder Kayexalate, Cholestyramine,

Kayexalate

Cardiac Glycosides: Digoxin - Drugs/ Food Binding Kayexalate? Bile Acid Sequestrants, Sodium Polystyrene Sulfate- Potassium Binder

Sodium Polystyrene Sulfate- Potassium Binder

Cardiac Glycosides: Digoxin - Drugs/ Food Binding Do Digoxin bind to ? Low fiber food (peaches ) or High fiber food (bran)

High fiber food - Bran

Cardiac Glycosides: Digoxin - Pharmacokinetics Digoxin requires adjustment in (Hepatic or Renal) impairment?

Renal Kidneys

Digoxin eliminates through Hepatic or Renal system

Renal Kidneys

What are the normal potassium levels? 2.5 - 5 mEq/L, 3.5 -4 mEq/L, 3.5 -5 mEq/L

3.5 -5 mEq/L

Cardiac Glycosides: Digoxin - Nursing Considerations a. Nurses should assess heart rate after administration b. Educate patients to check their pulse at home after use c. Normal range (60-100 bpm) d. Notify provider if HR>60 e. Notify provider if patient has palpitations f. Should see improved Urine Output (>30ml/hr)

c. e. f. A.. Before B. Before d. <60

Feel in the blank? If ? lb weight gain in 1 day OR ? lb in 1 week Need to notify provider (developing fluid overload)

2 | 5

Which is a Phosphodiesterase 3 Inhibitor Inodilator, Cardiac Glycoside, VASOPRESSORS/SHOCK Digoxin, Dopamine, Milrinone,

Milrinone - Inodilator

Which 3 drugs are a Positive Inotropic Agents Inodilator, Cardiac Glycoside, VASOPRESSORS/SHOCK Digoxin, Dopamine, Milrinone,

Milrinone - Inodilator | Dopamine- VASOPRESSORS/SHOCK

Which deals with PDE3, PDE$, PDE5 Inodilator, Cardiac Glycoside, VASOPRESSORS/SHOCK Digoxin, Dopamine, Milrinone,

Milrinone- Inodilator

Milrinone- Inodilator PDE4 CHF, COPD- Theophylline, PENIS- Erectile Dysfunction

COPD- Theophylline

Milrinone- Inodilator PDE3- CHF, COPD- Theophylline, PENIS- Erectile Dysfunction

CHF

Milrinone- Inodilator PDE5 CHF, COPD- Theophylline, PENIS- Erectile Dysfunction

PENIS- Erectile Dysfunction

Milrinone- Inodilator Sildenafil/Tadalafil PDE3, PDE4, PDE5,

PDE5

Milrinone- Inodilator NITRATES can be mixed with? PDE3, PDE4, PDE5,

PDE5

Severe, decompensated HF (late stages) Bridge to await a heart transplant Palliative therapy Inodilator, Cardiac Glycoside, VASOPRESSORS/SHOCK Digoxin, Dopamine, Milrinone,

Milrinone- Inodilator

VASODILATOR AND POSITIVE INOTROPIC AGENT Inodilator, Cardiac Glycoside, VASOPRESSORS/SHOCK Digoxin, Dopamine, Milrinone,

Milrinone- Inodilator

Adverse side effect ? dysrhythmias (ventricular)- pushing the heart hard! Hypotension Inodilator, Cardiac Glycoside, VASOPRESSORS/SHOCK Digoxin, Dopamine, Milrinone,

Milrinone- Inodilator

CONTRA-INDICATIONS: Can’t use if MI or dysrhythmia Inodilator, Cardiac Glycoside, VASOPRESSORS/SHOCK Digoxin, Dopamine, Milrinone,

Milrinone- Inodilator

What do a nurse to check before giving Milrinone Heart rate, Blood pressure, or Both

Blood pressure

Which is IV continuous drip Inodilator, Cardiac Glycoside, VASOPRESSORS/SHOCK Digoxin, Dopamine, Milrinone,

Milrinone- Inodilator | Dopamine- VASOPRESSORS/SHOCK

Which is used in the late stages of heart failure Inodilator, Cardiac Glycoside, VASOPRESSORS/SHOCK Digoxin, Dopamine, Milrinone,

Milrinone- Inodilator | Dopamine- VASOPRESSORS/SHOCK

Which is Hemodynamic Support Inotropic Support for Heart Failure Inodilator, Cardiac Glycoside, VASOPRESSORS/SHOCK Digoxin, Dopamine, Milrinone,

Dopamine- VASOPRESSORS/SHOCK

Dopamine- VASOPRESSORS/SHOCK DA Renal perfusion (oxygenate kidneys= inc urine output) Moderate, Low, High

Low

Dopamine- VASOPRESSORS/SHOCK (DA+Beta1+Alpha1) (improved blood pressure) Moderate, Low, High

High

Dopamine- VASOPRESSORS/SHOCK Beta (DA+Beta1) (Cardiac Output) Moderate, Low, High

Moderate

Adverse side effect ? dysrhythmias (ventricular)- pushing the heart hard! Hypertension Inodilator, Cardiac Glycoside, VASOPRESSORS/SHOCK Digoxin, Dopamine, Milrinone,

Dopamine- VASOPRESSORS/SHOCK

Which has the following Nursing conderations? DA- urine output, improvement of the AKI/ARF (SCr/BUN down) Inodilator, Cardiac Glycoside, VASOPRESSORS/SHOCK Digoxin, Dopamine, Milrinone,

Dopamine- VASOPRESSORS/SHOCK

Which has the following Nursing conderations? Beta- inotropic support Inodilator, Cardiac Glycoside, VASOPRESSORS/SHOCK Digoxin, Dopamine, Milrinone,

Dopamine- VASOPRESSORS/SHOCK

Which has the following Nursing conderations? Alpha- BP Inodilator, Cardiac Glycoside, VASOPRESSORS/SHOCK Digoxin, Dopamine, Milrinone,

Dopamine- VASOPRESSORS/SHOCK