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FNP practice 2021-2022 > cardiac SM > Flashcards

cardiac SM Flashcards

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Family Nurse Practitioner (FNP) flashcards
1
Q

When ASCVD risk is >____, start a stain

A

7.5%

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2
Q

What is normal total cholesterol level? Triglycerides? HDL? LDL

A

<200
<150
40-60
<100

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3
Q

What are 2 high intensity statins?

A

Atorvastatin 40-80

Rosuvastatin 20-40

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4
Q

What are expected findings of a patient with high cholesterol levels?

A

arcus senilus

xanthelasma - younger (benign in elderly)

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5
Q

Go to treatment before medication?

A

lifestyle modifications

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6
Q

If you suspect rhabdomyolysis in a patient that is on a statin, what lab should you order? If you do not discontinue the statin, what may happen?

A

CK level
5x normal limit
acute renal failure

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7
Q

If a patient on a statin develops new jaundice, what do you suspect? What lab should you order?

A

acute drug induced hepatitis

liver function tests

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8
Q

What should a patient not ingest if they are taking a statin?

A

grapefruit juice

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9
Q

What differentiates rhabdomyolysis from acute drug-induced hepatitis?

A

rhabdo - MUSCLE PAIN

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10
Q

Triglycerides are >500, what should you start this patient on? What are we trying to prevent?

A

Fenofibrate

pancreatitis (>500 high risk)

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11
Q

What are 2 possible signs of necrotizing pancreatitis?

A

cullens and turners sign

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12
Q

When should you initiate treatment with JNC 8 guidelines? (>60 years, <60 or CKD, DM) Goal BP?

A

> 60 years >150/90
<60 years CKD, DM>140/90

Goal: <140/90

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13
Q

When should you initiate treatment with AHA/ACC guidelines?

A

<130/80

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14
Q

What herbal supplement is good for the heart?

A

Coenzyme 10 - CoQ10

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15
Q

What is our initial plan of attack for any new

hypertension patients?

A

lifestyle modifications

consider at home monitoring and follow up

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16
Q

What labs should be monitored for a patient taking ACE inhibitors?

A

renal function - BUN, creatinine, potassium

risk of hyperkalemia

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17
Q

What medication should be substituted for the patient that experienced angioedmea with ACE inhibitors?

A

ARB -sartan

ACE first - decrease CV events and mortality

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18
Q

Who should NOT be put on a thiazide diuretic? Who benefits the most from this medication?

A

Hyperglycemia
Uric acid
Hypertriglyceridemia

good - Osteoporosis

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19
Q

Who should NOT be put on a beta blocker?

A

not first line! (given after a MI)

NO COPD, asthma

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20
Q

Who should NOT be put on a calcium channel blocker?

A

GERD

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21
Q

What are common complaints of calcium channel blockers?

A

ankle edema

headaches

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22
Q

What 3 medications are SAFE for pregnancy?

A

New Little Momma

Nifedipine
Labetalol
Methyldopa

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23
Q

What are category X medications for pregnancy?

A

Statins
ACEi, ARBS
Dmards - methotrexate

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24
Q

Initiate blood pressure medications if a patient has an ASCVD risk of :

A

> 10%

hyperTENsion

25
Q

A “go-to” blood pressure medication for a patient with hypertension and diabetes? What should NOT be given to this patient?

A

ACE inhibitors and ARBs
kidney protection

Thiazides (increase glucose)

26
Q

What is isolated systolic hypertension? What is the preferred BP medication?

A

ISH - elderly, elevated systolic, normal diastolic, stiffened arteries
Calcium channel blockers

27
Q

__________ occurs when there are variances in heart rate upon inspiration and expiration. Who do you see this most commonly in? Do you need to intervene/treat?

A

Respiratory sinus arrhythmia

young and healthy athlete
NO

28
Q

Describe pulsus paradoxus. What is suspected with this?

A

There is a 10 point drop in systolic BP upon expiration

cardiac tamponade, status asthmaticus, etc

29
Q

What are initial diagnostic tests to determine if a patient has heart failure?

A

BNP
EKG
ECHO - ejection fraction is 40-50 <40% = HF

30
Q

What medications should a patient with heart failure be on?

A

diuretic

ACE or ARB

31
Q

What extra heart sound is heard with fluid overload?

A

S3

pregnancy is also S3 heart sound

32
Q

What OTC medications should a patient with heart failure avoid?

A

NSAIDS!!!!

increases sodium and fluid retention = exacerbation

33
Q

A patient with diabetes, heart failure, and hypertension. What medication would be good for this patient?

A

ACE inhibitor

maybe beta blocker

34
Q

When should a heart failure patient call you based on weight gain amount?

A

2Kg in one day

35
Q

What diabetic medication should be AVOIDED in the heart failure patient?

A

TZDs

36
Q

What 2 medications are atrial fibrillation patients on?

A

anticoagulant - aspirin, warfarin

Rate control - Metoprolol

37
Q

What is the goal INR for the patient on warfarin with atrial fibrillation? A patient with a stent?

A

Afib, DVT 2-3

stent: 2-2.5 or 2.5-3.5

38
Q

What is the antidote to Warfarin?

A

vitamin K

39
Q

The only heart sound heart at the base of the heart?

A

S2

40
Q

When is hearing a split S2 normal? When is it not normal? Where do you auscultate for a split S2?

A

split S2 during inspiration ONLY = normal
heard during inspiration and expiration = ABNORMAL
base

41
Q

When do you hear the S1 heart sound?

A

AV valves

closure of mitral and tricuspid

42
Q

When do you heart the S2 heart sound?

A

Semilunar valves

closure of aortic and pulmonic

43
Q

When do you hear S3 heart sound?

A

fluid overload

44
Q

When do you hear S4 heart sound?

A

uncontrolled HTN

LV hypertrophy

45
Q

What are the only murmurs that radiate?

A

systolic murmurs

46
Q

What is the mnemonic for diastolic murmurs?

A

MS. ARD
mitral stenosis
aortic regurgitation

47
Q

what is the mnemonic for systolic murmurs?

A

MR.PASS MVP
mitral regurgitation
aortic stenosis
mitral valve prolapse

48
Q

What murmur radiates to the axilla?

A

mitral Regurgitation

aRmpit

49
Q

What murmur radiates to the neck?

A

aortic stenosis

closer to the neck

50
Q

When is MVP common with a click sound?

A

Marfan syndrome

51
Q

What grade murmur do we feel a palpable thrill?

A

grade IV

52
Q

What are expected findings of peripheral arterial disease?

A

intermittent claudication (pain with walking)
shiny, purple shins without hair
decreased blood flow
ulcers on feet/toes

53
Q

What score of ABI indicates PAD?

A

<0.9

dividing BP in artery of ankle by BP in artery in arm

54
Q

What is the biggest risk factor of PAD?

A

smoking!

55
Q

What are expected signs and symptoms of chronic venous insufficiency?

A

reddish-brown discoloration of skin
varicose veins
Swelling/heaviness

56
Q

What are peoeple with Chronic venous insufficiency at risk for?

A

clots - DVT

57
Q

what are s/s of DVT? What is a diagnostic sign? What should be ordered?

A

Localized swelling with tenderness and warmth
Pain in calf, foot, or leg
Homan’s sign - not considered accurate anymore
DX: doppler

58
Q

What is raynaud’s phenomenon? Triggers? Treatment?

A

decreased blood flow to fingers
cold, stress
Tx: calcium channel blockers, avoid triggers

FNP practice 2021-2022 (19 decks)

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