CARDIOVASCULAR Flashcards
Your patient has a history of coagulopathy and is about to go to surgery. Which order is appropriate for DVT/Bleeding prophylaxis?
Pneumatic stockings
Which of the following is least likely to experience a DVT?
58 Y M liver patient
The nurse calls you to report low BP in a CHF patient on the unit. You have IVF ordered, and the cardiologist has ordered Lasix.
D/C the Lasix
You are assessing heart sounds pre-operatively and hear a classic “aortic stenosis” type murmur, as well as a carotid bruit. There are no neurological symptoms. What should you order first?
Echocardiogram
Which of the following is contraindicated for a patient receiving a renal angiogram?
Ace Inhibitor
Your 45M patient has new onset Atrial Fibrillation, but no other past medical history. What should you prescribe?
ASA (young with no risk factors/history)
Which is best used to diagnose pulmonary HTN?
2D ECHO (confirmed by cardiac cath)
Your patient has overdosed on Lopressor. It has been 5-6 hours. What do you order?
Glucagon and Atropine
Your pt is pre-operative for an elective surgery. You notice a pulsating mass in the mid abdomen (AAA). What is next action?
Order abdominal U/S
Your patient is post-op after an aneurysm clipping. Which intervention is used?
Place pt in a quiet room
Your 67 yr old pt has a BP of 168/92. On her second visit her BP is 158/88. What is your initial Tx plan?
Teach lifestyle changes
Normal HDL
40-60
Normal LDL
100 mg/dL or less
Normal Triglycerides
150 md/dL or less
Normal total cholesterol
180 to 200
Your patient is an obese 38 F with the following fasting lipid panel: TC 270, LDL 168, HDL 28. What is your action?
Start a statin (key word is obese)
Which med must be on the d/c list of a patient admitted for CHF?
Lisinopril-ACE
31 yo M with a blowing murmur occurring during S1 and galloping addition heart sound. Murmur is heard best at the base of the heart. What is the murmur?
Mitral Regurgitation
When d/c an 85F pt w/stasis dermatitis, the NP includes instructions to:
keep legs elevated while seated.
A 70-year-old patient with acute systolic HF denies any functional limitations, is able to walk five blocks before tiring, and is euvolemic. Which medication is the first-line therapy for this patient?
Lisinopril (Zestril).
A patient with HF has DOE and sleeps all night while using 3 pillows. What is her NYHA HF stage?
Stage III
Treatment 2nd type 2 or Complete/3rd degree block
Tx transcutaneous pacing, venous if can’t capture, atropine if very symptomatic, plan for pacemaker. d/c AV-nodal blocking drugs
Pt had an EF of 20 and bronchospasm-what med caused it?
Beta Blocker
Hypertensive Emergency
220/120 (Urgency is 180/110)
Treat Afib
check TSH (for hyperthyroid), Tx with beta blocker
What grade murmur do /you first hear a thrill
4 (listed on test as IV)
On physical exam, you note a mod. Loud MM with no thrill. What grade?
3
Pt has low diastolic rumble murmur in the left lateral position with no radiation
Mitral stenosis
Pt presents with suspected mitral regurg. What physical findings would confirm?
S3 systolic murmur
Heart problems with RA
tricuspid regurgitation
Pt w/Hx of HF or PRBCs, wet LS, LE edema, dyspnea- cause of edema:
increased hydrostatic capillary pressure.
What is the purpose of cardiac stress testing?
Differentiate ischemia vs infarction
STEMI guidelines
“door to needle” 30 minutes “door to balloon” 90 minutes
Pt is post-MI, on a beta blocker and statin. What do they need?
ACE-I
HTN + DM
ACEi
Which drug prevents cardiac remodeling
ACEi (double checked this. Beta blockers also possibly prevent remodeling)
Pt w/ 14 hrs of CP presents to the ED. next step of action?
Take to cath lab (fibrinolytic therapy 6° window is closed)
Pericarditis
pt with normal CXR, low grade temp, elevation in all leads- best diagnostic test- echo, send home on NSAIDS, -risk for what: tamponade
A pt post CABG with abd distention, labs provided, diagnosis?
Dx = mesenteric infarct (one RF is cardiac surgery)
Gerontology and cardiac problems
Cardiomegaly
Treatment for CVI: Venous status ulcer
use compression stocking
How pt w/ DM and ♥dz decrease LDL non-pharm?
Diet and exercise, lifestyle changes
Temporal arteritis requires immediate Tx in order to prevent what
blindness in the affected eye.
Pt in the ER with sudden LOC and motor function. The ER dx TIA. The pt has right-handed weakness and numbness. Carotid studies are completed and revel 92-95% occlusion bilaterally. What is next step?
Patient to have left carotid explored first followed by the right one at a later date
62 yo M presents with angina after his daily walk. Lipid panel reveals LDL 250, HDL 25, chol 350 and triglycerides 250. You prescribe niacin. How would you explain the mechanism of action to the pt?
Niacin lowers LDL and increases HDL
