CHF

Question 1

Stable CHF: IG

Answer 1

electrolytes
Blood urea nitrogen (BUN)
Cardiac biomarkers
CBC
peripheral perfusion
Cough/sputum production
Brain natriuretic peptide (BNP)
CXR
12 lead ECG
Echocardiogram

Question 2

Stable CHF ECG shows ST depression, what do you order?

Answer 2

Stress test
Cardiac catheterization
CTA

Question 3

Assess for pulmonary edema

Answer 3

Peripheral perfusion
Frothy pink secretions
Breath sounds
Chest pain
SpO2 monitoring
CXR
Cardiac bio markers
Echocardiogram
NO PA CATHETER UNLESS NEEDED FOR DX

Question 4

Treatment/DM for stable CHF

Answer 4

Disease management education
Sodium and fluid restriction
Smoking cessation
Monitor BP, weight control, moderate aerobic exercise

Question 5

Medications for DM in stable CHF

Answer 5

ACE inhibitor
Angiotensin receptor blocker
Beta blocker
Digoxin
Loop diuretic
Aldosterone antagonist

Question 6

Managing decompensation/pulmonary edema

Answer 6

O2 therapy via NRB/HFC SpO2 >90%
CPAP/BiPAP with 100%
Morphine or benzo

Question 7

Meds for non hypotensive decompensation/pulmonary edema

Answer 7

Vasodilator (nitroglycerin, sodium nitroprusside, nesiritide)
Loop diuretic (furosemide, torsemide)

Question 8

Meds for hypotensive decompensation/pulmonary edema

Answer 8

Inotropic agent (dobutamine)

Question 9

Acute MI with persistent hypotension/pulmonary edema

Answer 9

Intra-aortic ballon pump until angioplasty or cardiac surgery