Drugs for HF, Angina & MI Flashcards
Which side of the heart is the venous side of the heart?
Right
Which side is the arterial side of the heart?
Left
What structures help move blood in the venous system against gravity?
Valves
Skeletal muscles
What pressure (+/-) is in the right atrium?
negative
How does the heart get oxygen & nutrients?
coronary arteries
Where do the coronary arteries originate?
root of the aorta
What affects the oxygen demand of the heart?
Cardiac workload
What happens when the heart is hypoxic?
angina (chest pain)
What is a syndrome?
Condition with a set of characteristic symptoms
What is an example of a progressive heart syndrome?
heart failure
Heart failure usually can be cured. T or F
False
What is the goal caring for patients with heart failure?
Treat the symptoms to maximize quality of life
What regulates the heart?
sympathetic & parasympathetic branches of the autonomic nervous system
Which branch of the autonomic nervous system predominates heart regulation?
parasympathetic nervous system
What CN regulates the heart rate?
Vagus nerve (CNX)
What is hemoptysis?
Coughing up blood-tinged sputum
What hormone does the body secrete to compensate during heart failure?
ADH
What are the compensatory mechanisms of the heart?
Cardiac dialation & cardiac hypertrophy
What compensatory mechanism of the heart comes first?
Cardiac dialation
What is cardiac dialation?
widening of the heart chambers
What is cardiac hypertrophy?
thickening of the heart muscle walls
What is pre-load?
Volume of blood filling chambers during
What is after-load?
Diameter of the arteries that the heart has to pump against
What drugs decrease pre-load?
diuretics
What drugs decrease after load?
B Blockers, ACE inhibitors, ARBs, Ca Channel blockers
What is the most common cause of heart failure?
Coronary artery disease
What are the main diseases that accelerate HF progression?
CAD
MI
mitral stenosis
dyslipidemia
chronic HTN
DM
What are the NYHA classes of heart failure?
Class I-IV
What are s/s of Class I HF?
Asymptomatic (still tolerates usual activity)
What are s/s of Class II HF?
Mild symptoms (slight SOB and decreased tolerance in usual activity)
What are s/s of Class II HF?
Marked limitations (Peripherial edema, SOB with minimal activity)
May start on oxygen
What are s/s of Class IV / end-stage HF?
Severe limitations (fatigue, SOB, edema at rest)
What are the AHA stages of HF?
Stages A-D
What is stage
What do positive inotropic drugs do?
increase cardiac contractility
What do negative chronotropic drugs do?
decrease HR
What are the usualy goals of HF meds?
positive inotropic and negative chronotropic
How can HF be measured?
ejection fraction
What is a normal ejection fraction?
50-65%
How does efficacy of HF management measured?
ejection fraction changes
S/S (overall quality of life) changes
number of hospital admissions
What types of B Blockers are used to manage HF?
cardio selective B Blocker
When would diuretics be given to a patient with HF?
If pt has edema, cardiac dialation, and or in stage C of HF
When would a patient with HF get thiazide diuretics?
GFR is high
When would a patient with HG get loop diuretics?
GFR is low
When would a patient with HF get aldosterone antagonist diuretics?
If hypoKalemic
What should the nurse expect to give in end-stage HF pt anxious d/t SOB?
morphine
What is angina?
CP d/t O2 supply is < heart O2 demand
What influences heart O2 demand?
Cardiac muscle contractility
Heart rate
What is the first safest option for angina? (increase O2 supply or decrease O2 demand)
increase O2 supply
What does decreasing O2 demand put the pt at risk for?
HF
What happens during CAD?
Artheriosclerosis of
What is ischemia
Lack of O2 perfused to a tissue
What is a symptom of cardiac ischemia?
angina
What eventually happens to untreated ischemia of a tissue?
necrosis (death) of tissue
What are the types of CAD lesions?
stenotic & non-stenotic
Describe stenotic lesions
Less common
Fibrotic & stiff
Describe non-stenotic lesions.
More common
thin cap between vessel wall and space
What is the most important test to do to differentiate angina from active MI?
EKG
What is a sign of ischemia on the EKG?
saggy ST waves
What is a sign of MI on an EKG?
STEMI (ST elevation)
What indicates acute MI?
STEMI on EKG & Cardiac markers
What indicates unstable angina?
NSTEMI on EKG & angina @ rest
What are types of acute coronary syndrome?
acute MI & unstable angina
What happens with stable angina?
Agina relieved with rest
What happens with variable angina?
Coronary arteries spasm d/t nicotine, illicit drugs, extreme cold
What is mainly used to open up arteries (and veins)?
nitroglycerin