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Pharmacology > EXAM 3 > Flashcards

EXAM 3 Flashcards

1
Q

What are the upper and lower parts of the heart called

A

Upper = Atrium
Lower = Ventricles

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2
Q

What type of blood does the right half of the heart receive? From where?

A

deoxygenated blood from the veins

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3
Q

What type of blood does the left half of the heart receive? From where?

A

oxygenated blood from the pulmonary artery, which directs blood into aorta

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4
Q

left sided vs right sided heart failure symptoms

A

left: affects the LUNGS
right: the REST of the body (edema)

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5
Q

Cardiac Cycle

A

beginning of one heartbeat to the beginning of the next heart beat

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6
Q

stages of cardiac cycle

A

atrial and ventricle diastole: chambers are relaxed and filling with blood
atrial systole: atria contraction and remaining blood is pushed into ventricles
ventricular systole: ventricle contract and push blood to though aorta and pulmonary artery

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7
Q

Startling’s Law

A

the contractile properties of the heart. the more the muscle is stretched, the stronger it will react until it is stretched to the point at which it will not react at all

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8
Q

what is systole

A

contraction of the heart

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9
Q

what is diastole

A

relaxation of the heart

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10
Q

Cardiac Conduction

A

SA Node: generates electrical signal to start heartbeat
signal travels to atria, causing contraction
AV Node: delays signal until atria is empty of blood.
signal travels though bundle of His to Pukinje fibers.
Purkinje fibers carry signal to ventricles causing contraction and blood pumping

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11
Q

Phases of Action Potential

A

Phase 0: cycle starts with a rapid depolarization
Phase 1: followed by a brief depolarization
Phase 2: sustained plateau phase
Phase 3: final depolarization
Phase 4: return to resting state

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12
Q

automaticity

A

cells in the heart can generate action potential without being excited or by external stimuli

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13
Q

Conductivity

A

specialized cells of the heart conduct impulses rapidly though the system, so muscle cells of the heart are stimulated at approx. the same time
- slowest in AV node
- fastest in Purkinje fibers

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14
Q

Circulation of Blood

A

superior/inferior vena cava, right atrium, tricuspid valve, right ventricle, pulmonary valve, pulmonary artery, lungs, left atrium, left ventricle, aorta, to the rest of the body

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15
Q

blood circulation (slides)

A

-blood enters through the right atrium
-deoxygenated blood returns to heart from venous system
-blood passes through tricuspid valve
-blood is pumped from right ventricle to lungs
-oxygenated blood enters the left atrium
-blood passes through mitral valve
-oxygenated blood is pumped into circulation

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16
Q

Pulmonary Circulation (heart/lung)

A
  • right side of the heart sends blood to the lungs
  • co2 and waste is removed from blood
  • o2 is picked up by red blood cells
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17
Q

Systemic Circulation

A
  • left side of the heart sends oxygenated blood out to all cells in the body
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18
Q

what is coronary circulation

A

flow of blood that is contained within the heart

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19
Q

forces that impact oxygen consumption

A
  • Heart rate = faster heart rate means more oxygen is needed
  • pre load = includes in blood return to the heart which causes the heart to work harder - congestive heart failure
  • after load = more resistance which means the heart must contract harder - hypertension
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20
Q

what is systemic arterial pressure

A

force exerted by blood on the walls of large arteries throughout the body

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21
Q

what are natriuretic peptides (BNP)

A

hormones that help regulate blood pressure and blood volume

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22
Q

Renin-Antiotensis-Aldosterone-System

A

process the body uses to control blood pressure
- ace inhibitors

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23
Q

what is venous pressure

A

pressure of blood in veins or the heart’s atria

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24
Q

when does heart failure occur

A

when the heart can’t pump enough blood to the body

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25
stages of heart failure
Stage A: high risk for heart failure but no structural heart disease or symptoms Stage B: structural heart disease but no signs or symptoms Stage C: structural heart disease with prior or no current symptoms Stage D: refractory heart failure requiring specialized interventions
26
classes of heart failure
Class I: no limitation of physical activity Class II: slight limitation of physical activity Class III: marked limitation of physical activity Class IV: unable to perform any physical activity without symptoms, or symptoms at rest
27
signs and symptoms of heart failure
-shortness of breath, especially at night -chest pain -fatigue -swelling in ankles, legs, and abdomen -weight gain -coughing up white or pink, foamy mucus
28
what is an arrhythmia
change to the automaticity or conductivity of the heart cells
29
Class 1a antiarrhythmic agents
Procainamide
30
Class 1b antiarrhythmic agents
Lidocaine
31
Class 1c antiarrhythmic agents
Flecainide
32
Class II antiarrhythmic agents
Proproanolol
33
Class III antiarrhythmic agents
Amiodarone
34
Class IV antiarrhythmic agents
Diltiazem
35
other antiarrhythmic agents
Adenosine, digoxin
36
unmodifiable vs modifiable risk factors for artheosclerotic cardiovascular disease
unmodifiable: age, sex, genetic disposition modifiable: cigarette smoking, sedentary lifestyle, unhealthy diet, high stress, obesity, diabetes
37
where are lipoproteins produced
in the liver
38
what are different lipoproteins and what are they considered
VLDL: considered "bad" cholesterol because high levels can contribute to clogged arteries IDL: considered "repentant" of VLDL after some fat has been used up by the body and can be processed into LDL LDL: "bad cholesterol" because it carries cholesterol throughout the body and can build up in your arteries causing plaque buildup and increase risk for heart disease HDL: "good" cholesterol because higher levels are associated with a lower risk of heart disease and stroke
39
what is hyperlipidemia and what causes it
high levels of lipids in the blood that is caused by poor diet and genetic disposition
40
medications that are Bile Acid Sequesterants
colesevelam (Welchol)
41
medications that are HMC-CoA Reductase Inhibitors
atorvastatin (Lipitor), simvastatin (Zocor) statins
42
medications that are Cholesterol Absorption Inhibitors
ezetimibe (Zetia)
43
medications that are Fibrates
gemfibrozil (Lopid)
44
what is hemostasis
created by protective mechanisms to prevent excess blood loss though: - vascular constriction - formation of the platelet plug - activation of coagulation cascade - formation of a blood clot
45
dysfunction of hemostasis
thrombosis and bleeding
46
what are coagulation pathways
intrinsic pathway, extrinsic pathway, common clotting pathway
47
what initiates the intrinsic pathway
when the blood contacts a negatively charged surface like exposed collaged in a damaged vessel, activating factor XII (internal damage to blood vessels)
48
what initiates the extrinsic pathway
the tissue factor (released from damaged cells) - rapid response: primary mechanism for quick clot formation when there is significant injury
49
what initiates the common clotting pathway
activated by either the extrinsic or intrinsic pathway - the pathway is marks the meeting of the intrinsic and extrinsic pathways
50
what are blood coagulation disorders
thromboembolic disorders and hemorrhagic disorders
51
what are thromboembolic disorders
involve the formation of thrombi resulting in decreased blood flow or total occlusion of a blood vessel. - sickle cell
52
what are hemorrhagic disorders
excessive bleeding
53
what are anitplatelet drugs and what do they do
alter platelet aggregation and formation of platelet plug - clopidogrel (Plavix)
54
what are anticoagulant drugs and what do they do
interfere with clotting cascade and thrombin formation -enoxaparin (Lovenox), Heparin, Warfarin, rivaroxaban (Xalerlato), apixiaban (Eliquis)
55
what are thrombolytic drugs and what do they do
break down the thrombus that has been formed by stimulating the plasmin system (break down clots) - alteplase (Activase)
56
what are the components of blood
plasma: liquid part of blood that is mostly water and contains proteins that are essential for immune response and clotting formed elements of blood : - leukocytes( (WBCs) - erythrocytes (RBCs) - platelets
57
what is erythropoiesis
the process of producing red blood cells in the bone marrow and is controlled by the body's need for oxygen
58
how do you produce healthy red blood cells
adequate iron, minute amounts. of vitamin b12 and folic acid, essential amino acids and carbohydrates
59
types of anemia
Iron deficiency anemia: negative iron balance megaloblastic anemia: folic acid or vitamin b12 anemia, pernicious anemia hemolytic anemia: sickle cell disease, thalassemia
60
iron deficiency anemia common problems
-menstruating people who lose RBCs monthly - pregnant and lactating people who have increased demands for iron -rapid growing adolescents, especially those without a nutritious diet
61
megaloblastic anemia
folate deficiency - malnutrition that accompanies alcoholism - repeated pregnancies vitamin
62
what does a pacemaker compensate for
dysfunction of the SA node
63
characteristic to describe cardiac cells performance
spontaneously generate action potential
64
how to calculate pulse pressure
substract systole minus diastole
65
if a pt has bp of 161/106, how does the nurse explain how the bp will affect the cardiac workload
increased afterflow
66
what area of the heart controls heart rate
SA node
67
alterations in conduction of impulses in the SA node - what is the most likely finding
Dysarrythimas
68
Coronary artery diseases disables what process that controls blood pressure
ability of arterials to increase or decrease resistance
69
if a patient as a myocardial infarction what layer of the heart is being damaged
myocardium
70
patient has decreased blood flow to kidney and bp is 150/100 - what causes this
release of renin
71
what arrhythmia is the nurses highest priority
v-fib
72
why is the left ventricle larder than the right ventricle
left ventricle has to pump blood through the entire body
73
if BP is low due to shock and vasodilation of blood vessels - ho will this affect preload
preload will decrease
74
if a pt is taking lisinopril to help w hypertension - what changes ma ferule in a need for change in drug therapy
decrease in renin clearance
75
when taking an ace inhibitor - what client related variable should be considered
sweating
76
if a pt is prescribed losartan - what will be added for better control of hypertension
a diuretic
77
what lab values should be checked for a pt on spirolactone
serum potassium

Pharmacology (8 decks)

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