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fnp exam 3 Flashcards

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Family Nurse Practitioner (FNP) flashcards
1
Q

which side of the heart has higher pressure and more muscle to pump to the body?

A

left side of heart

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2
Q

what do the coronary vessels do?

A

provide oxygenation to the heart muscle

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3
Q

arteries carry blood ____ from the heart and are filled with _____ blood (what is the one exception?)

A

away, oxygen
pulmunary artery carries DEOXYGENATED blood to the lungs

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4
Q

veins carry blood _____ the heart and carry ______ blood (what is the one exception?)

A

to, deoxygenated
pulmonary vein carries oxygen rich blood from the lungs to the heart

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5
Q

what and where is the SA node?

A

Natural pacemaker of the heart located in the right atrium

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6
Q

What does the AV node do?

A

delays conduction to allow ventricles to fill with blood on systole

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7
Q

What do the bundle of HIS/Purkinjie fibers do?

A

carry signal through the ventricles

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8
Q

Starlings Law (in a healthy person)

A

the more volume in the ventricles before contraction, the higher the stroke volume. this is because the ventricles will be stretched and “bounce back” more forcefully

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9
Q

classic ischemic or MI-related chest pain symptoms

A

pressure, tightness, or squeezing

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10
Q

what EKG changes should trigger immediate ER referral?

A

ST-segment changes, new-onset left bundle branch block, presence of Q waves, ST elevations

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11
Q

what symptoms should be sent to the ER?

A

nausea, dizziness, sweating, shortness of breath, pain radiating to the jaw or arm, crushing chest pressure

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12
Q

MICE criteria for possible HF

A

Male
Infarction history (MI)
Crepitations
Edema in ankles

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13
Q

Acute MI labs and normal values

A

CK-MB normal 0.24 IU/L
Myoglobin normal 50-85 ng/mL
Troponin 0-0.5 ng/mL

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14
Q

Stable angina definition

A

predictable and consistent pain on exertion lasting around 5-10 minutes

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15
Q

unstable angina definition

A

less frequent, lasts longer than 20 minutes

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16
Q

Variant/Prinzmetal Angina

A

Pain occurs at rest with reversible ST changes

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17
Q

First line meds for Stable Angina

A

(Beta Blocker or Calcium Channel Blocker) + nitrates

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18
Q

Labs to get for HLD

A

Lipid panel, CBC, CMP with liver labs, TSH, CRP/ESR

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19
Q

Tests to order for HLD

A

EKG, Treadmill stress test, Nuclear stress test, Echo, US, CT (calcium CT), Coronary angioplasty (refer to cards)

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20
Q

First line of therapy for HLD

A

Dietary modifications (Dash diet, mediterranean diet, AHA diet)

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21
Q

Gold standard for HLD meds

A

statins

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22
Q

Left sided heart failure is usually due to what? and causes what symptoms? and is also called what kind of HF?

A

-due to uncontrolled HTN which causes left ventricular hypertrophy
-causes back up into the lungs (pulm s/s)
-also called SYSTOLIC HF

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23
Q

who are statins for?

A

someone with
-CVD,
-CVD risk > 7.5%
-LDL > or equal to 190
-DM & LDL > or equal to 70

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24
Q

what is LDL goal in DM or CV risk?

A

<70

25
Q

Normal Lipid Panel

A

Total Cholesterol: <200
LDL <100 (<70 in DM or CV risk)
HDL >40
TG <150

26
Q

What level of triglycerides is LDL unreliable?

A

> 500

27
Q

How frequently to monitor liver function after starting a statin

A

before, then 4-6 weeks after starting, then every 6-12 months

28
Q

Can you use a statin in pregnancy?

A

NO! Category X

29
Q

What is the EF of Reduced function HF and Preserved function HF?

A

RF <40%
PF >50%

30
Q

Left side HF causes and s/s

A

causes: left ventricular hypertrophy from uncontrolled HTN causing weaker systole
s/s: backs up in lungs! (dyspnea, hemoptysis, fatigue, cough, orthopnea, paroxysmal nocturnal dyspnea, crackles S3 (kentucky)

31
Q

Right side HF causes and s/s:

A

causes: usually from compensation from Left HF, usually a problem with diastole
s/s: backs up in extremities, edema, nausea, right upper abdominal pain or fullness, JVD, hepatomegaly, S4 sound (tennessee)

32
Q

Labs for HF

A

CMP, BNP, Trop, Lipids, CMP, A1C

33
Q

DM meds that helps HF

A

SGLT2 inhibitor

34
Q

Meds needed for HF

A

diuretics, ACEi with BB (not for HR <60), statin

35
Q

What weights do pt need to monitor and call Dr. about?

A

If >2lbs in one day or >5lbs in one week

36
Q

when to admit patients?

A

hypoxia, gross fluid overload, pulmonary edema

37
Q

symptoms of reduced blood flow that could be from a murmur:

A

reduced blood flow, Chest pain, dyspnea, palpitations, SOB, exercise intolerance, light headedness

38
Q

Mnemonic for areas of the heart

A

All People Enjoy Time Magazine (aortic, pulmonic, Erbs point, tricuspid, mitral)

39
Q

Mnemonic for Systolic murmurs

A

MR. Peyton Manning AS MVP
-mitral regurgutation
-physiologic murmur
-aortic stenosis
-mitral valve prolapse (click)

40
Q

Mnemonic for diastolic murmurs

A

ARMS
-aortic regurgitation
-mitral stenosis

41
Q

Aortic Stenosis

A

systolic murmur common in elderly, heard in the 2nd/3rd intercostal space

42
Q

Smart/Mart inhalers

A

-ICS (inhaled corticosteroid) with formoterol (long acting beta agonist)
-used as maintenance treatment plus whenever needed for symptom relief

43
Q

AIR inhalers

A

-anti inflammatory reliever that contains an ICS (inhaled corticosteroids) and SABA (short acting beta agonists)
-Takes whenever needed for symptom relief

44
Q

bacterial bronchitis treatment

A

Macrolide (mycins) or amoxi-clav (augmentin)

45
Q

bacterial infection with emphysema treatment

A

doxy, bactrim, clarithromycin, cefaclor

46
Q

Gold grades and severity

A

1: Mild FEV1 > 80%
2: Moderate FEV1 50-80%
3: Severe FEV1 30-50%
4: Very Severe FEV1 <30%

47
Q

If eosinophil level is >300, what do you add to COPD therapy?

A

add ICS to current LABA + LAMA therapy

48
Q

Pertussis abx

A

Macrolides or bactrim if >2 months old and unable to take macrolides

49
Q

red flag labs for pertussis

A

Leukocytosis > 30,000

50
Q

how many weeks to repeat CXR after pneumonia dx to document clearance?

A

6 weeks

51
Q

What test is not recommended for dx CAP?

A

sputum culture

52
Q

CURB-65 tool

A

C-confusion
U- BUN >19.6
R- respirations >30 breaths/min
B- blood pressure <90/60
65- or older

53
Q

Cancer screening in older adults criteria and test

A

test: low-dose CT
criteria: ages 55-80 years who smoke 30 pack years or have quit in the past 15 years

54
Q

what cardiac med can asthmatics not take?

A

Beta Blockers

55
Q

what labs is it important to monitor when taking statins

A

Liver function

56
Q

Statins that are available as low intensity

A

-statin
Lova
Simva
Prava

57
Q

Statins that are available as high intensity

A

-statin
Atorva
Rosuva

58
Q
A

FNP (14 decks)

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