Heart Failure & Medications Quiz (Week 6) Flashcards
Match the adrenergic receptor with the response to stimulation:
1.) Alpha
2.) Beta 1
3.) Beta 2
4.) Dopaminergic
a.) Dilation of Renal & mesenteric arteries
b.) Vasoconstriction of peripheral arterioles
c.) Vasodilation of peripheral arteries & bronchodilation
d.) Increased heart rate, conduction, & contractility
1-b.) Alpha = Vasoconstriction of peripheral arterioles
2-d.) Beta 1 = Increased heart rate, conduction, & contractility
3-c.) Beta 2 = Vasodilation of peripheral arteries & bronchodilation
4-a.) Dopaminergic = Dilation of renal & mesenteric arteries
Match the followoing statements regarding cardiac output & stroke volume:
1.) Preload
2.) Afterload
3.) Contractility
4.) Left Ventricular Ejection Fraction (LVEF)
a.) Pressure the ventricle has to generate to overcome resistance to ejection.
b.) Volume in the ventricles at the end of diastole.
c.) Force of myocardial contraction.
d.) Ratio of stroke volume to end-diastolic volume.
1-b.) Preload = Volume in ventricles at the end of diastole
2-a.) Afterload = Pressure the ventricle has to generate to overcome resistance to ejection
3-c.) Contractility = Force of myocardial contraction
4-d.) Left Ventricular Ejection Fraction (LVEF) = Ratio of stroke volume to end-diastolic volume
Match the clinical condition or pharmacologic agent with the effect on stroke volume:
1.) Reduction in preload
2.) Increase in preload
3.) Reduction in contractility
4.) Increase in contractility
5.) Increase in afterload
6.) Decrease in afterload
a.) Levarterenol (Levophed)
b.) Septic Shock
c.) Acidosis
d.) Dobutamine
e.) Hemorrhagic Shock
f.) Fluid Challenge
1-e.) Hemorrhagic Shock REDUCES preload
2-f.) Fluid Challenge INCREASES preload
3-c.) Acidosis REDUCES contractility
4-d.) Dobutamine INCREASES contractility
5-a.) Levarterenol (Levophed) INCREASES afterload
6-b.) Septic Shock DECREASES afterload
Normal ejection fraction (EF) is:
a.) 10 - 20%
b.) Less than 40%
c.) 40 - 50%
d.) Over 55%
d.) Over 55%
You have been asked to administer a 500cc normal saline fluid bolus to your 50 year old patient with an inferior wall MI and suspected right ventricular infarction. The patient does NOT have a CVC or pulmonary artery catheter in place. You are midway through the infusion. What clinical parameters would make you hold the infusion and call the physician? (Select all that apply)
a.) Improved mentation
b.) Urine output = 0.5-1cc/kg/hr
c.) New onset of crackles
d.) Development of S3
e.) Occasional PACs
f.) Clear breath sounds bilaterally
c.) New onset of crackles
d.) Development of S3
A 50 year old patient with an inferior wall MI and suspected right ventricular infarction is receiving a 500cc normal saline fluid bolus. The fluid bolus is an intervention that should improve cardiac output by: (Select all that apply)
a.) Increasing preload
b.) Decreasing preload
c.) Improving contractility
d.) Decreasing contractility
e.) Increasing afterload
f.) Decreasing afterload
a.) INCREASING preload
c.) IMPROVING contractility
Which of the following drugs have a positive inotropic effect on the heart? (Select all that apply)
a.) Dobutamine
b.) Beta Blockers
c.) Epinephrine
d.) Dopamine in appropriate range
e.) Digoxin
f.) Therapeutic Heparin
a.) Dobutamine
c.) Epinephrine
d.) Dopamine in appropriate range
e.) Digoxin
Which of the following drugs have vasodilating properties? (Select all that apply)
a.) Sodium nitroprusside (Nipride)
b.) Nitroglycerin
c.) Lasix
d.) Morphine
e.) ACE Inhibitors
f.) Epinephrine
a.) Sodium nitroprusside (Nipride)
b.) Nitroglycerin
c.) Lasix
d.) Morphine
e.) ACE Inhibitors
The following descriptions regarding ACE Inhibitors are TRUE: (Select all that apply)
a.) Functions predominantly as a positive inotropic agent
b.) Decreases peripheral vascular resistance
c.) Do not cause reflex tachycardia, sodium, or water retention
d.) Delay or inhibit ventricular remodeling
e.) Should be considered in all patients admitted with CHF
f.) No significant side effects
b.) Decreases peripheral vascular resistance
c.) Do not cause reflex tachycardia, sodium, or water retention
d.) Delay or inhibit ventricular remodeling
e.) Should be considered in all patients admitted for CHF
ACE inhibitors may cause an irritating cough or angioneurotic edema
Causes of pulmonary edema include: (Select all that apply)
a.) Heroin drug overdose
b.) Head injury
c.) Anterior wall MI
d.) Cardiomyopathy
e.) EF of 65%
f.) PCWP or CVP reading of 25 mmHg
a.) Heroin drug overdose
b.) Head injury
c.) Anterior wall MI
d.) Cardiomyopathy
f.) PCWP or CVP reading of 25 mmHg
Causes of heart failure include: (Select all that apply)
a.) Hypertension
b.) Myocardial infarction
c.) Valvular disease
d.) Cardiomyopathy
a.) Hypertension
b.) Myocardial infarction
c.) Valvular disease
d.) Cardiomyopathy
You are the nurse caring for a patient who suffers a cardiopulmonary arrest. In what situations should Epinephrine be considered as the drug of choice? (Select all that apply)
a.) Hypotensive patient with Ventricular Tachycardia (V-Tach) and pulse present.
b.) Ventricular fibrillation (V-Fib)
c.) PEA
d.) Asystole
e.) Supraventricular tachycardia (SVT)
b.) Ventricular fibrillation (V-Fib)
c.) PEA
d.) Asystole
- Epinephrine is always considered for pulseless rhythems & is considered the “heart starter”.
Symptoms of pulmonary edema include which of the following? (Select all that apply)
a.) Pink frothy sputum
b.) Anxiety & restlessness
c.) Crackles at both bases
d.) Improved mentation
a.) Pink frothy sputum
b.) Anxiety & restlessness
c.) Crackles at both bases
Which of the following are treatments for cardiogenic pulmonary edema? (Select all that apply)
a.) Lasix
b.) Morphine
c.) Non invasive ventilation such as CPAP
d.) Beta blockers in acute phase
a.) Lasix
b.) Morphine
c.) Non invasive ventilation such as CPAP
