Perfusion Flashcards
Nitroglycerin is a ___
Vasodilator
Which class of drugs can help lower cholestrol?
Statins
Which of the following is a side effect of metoprolol?
a. ) yellow-green halos
b. ) Hyperkalemia
c. ) Hypoglycemia
d. ) Pulmonary fibrosis
C - Hypoglycemia
A client still has chest pain after 3 rounds of Nitro. Which BP indicated it is safe to give morphine?
a. ) 82/44
b. ) 99/53
c. ) 90/61
d. ) 115/70
D - 115/70
A client is taking furosemide for CHF. Which of the following labs would concern you?
a. ) Ca 8.2
b. ) K 3.0
c. ) BS 120
d. ) Na 140
B - K+ 3.0
You admin clopidogrel to a client who received a stent. Why would you give that med?
Med helps prevent developing clots
Which med is most important to admin to a client experiencing chest pain?
a. ) Kettorlac
b. ) Metoprolol
c. ) Aspirin
d. ) Atorvostatin
C - Aspirin
Modifiable Risk Factors for CAD
Smoking High LDL, Low HDL HTN Diabetes Obesity Physical activity Stress Excessive alcohol intake
Unmodifiable risk factors for CAD
Gender Race Age > 45 for men Family Hx/Genetics Postmenopausal
Ischemia
Blockage/clot in coronary vessel deprives heart of blood flow
Infarction
Cardiac cells die from lack of O2
Mi is most often caused by ___
CAD
A diabetic is having an MI what type of clinical manifestations will you see?
None/very little symptoms related to MI b/c diabetic will most commonly show no symptoms
What is your #1 intervention for a pt. with MI?
EKG
PAD #1 intervention
Assess pulses and skin
Ankle brachial index
CHF #1 intervention
VS and O2
Diuretics
Normal Troponin levels
<0.4 ng/mL
Normal High Sensitivity Troponin levels
<100 ng/mL
Normal CK levels
55-170 U/L
Normal CK-MB levels
0-3 mg/mL
After a stent placement what kind of med should the nurse give the pt. and why?
Anti-platelet to prevent reocclusion
What is an open heart surgery called when they graft a vein in to the coronary vessels to create an alternate channel
CABG - Coronary Artery Bypass Graft
TPA, Alteplase, and Streptokinase are clot-busting drugs and should be given ___ min after hospital arrival
30 min
What is the major risk for giving clot busting drugs (Ex. TPA, Alteplase, and Streptokinase)
Bleeding risk very high
What should the nurse do for a client who has just had a stent or CABG procedure?
Maintain best rest for 2-6 hr.*** Assess for bleeding*** Chest pain Signs of stroke Pulses, skin temp Urine output
After pt. MI the pt. is being discharged. They pt. asks when he should come back to seek help. Nurses response:
If the site of procedure starts to bleed and if you have chest pain
How much exercise should a pt. with a previous MI do?
at least 150 min. moderate intensity aerobic a week
Ace inhibitors “-prils”
Decrease BP
Losartan (ARB) (“-sartan”)
Decrease BP
Metoprolol Beta-Blocker “-olol”
Decrease HR and BP
Side Effects of ACE inhibitors
Angioedema
Irritating cough
Hyperkalemia
Tachycardia
Side Effects of ARBs inhibitors
Angioedema
Renal Failure
Side Effects of Beta-Blocker inhibitors
Hypoglycemia
CHF
Bronchospasms
Very Nice Drugs Ca Channel Blockers
Decrease contractibility, conductivity and O2 demand
Side Effects of Ca Channel Blockers
AV heart block
Bradycardia
Interacts with: grapefruit juice, Digoxin and Beta-Blockers
What is Hydralazine
Vasodilator
Nitro is a ___
Vasodilator
Amiodarone and Digoxin are a ___
Antidysrhythmic
A pt. is taking a “-statin” what should you report immediately to the HCP?
Muscle pain b/c side effect is rhabdo
What is the main clinical manifestation of PAD?
Intermittent Claudication
What are other side effects of PAD?
Pain/pallor when legs are elevated Little hair on legs Diminished pulses Ulcers Necrosis
How do you diagnose PAD?
Ankle-bracial test
What kind of meds can the nurse anticipate be prescribed for a pt. with PAD?
ACE inhibitors
Ca Channel Blockers
Antiplatlets
Statins
What might be a complication for a pt. with PAD?
Infection/Gangrene
Pt. with PAD want to know if exercise is okay with his new condition. What is the nurse’s response?
Ration exercise - walking is best
What is the most common cause of CHF
Previous MI
What lab will be elevated in a pt. with CHF
BNP
Normal BNP level
<100 pg/nK
Normal Ejection Fraction
55-70%
A pt. with an EF of 35 will be classified as:
Heart failure with reduce ejection fraction (Systolic HF)
A pt. with an EF of 65 will be classified as:
Heart failure with preserved ejection fraction (Diastolic HF)
With systolic HF what happens to the heart physically?
Heart chambers are stretched and thin - heart cannot pump
With diastolic HF what happens to the heart physically?
Heart chambers are stiff and thick - heart cannot fill
Signs of Left sided Heart Failure
SOB Crackles Fatigue/weakness Delay cap refill weak pulses pallor
Signs of Right sided Heart Failure
Ascites
Edema
JVD
Hepatomegaly
What are some med that would be prescribed for a pt. with CHF?
ACE inhibitors ARBs Vasodilators Diuretics*** Beta-blockers Digoxin
Interventions for CHF
H - HOB elevated
O - O2 via nasal cannula
P - Provide diuretics (and others)
E - Eliminate Na+
What are complications of CHF
Pulmonary edema
Renal Failure
Gold standard for diagnosing an MI
Combination of EKG and Cardiac cath
First line Tx for pt. with CHF
Medications
