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Cardiopulmonary > Quiz #3 prep > Flashcards

Quiz #3 prep Flashcards

1
Q

In Left-sided CHF what effects lead to pulmonary congestion or edema? (5 steps)

A
  1. L ventricle weakens & cannot empty
  2. decr. in CO to system
  3. decr. is renal blood flow stimulates renin-angiotensin (retain H2O) and aldosterone secretion.
  4. backup of blood into pulmonary vein
  5. high pressure in pulmonary capillaries leads to pulmonary congestion or edema.
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2
Q

In Right-sides CHF what effects lead to descended neck vein and cerebral edema? (6 steps)

A
  1. R ventricle weakens & cannot empty
  2. decr. CO to system
  3. decr. is renal blood flow stimulates renin-angiotensin
  4. backup of blood into systemic circulation (venue cavae)
  5. incr. venous pressure results in edema in legs, liver, and abdominal organs.
  6. very high venous pressure causes distended neck vein and cerebral edema.
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3
Q

What is a cardiac glycoside, what does it do?

A

example is digitalis, it will incr. the strength of heart contractions.

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4
Q

What does a phosphodiesterase inhibitor do?

A

forces release of Ca stores, positive inotropic effect (milrinone and amrinone)

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5
Q

What does a diuretic do?

A

decr. fluid load.

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6
Q

What does angiotensin-converting enzyme (ACE) inhibitor do?

A

reduce peripheral vascular resistance and decor fluid retention. (dear. angiotensin) (captopril, ramipril)

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7
Q

What does/is a (+) inotropic effect med mean/doing?

A

Positive inotropes stimulate and increase the strength of heart muscle contraction causing the heart rate to increase.

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8
Q

What medication is contraindicated for management of CHF?

A

beta-blockers b/c they slow down the HR and decr. contractibility.
But, they may be used with pt who are stabilized with diuretic and ACE inhibitor (propranolol)

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9
Q

What drug disrupts the coagulation cascade, is slow acting and inhibits the SYNTHESIS of clotting factors (including factor X and thrombin)?

A

Warfarin (coumadin) (vitamin K antagonist)

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10
Q

What drug disrupts the coagulation cascade, inhibits the ACTIVITY of clotting factors and is faster acting?

A

Heparin

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11
Q

What drugs inhibit platelet aggregation and are most effective at preventing ARTERIAL THROMBOSIS?

A

Anti platelet drugs (aspirin, clopidogrel)

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12
Q

What drugs promote lysis of fibrin and thereby cause dissolution of thrombi?

A

Thrombolytic drugs (alteplase, streptokinase)

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13
Q

What anticoagulant drug is a direct thrombin inhibitor thus fast acting?

A

Pradaxa

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14
Q

What is partial thromboplastin time (PTT)?

A

a test to screen for bleeding disorders, monitor heparin therapy - more complete than PT
ratio = prothrombin time / pt reference range

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15
Q

PTT reference range is what?

A

30-40 sec.

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16
Q

The PTT therapeutic range is ______ depending on dx.

A

2-3, meaning it takes the pt longer to clot than the reference range.

17
Q

What INR values is a pt at risk for bleeding and you need to modify their activity?

A

> 3.5

18
Q

What INR values is a pt on bed rest d/t the risk of bleeding?

A

> 5

19
Q

What are two important precautions when using warfarin or coumadin?

A
  1. can cause hemorrhage

2. need to be aware of diet - carful with foods having a high vitamin K content.

20
Q

In general signs of CHF are ___________ and symptoms are ___________.

A

objective; subjective

21
Q

Define the classifications (A-D) of chronic heart failure.

A

stage A - high risk for LV dysfunction (tx=risk modification)
stage B - have LV dysfunction & asymptomatic (tx=prevent S&S & risk modification)
stage C - have LV dysfunction & symptomatic (tx=alleviate S&S and slow progress)
stage D - end stage heart failure (tx=special pharmacology & surgery)

22
Q

What are normal albumin levels?

A

3.5 - 5.5 g/dl
causes of abnormally high - dehydration, IV albumin infusions
causes of abnormally low - malnutrition, malabsorption, hyperthyroidism, pregnancy, impaired liver or chronic infection, edema, ascots, burns, hemorrhage.

23
Q

what is normal blood urea nitrogen (BUN) values?

A

7-18 mg/dl
causes of abnormal high values - renal failure, CHF, GI bleed, acute MI, stress, drugs
causes of abnormal low values - diuresis, severe liver damage, diet (malnutrition), incr. use of protein for synthesis (anabolic steroids, late pregnancy)

24
Q

what is normal creatinine values?

A

Female: 0.5 - 1.1 mg/dl
Male: 0.6 - 1.2 mg/dl
cause of abnormally high - ingestion of raw meat, impaired renal function,
low values are not clinically significant.

25
Q

Preferred INR for prophylaxis DVT.

A

1.5 -2.0

26
Q

Preferred INR for DVT treatment.

A

2.0 - 3.0

27
Q

Preferred INR for orthopedic surgery.

A

2.0 - 3.0

28
Q

Preferred INR for A-fib.

A

2.0 - 3.0

29
Q

Preferred INR for pulmonary embolism.

A

2.5 - 3.5

30
Q

Preferred INR for prosthetic valve prophylaxis.

A

3.0 - 4.0

Cardiopulmonary (5 decks)

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