Unit2 BB Questions N2550 Flashcards
What is the purpose of aspirin in a client experiencing an MI?
Aspirin is an antiplatelet agent that helps prevent further clotting and reduces mortality in MI patients by inhibiting platelet aggregation.
What is the rationale for using Clopidogrel (Plavix) in MI patients?
Clopidogrel is an antiplatelet that may be given in conjunction with aspirin, particularly in STEMI, to further reduce the risk of thrombus formation.
How do beta-blockers like Metoprolol help in MI management?
Beta-blockers decrease heart rate and myocardial oxygen demand, limiting damage to the heart muscle during an MI and reducing the risk of future MIs.
What is the role of ACE Inhibitors like Lisinopril in MI treatment?
ACE inhibitors lower blood pressure and reduce left ventricular workload, providing cardioprotective effects and improving survival rates post-MI.
Why are statins like Atorvastatin used in MI patients?
Statins lower cholesterol levels and stabilize atherosclerotic plaques, reducing the risk of future cardiovascular events.
What is the function of thrombolytics like Alteplase in MI?
Thrombolytics dissolve clots in the arteries, restoring blood flow during an acute MI, especially if given within a certain time frame from symptom onset.
What is the rationale for using nitrates like Nitroglycerin in MI?
Nitrates relieve chest pain by dilating blood vessels, decreasing myocardial oxygen demand and improving blood flow.
What medications should be avoided in MI management?
NSAIDs, calcium channel blockers in certain situations, high-dose morphine, glucocorticoids, and tricyclic antidepressants should be avoided due to potential complications.
What is medication titration?
Medication titration is the process of adjusting the dosage of medication to achieve the desired therapeutic effect while minimizing side effects.
What is the purpose of medication titration?
The purpose of titration is to find the optimal dose that effectively manages a condition without causing undue side effects.
What are common medications that may be titrated?
Common medications include antihypertensives (e.g., Lisinopril), insulin, anticoagulants (e.g., Warfarin), antidepressants (e.g., Sertraline), opioids (e.g., Morphine), and antiepileptics (e.g., Levetiracetam).
What parameters are considered when titrating medications?
Parameters include therapeutic effect, side effects, patient-specific factors, laboratory values, patient feedback, and time frame for adjustments.
What are ACE inhibitors used for in heart failure?
ACE inhibitors help relax blood vessels, lower blood pressure, and reduce the workload on the heart, decreasing mortality and improving symptoms.
What is the role of ARBs in heart failure treatment?
ARBs provide similar benefits to ACE inhibitors but are used in patients who cannot tolerate ACE inhibitors due to side effects.
How do beta-blockers benefit heart failure patients?
Beta-blockers slow the heart rate and reduce myocardial oxygen demand, improving survival rates and alleviating symptoms of heart failure.
What is the function of diuretics in heart failure management?
Diuretics manage fluid retention and congestion in heart failure patients by promoting the excretion of excess fluid.
What are aldosterone antagonists used for in heart failure?
Aldosterone antagonists block the effects of aldosterone, improving outcomes and reducing mortality in patients with heart failure with reduced ejection fraction.
What is the purpose of hydralazine and nitrates in heart failure treatment?
This combination is used in patients who cannot tolerate ACE inhibitors or ARBs, decreasing the heart’s workload and improving symptoms.
How do SGLT2 inhibitors benefit heart failure patients?
SGLT2 inhibitors promote diuresis, reduce hospitalizations, and improve cardiovascular outcomes in heart failure patients.
What are positive inotropes used for in heart failure?
Positive inotropes increase the strength of the heart’s contractions and are typically used in acute heart failure.
How do anticoagulants help heart failure patients?
Anticoagulants prevent blood clots in patients with heart failure who have atrial fibrillation or are at risk for thromboembolism.
What is the role of statins in heart failure management?
Statins help manage cholesterol levels and promote cardiovascular health in patients with heart failure due to ischemic heart disease.
What interventions are important for clients with heart failure?
Interventions include medication management, dietary modifications, weight monitoring, physical activity, patient education, monitoring vital signs, psychosocial support, advanced care planning, and regular follow-up.
What is the significance of daily weighing in heart failure management?
Daily weighing helps monitor for sudden weight gain, which may indicate fluid retention, and patients should report significant changes to their healthcare provider.
What are the differences between left-sided and right-sided heart failure?
Left-sided heart failure affects the lungs and systemic circulation, while right-sided heart failure affects systemic venous return and peripheral tissues.
What are common symptoms of left-sided heart failure?
Symptoms include shortness of breath, fatigue, pulmonary congestion, orthopnea, and paroxysmal nocturnal dyspnea.
What are common symptoms of right-sided heart failure?
Symptoms include swelling in the ankles, legs, and abdomen, fatigue, increased urination at night, jugular venous distension, and ascites.
What are two medications from the ACE-I class?
Lisinopril and Enalapril.
What are common side effects of ACE inhibitors?
Side effects include cough, elevated potassium levels, and angioedema.
What patient teaching is important for ACE inhibitors?
Monitor for persistent cough, regularly check potassium levels, and be aware of signs of angioedema.
What are two medications from the beta-blocker class?
Metoprolol and Atenolol.
What are common side effects of beta-blockers?
Side effects include fatigue, bradycardia, and dizziness or orthostatic hypotension.
What patient teaching is important for beta-blockers?
Do not abruptly stop the medication, monitor heart rate and blood pressure, and report severe fatigue or dizziness.
What are two medications from the calcium channel blocker class?
Amlodipine and Diltiazem.
What are common side effects of calcium channel blockers?
Side effects include swelling in the legs and ankles, dizziness, and flushing.
What patient teaching is important for calcium channel blockers?
Report unusual swelling or weight gain, avoid activities requiring alertness until effects are known, and take medication consistently.
What are two medications from the diuretic class?
Furosemide (Lasix) and Hydrochlorothiazide.
What are common side effects of diuretics?
Side effects include electrolyte imbalance, increased urination, and dehydration.
What patient teaching is important for diuretics?
Monitor weight daily, maintain hydration, and take medication in the morning.
What are two medications from the vasopressor class?
Norepinephrine and Dopamine.
What are common side effects of vasopressors?
Side effects include increased heart rate, hypertension, and tissue ischemia.
What patient teaching is important for vasopressors?
Understand these meds are used in critical care, report chest pain or severe headache, and monitor blood pressure.
What are two medications from the vasodilator class?
Nitroglycerin and Hydralazine.
What are common side effects of vasodilators?
Side effects include headache, dizziness, and flushing.
What patient teaching is important for vasodilators?
Sit or lie down if feeling dizzy, report persistent headaches, and avoid sudden position changes.
What are thrombolytics?
Thrombolytics are medications used to dissolve blood clots in cases of acute myocardial infarction.
What symptoms should be reported immediately?
Report any symptoms of chest pain or severe headache.
What should be monitored regularly in patients on vasodilators?
Monitor blood pressure regularly.
What are common vasodilator medications?
Common vasodilators include Nitroglycerin and Hydralazine.
What are the side effects of vasodilators?
Side effects include headache, dizziness, and flushing.
What patient teaching is important for those on vasodilators?
Sit or lie down if feeling dizzy or lightheaded. Report persistent headaches to a HCP. Avoid sudden position changes.
What are thrombolytics?
Thrombolytics are medications used to dissolve blood clots obstructing blood flow.
What are important interventions related to thrombolytics?
Conduct thorough patient history, monitor vital signs, and implement bleeding precautions.
What should be monitored for in patients receiving thrombolytics?
Monitor for signs of bleeding, such as ecchymosis, hematuria, or melena stools.
What is the purpose of administering thrombolytics?
To dissolve blood clots in critical situations like myocardial infarction and strokes.
What are common vasodilators used for cardiac patients?
Common vasodilators include Nitroglycerin, Isosorbide dinitrate, Hydralazine, and Nitroprusside.
What side effects should be monitored for with vasodilators?
Monitor for hypotension, headache, dizziness, reflex tachycardia, flushing, and nausea.
What does the acronym THROMBINS stand for?
T-Thienopyridines, H-Heparin, R-Renin angiotensin system blockers, O-Oxygen, M-Morphine, B-Beta-Blockers, I-Interventions, N-Nitroglycerin, S-Statin/Salicylate.
What are cardiac enzymes/biomarkers used for?
They indicate myocardial injury and help assess heart damage.
What is coronary artery disease (CAD)?
CAD is the narrowing or blockage of coronary arteries due to atherosclerosis.
What are modifiable risk factors for CAD?
High BP, high cholesterol, smoking, diabetes, obesity, physical inactivity, and unhealthy diet.
What are important postoperative nursing interventions for CABG?
Monitor vital signs, manage pain, inspect wounds, and provide respiratory support.
What is a PVC?
Premature Ventricular Contractions are early heartbeats originating in the ventricles.
What are the side effects of nitroglycerin?
Side effects include headache, hypotension, dizziness, tachycardia, flushing, and nausea.
What nursing interventions should be implemented with nitroglycerin?
Monitor vital signs, provide patient education, assist with positioning, and assess pain.
What is Diltiazem and its effects?
Diltiazem is a calcium channel blocker that relaxes blood vessels, decreases heart rate, and reduces myocardial oxygen demand.
Side effects include dizziness, headache, peripheral edema, and bradycardia. Teaching includes rising slowly to prevent dizziness and avoiding grapefruit juice. Effectiveness indicators are reduced blood pressure, decreased angina episodes, and improved exercise tolerance.
What is Amiodarone and its effects?
Amiodarone is an antiarrhythmic that slows heart rate, prolongs refractory period, and stabilizes heart rhythm.
Side effects include pulmonary toxicity, thyroid dysfunction, bradycardia, and hypotension. Teaching involves advising regular pulmonary function tests and reporting any cough or breathing difficulties. Effectiveness indicators are restoration of normal heart rhythm and absence of arrhythmias.
What is Lidocaine and its effects?
Lidocaine is an antiarrhythmic (class 1B) that stabilizes cardiac membrane and suppresses ventricular arrhythmias.
Side effects include drowsiness, confusion, seizures, and hypotension. Teaching includes monitoring for signs of toxicity and reporting any unusual neurological symptoms. Effectiveness indicators are resolution of PVCs or ventricular tachycardia.
What is Dopamine and its effects?
Dopamine is an inotropic agent that increases cardiac output and improves renal perfusion.
Side effects include tachycardia, hypertension, and arrhythmias. Teaching involves explaining the purpose of the medication and the need for continuous monitoring. Effectiveness indicators are increased urine output, improved cardiac output, and better vital signs.
What is Dobutamine and its effects?
Dobutamine is an inotropic agent that increases heart contractility and cardiac output.
Side effects include tachycardia, hypertension, and arrhythmias. Teaching involves informing patients about potential side effects and the need for cardiac monitoring. Effectiveness indicators are signs of enhanced perfusion, improved cardiac output, and stable vital signs.
What is Atropine and its effects?
Atropine is an anticholinergic that increases heart rate by inhibiting vagal effects on the heart.
Side effects include dry mouth, blurred vision, urinary retention, and tachycardia. Teaching involves advising on possible side effects and encouraging adequate hydration. Effectiveness indicators are increased heart rate and improved symptoms of bradycardia.
What is Metoprolol and its effects?
Metoprolol is a beta-blocker that decreases heart rate, myocardial contractility, and blood pressure.
Side effects include fatigue, dizziness, bradycardia, and hypotension. Teaching involves instructing patients to monitor their heart rate and blood pressure and not to abruptly stop taking the medication. Effectiveness indicators are lowered blood pressure, reduced heart rate, and decreased angina episodes.
What is Alteplase and its effects?
Alteplase is a thrombolytic agent that dissolves blood clots in cases of myocardial infarction or stroke.
Side effects include bleeding, allergic reactions, and hypotension. Teaching involves explaining the purpose and potential risks of the medication and monitoring for signs of bleeding. Effectiveness indicators are restoration of blood flow, such as resolution of chest pain and ST-segment normalization.
What is Enoxaparin and its effects?
Enoxaparin is a low molecular weight heparin (LMWH) that prevents and treats thromboembolic disorders by reducing the formation of blood clots.
Side effects include bleeding, bruising, injection site reactions, thrombocytopenia, and elevated liver enzymes. Teaching includes instructing patients on proper self-injection techniques, monitoring for signs of bleeding, and avoiding other anticoagulants without consulting a healthcare provider. Effectiveness indicators are prevention of DVT, pulmonary embolism, resolution of thromboembolic events, and normalizing of labs.
What is Acetylcysteine and its effects?
Acetylcysteine is a mucolytic and antidote for acetaminophen overdose that reduces viscosity of mucus and protects the liver in overdose cases.
Side effects include nausea, vomiting, rash, and bronchospasm. Teaching involves informing patients about the importance of hydration and possible side effects. Effectiveness indicators are improved respiratory function and liver enzyme levels in overdose situations.
What is Percutaneous Coronary Intervention (PCI)?
PCI is a non-surgical procedure used to treat narrowing or blockages in the coronary arteries.
Nursing interventions include patient education, thorough assessment, medication administration, ensuring NPO status, and establishing IV access pre-procedure. Post-procedure interventions include monitoring vital signs, site care, assessing pulses, monitoring for complications, promoting rest, patient education for discharge, and discussing follow-up care.
What should be included in the chest pain assessment?
The pain assessment should include location, quality, intensity, duration, timing, aggravating and alleviating factors, associated symptoms, past medical history, medications, and psychosocial factors.
This comprehensive assessment helps in understanding the nature of the chest pain and its potential causes.
What are the characteristics and interventions for Atrial Fibrillation (AFib)?
AFib is characterized by an irregular and often rapid heart rate, absence of P waves, and can lead to decreased cardiac output and increased risk of thromboembolism.
Interventions include monitoring vital signs and ECG, assessing for signs of stroke or heart failure, administering anticoagulants, and considering rate control medications.
What are the characteristics and interventions for Ventricular Fibrillation (VFib)?
VFib is characterized by chaotic electrical activity with no identifiable QRS complexes, and the patient is unresponsive, pulseless, and apneic.
Immediate interventions include initiating CPR, defibrillation, and administering oxygen and advanced airway management as needed.
What are the characteristics and interventions for Ventricular Tachycardia (VTach)?
VTach is characterized by three or more consecutive ventricular beats at a rate over 100 bpm and may present with symptoms like dizziness or loss of consciousness.
Interventions include assessing patient stability, monitoring vital signs, and administering oxygen and IV access for medication administration.
What are the characteristics and interventions for Asystole?
Asystole is characterized by a complete absence of electrical activity in the heart, indicated by a flatline on the ECG, with the patient being unresponsive, pulseless, and apneic.
Immediate interventions include initiating CPR, ensuring correct lead placement, and administering epinephrine as per ACLS guidelines.
What are the characteristics and interventions for Sinus Tachycardia?
Sinus tachycardia is characterized by a heart rate over 100 bpm, a regular rhythm originating from the SA node, and P waves present before each QRS complex.
Interventions include assessing underlying causes, monitoring vital signs, encouraging relaxation techniques, and administering fluids if dehydration is suspected.
What are the characteristics and interventions for Sinus Bradycardia?
Sinus bradycardia is characterized by a heart rate under 60 bpm, a regular rhythm originating from the SA node, and P waves present before each QRS complex.
Interventions include assessing the patient for symptoms, monitoring continuously, and considering medication if symptomatic.
What are the characteristics of sinus bradycardia?
• HR <60bpm
• Regular rhythm originating from the SA node
• P waves present and consistent before each QRS complex
• May be asymptomatic or associated with symptoms such as fatigue, dizziness, or syncope.
What are the interventions for sinus bradycardia?
• Assess pt for symptoms and vital signs
• Monitor pt continuously, especially if symptomatic
• Consider need for atropine if the pt is symptomatic or if there are signs of hemodynamic instability
• Shake them wake them
What medications are used for sinus bradycardia?
• Atropine sulfate (0.5 mg IV) may be administered to increase HR
• In severe cases, transcutaneous pacing or dopamine/epinephrine infusion may be considered.
What are the characteristics of sinus rhythm?
• HR typically between 60-100bpm
• Regular rhythm originating from the SA node
• P waves present and consistent before each QRS complex, indicating normal atrial depolarization
• Indicates a normal, healthy heart rhythm.
What are the interventions for sinus rhythm?
• Continue monitoring vital signs as part of routine care
• Edu pt on maintaining a heart-healthy lifestyle, including diet and exercise
• Assess for any changes in rhythm or new symptoms during monitoring.
What medications are needed for sinus rhythm?
• Generally, no specific meds are needed for sinus rhythm if the pt is asymptomatic
• If underlying conditions are present (e.g., hypertension), appropriate meds may be prescribed.
What does the P-wave represent in cardiac rhythm?
• Atrial depolarization
• The electrical activity causes the atria to contract. The first deflection on the ECG.
What does the PR interval represent in cardiac rhythm?
• Time taken for electrical impulses to travel from atria to ventricles
• Measured from beginning of p wave to beginning of QRS complex, indicates conduction time through the atrioventricular (AV) node.
What does the QRS complex represent in cardiac rhythm?
• Ventricular depolarization
• Indicates electrical activity that leads to ventricular contraction.
What does the ST segment represent in cardiac rhythm?
• Period between ventricular depolarization and repolarization
• It is crucial for identifying ischemia or infarction. Any elevation or depression can indicate cardiac issues.
What does the T-wave represent in cardiac rhythm?
• Ventricular repolarization
• Reflects recovery phase of ventricles.
What are the key components of nursing interventions for ABGs?
• Appropriate mask
• Appropriate medication
• I would do this and this and this.
What is the criteria for diagnosing STEMI using ECG?
ECG demonstrates ST elevation > 1 mm (0.1 mV) in at least 2 contiguous precordial leads (V1-V6) or at least 2 adjacent limb leads.
What should be done if the initial urgent ECG is not diagnostic for STEMI?
If initial urgent (< 10 min) ECG is not diagnostic, but suspicion is high for STEMI, obtain serial ECGs at 5–10-minute intervals.
