Angiotensin II Receptor Blockers (ARBs) and Alternative Medications
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Questions and Answers

What is the mechanism of action of ARBs in reducing blood pressure?

  • Inhibiting the conversion of angiotensin I to angiotensin II
  • Increasing the excretion of sodium and water
  • Blocking the effects of angiotensin II at the receptor site (correct)
  • Reducing the force of myocardial contraction

    • What is the effect of hydralazine and isosorbide on the heart?

  • Decreases preload and afterload (correct)
  • Increases cardiac output and contractility
  • Increases blood pressure and heart rate
  • Reduces blood flow to the kidneys

    • What is the purpose of prescribing beta-blockers in hypertension?

  • To increase blood pressure and cardiac output
  • To reduce the effects of the constant stimulation of the SNS (correct)
  • To reduce blood flow to the kidney
  • To increase the force of myocardial contraction

    • What is the mechanism of action of digitalis in improving heart function?

    <p>Increases the force of myocardial contraction and slows conduction through the AV node</p> Signup and view all the answers

    What is the effect of diuretics in hypertension?

    <p>Removes excess extracellular fluid by increasing the rate of urine produced</p> Signup and view all the answers

    What is the primary goal of pharmacologic therapy in treating heart failure?

    <p>To decrease afterload and promote vasodilation</p> Signup and view all the answers

    Which medication is used to help the heart pump more effectively?

    <p>Digoxin</p> Signup and view all the answers

    What is the mechanism of action of ACE inhibitors in treating heart failure?

    <p>Blocking the conversion of angiotensin I to II</p> Signup and view all the answers

    Why are vasodilators like nitro drips used in treating heart failure?

    <p>To hide excess volume in the vasculature</p> Signup and view all the answers

    What is a potential complication of pharmacologic therapy in heart failure patients with renal disease?

    <p>Elevation of BUN and Cr</p> Signup and view all the answers

    Which inotrope is a phosphodiesterase inhibitor that delays the release of calcium from intracellular reserves and prevents extracellular calcium uptake by the cells?

    <p>Milrinone</p> Signup and view all the answers

    What is the primary effect of Dobutamine on the heart?

    <p>Increase in cardiac contractility</p> Signup and view all the answers

    Why are patients initially taken to the ICU when given Dobutamine for the first time?

    <p>To monitor for hypotension or arrhythmias</p> Signup and view all the answers

    What is the purpose of giving patients a 'Dobutamine tuneup' in the hospital?

    <p>To help the heart beat and pump more effectively and to diurese them a little bit</p> Signup and view all the answers

    What is the effect of Milrinone on preload and afterload?

    <p>Decreases preload and afterload</p> Signup and view all the answers

    What is the primary consideration when selecting a medication for dysrhythmia treatment?

    <p>Response to previous treatment</p> Signup and view all the answers

    What is the recommended dose of Amiodorone for cardiac arrest?

    <p>300 mg direct IV push</p> Signup and view all the answers

    Which medication is commonly used for numbing and ventricular tachycardia arrhythmias?

    <p>Lidocaine</p> Signup and view all the answers

    What is the main concern when using Lopressor in a patient who has just been admitted to the hospital for a heart attack?

    <p>The patient's systolic BP may be less than 100</p> Signup and view all the answers

    What is the primary purpose of using Beta blockers in dysrhythmia treatment?

    <p>To slow the heart rate</p> Signup and view all the answers

    What is the purpose of prescribing a beta-blocker in a patient with heart disease?

    <p>To decrease the heart rate and reduce blood pressure</p> Signup and view all the answers

    What medication can be used to prevent arrhythmias in the acute phase of a myocardial infarction?

    <p>Lidocaine or Amiodarone</p> Signup and view all the answers

    What is the purpose of prescribing a medication that blocks sodium channels in a patient with heart disease?

    <p>To prevent arrhythmias</p> Signup and view all the answers

    What is the effect of medications that block calcium channels in a patient with heart disease?

    <p>Decrease the heart rate and blood pressure</p> Signup and view all the answers

    What is the purpose of prescribing a medication that blocks potassium channels in a patient with heart disease?

    <p>To prevent arrhythmias</p> Signup and view all the answers

    What is the primary concern when administering nitroglycerin to a middle-aged man with chest pain who has taken sildenafil or silace?

    <p>Significant drop in blood pressure</p> Signup and view all the answers

    What is the typical approach to using ACE Inhibitors in patients with renal impairment?

    <p>Hold back on them for at least 72 hours</p> Signup and view all the answers

    What is the indication for administering morphine in a patient with chest pain?

    <p>To decrease anxiety and apprehension</p> Signup and view all the answers

    What is the significance of administering three or more nitroglycerin doses 5 minutes apart without relief?

    <p>The patient is having a heart attack and needs immediate attention</p> Signup and view all the answers

    What is the primary role of beta-blockers in heart disease?

    <p>Main line therapy for heart disease</p> Signup and view all the answers

    What is the primary effect of synthetic BNP in acute decompensated HF?

    <p>Arterial and venous dilation</p> Signup and view all the answers

    What is the antidote for heparin overdose?

    <p>Protamine sulfate</p> Signup and view all the answers

    What is a potential side effect of long-term use of amiodarone in a patient with CHF?

    <p>Idiopathic lung disease</p> Signup and view all the answers

    What is the primary goal of resynchronization therapy in patients with stage 4 HF?

    <p>Coordinate left and right side of the heart</p> Signup and view all the answers

    Which medication is used to prevent blood clots in patients with atrial fibrillation?

    <p>Heparin drip</p> Signup and view all the answers

    What is the primary effect of heparin SQ in patients with DVT?

    <p>Prevention of blood clots</p> Signup and view all the answers

    Which medication is used to treat bradycardia in patients with heart failure?

    <p>Atropine</p> Signup and view all the answers

    What is the mechanism of action of anticoagulants in patients with heart failure?

    <p>Prevention of blood clots</p> Signup and view all the answers

    What is the purpose of an ICD in patients with heart failure?

    <p>To regulate heart rhythm</p> Signup and view all the answers

    What is a potential side effect of long-term use of amiodarone in a patient with CHF?

    <p>Thyroid problems</p> Signup and view all the answers

    What is the most common type of pacemaker?

    <p>Transcutaneous pacemaker</p> Signup and view all the answers

    What is the purpose of a Transthoracic Echocardiogram (TTE)?

    <p>To provide a detailed picture of heart function and valve operation</p> Signup and view all the answers

    What is the purpose of performing an echocardiogram in a patient with heart failure?

    <p>To measure injection fraction and detect valve problems</p> Signup and view all the answers

    What is the significance of performing an AdaCXR in a patient with a pacemaker?

    <p>To confirm lead placement</p> Signup and view all the answers

    Which type of pacemaker is typically used during open-heart surgery?

    <p>Epicardial pacemaker</p> Signup and view all the answers

    What is the advantage of a Transesophageal Echocardiogram (TEE) over a TTE?

    <p>It provides a more detailed picture of the heart</p> Signup and view all the answers

    What is the primary purpose of a transesophageal echocardiogram (TEE)?

    <p>To identify atrial or ventricular septal defects</p> Signup and view all the answers

    What is the primary goal of nursing management in a patient with an ICD/pacemaker?

    <p>To assess the incision site and prevent complications</p> Signup and view all the answers

    Why is a TEE considered a more invasive procedure than a TTE?

    <p>It requires moderate sedation</p> Signup and view all the answers

    What is the significance of performing a 12-lead EKG in a patient with a pacemaker?

    <p>To confirm proper pacemaker function</p> Signup and view all the answers

    What type of pacing is commonly used in open heart surgery?

    <p>Epicardial</p> Signup and view all the answers

    What is the purpose of attaching wires directly to the heart in epicardial pacing?

    <p>To pace the heart</p> Signup and view all the answers

    What is the concern when using a ventricular probe via Swan Ganz catheter?

    <p>Pacemaker site movement</p> Signup and view all the answers

    What type of pacing is commonly seen in hospitals today?

    <p>Transcutaneous</p> Signup and view all the answers

    What is the significance of the first three settings in the Universal Code for pacemaker function?

    <p>They indicate the chamber being paced</p> Signup and view all the answers

    What is the primary goal of diagnosing heart failure?

    <p>To identify the signs and symptoms of fluid overload or inadequate tissue perfusion</p> Signup and view all the answers

    What is the purpose of performing an echocardiogram in a patient with heart failure?

    <p>To assess the heart's wall motions and valves</p> Signup and view all the answers

    What is the significance of an ejection fraction of less than 40% in a patient with heart failure?

    <p>The patient is likely to experience significant symptomatology even at rest</p> Signup and view all the answers

    What is the primary purpose of a pacemaker in patients with heart failure?

    <p>To regulate the heart rate</p> Signup and view all the answers

    What is the name of the test used to measure the heart's pulsation and heart rate?

    <p>Pulse oximetry</p> Signup and view all the answers

    What is a common indication for pacemaker therapy in patients with heart failure?

    <p>Slow pulse formation with hemodynamic compromise</p> Signup and view all the answers

    What is the purpose of resynchronization therapy in patients with heart failure?

    <p>To resynchronize the left and right ventricles to work together better</p> Signup and view all the answers

    What is the significance of the right coronary artery in relation to pacemaker function?

    <p>It feeds the SA node in 60% of people and the AV node in 90% of people</p> Signup and view all the answers

    What is the purpose of a pacemaker in a patient with heart failure?

    <p>To sense and respond to intrinsic activity, firing only when the patient needs it</p> Signup and view all the answers

    What is a potential complication of pacemaker insertion?

    <p>Pneumothorax/Hemothorax</p> Signup and view all the answers

    What is the effect of high sensitivity in a pacemaker generator?

    <p>The pacemaker can't see any heartbeat</p> Signup and view all the answers

    What is the primary purpose of an Implantable Cardioverter Defibrillator (ICD)?

    <p>To detect and terminate life-threatening episodes of tachycardia or fibrillation</p> Signup and view all the answers

    What is the unit of measurement for sensitivity in a pacemaker generator?

    <p>Millivolts</p> Signup and view all the answers

    What is a common indication for pacemaker implantation in patients with heart failure?

    <p>Class 3 or 4 HF</p> Signup and view all the answers

    What is the purpose of observing the dressing and chest wall for bleeding after pacemaker insertion?

    <p>To monitor for bleeding or hematoma</p> Signup and view all the answers

    What is the primary function of the electrodes in a pacemaker?

    <p>To carry the impulse created by the generator to the heart</p> Signup and view all the answers

    What is the typical location for implanting a pacemaker?

    <p>Upper left chest wall</p> Signup and view all the answers

    What is the primary concern when a pacemaker is implanted?

    <p>Risk of infection</p> Signup and view all the answers

    What is the purpose of a temporary wire during pacemaker replacement?

    <p>To hook the person up to a transvenous pacemaker</p> Signup and view all the answers

    How often may a pacemaker need to be replaced?

    <p>Every 8-10 years</p> Signup and view all the answers

    What is the purpose of maintaining a pacemaker?

    <p>To ensure the pacemaker is functioning correctly</p> Signup and view all the answers

    What is the primary benefit of AV Sequential pacing?

    <p>It allows for pacing of both the atrium and ventricle</p> Signup and view all the answers

    What is the primary purpose of pacemaker batteries?

    <p>To stimulate the myocardium</p> Signup and view all the answers

    What is the primary benefit of Biventricular pacing?

    <p>It allows for pacing of both sides of the heart</p> Signup and view all the answers

    What is the primary purpose of replacing pacemaker wires?

    <p>To ensure the pacemaker is functioning correctly</p> Signup and view all the answers

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