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 (A)</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 (C)</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 (C)</p> Signup and view all the answers

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

<p>Digoxin (C)</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 (C)</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 (C)</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 (C)</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 (C)</p> Signup and view all the answers

What is the primary effect of Dobutamine on the heart?

<p>Increase in cardiac contractility (B)</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 (A)</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 (A)</p> Signup and view all the answers

What is the effect of Milrinone on preload and afterload?

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

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

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

What is the recommended dose of Amiodorone for cardiac arrest?

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

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

<p>Lidocaine (A)</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 (D)</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 (A)</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 (A)</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 (A)</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 (D)</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 (A)</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 (D)</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 (D)</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 (B)</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 (A)</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 (A)</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 (B)</p> Signup and view all the answers

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

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

What is the antidote for heparin overdose?

<p>Protamine sulfate (A)</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 (C)</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 (D)</p> Signup and view all the answers

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

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

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

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

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

<p>Atropine (B)</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 (B)</p> Signup and view all the answers

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

<p>To regulate heart rhythm (A)</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 (B)</p> Signup and view all the answers

What is the most common type of pacemaker?

<p>Transcutaneous pacemaker (B)</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 (A)</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 (C)</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 (C)</p> Signup and view all the answers

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

<p>Epicardial pacemaker (D)</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 (C)</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 (D)</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 (D)</p> Signup and view all the answers

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

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

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

<p>Epicardial (A)</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 (A)</p> Signup and view all the answers

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

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

What type of pacing is commonly seen in hospitals today?

<p>Transcutaneous (C)</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 (A)</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 (B)</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 (C)</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 (C)</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 (C)</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 (A)</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 (D)</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 (B)</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 (C)</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 (B)</p> Signup and view all the answers

What is a potential complication of pacemaker insertion?

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

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

<p>Millivolts (C)</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 (A)</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 (C)</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 (B)</p> Signup and view all the answers

What is the typical location for implanting a pacemaker?

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

What is the primary concern when a pacemaker is implanted?

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

How often may a pacemaker need to be replaced?

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

What is the purpose of maintaining a pacemaker?

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

What is the primary purpose of pacemaker batteries?

<p>To stimulate the myocardium (C)</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 (A)</p> Signup and view all the answers

What is the primary purpose of replacing pacemaker wires?

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

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