Cardiovascular Health and Metabolic Syndrome Quiz
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Questions and Answers

What are the main components contributing to cardiac output?

  • Preload, afterload, stroke volume, and heart rate
  • Preload, afterload, contractility, and stroke volume
  • Preload, afterload, contractility, and ejection fraction
  • Preload, afterload, contractility, and heart rate (correct)

    • What is the primary goal of treatment for Metabolic Syndrome?

  • Reducing fasting glucose levels
  • Increasing HDL cholesterol
  • Lowering blood pressure
  • Preventing the development of cardiovascular disease (correct)

    • Which of the following is NOT a characteristic of Metabolic Syndrome?

  • High blood pressure (>=130/85 mmHg)
  • Large waist circumference (>=94 cm for men, >=80 cm for women)
  • Low HDL cholesterol (<1.0 mmol/L for men, <1.3 mmol/L for women)
  • High fasting glucose (>=5.6 mmol/L)
  • High LDL cholesterol (>=3.0 mmol/L) (correct)

    • What is the significance of Pat's HDL cholesterol level of 2.0 mmol/L?

    <p>It is considered low and is a risk factor for heart disease. (C)</p> Signup and view all the answers

    According to the information provided, what is the relationship between preload and cardiac output?

    <p>Increasing preload leads to increased cardiac output. (B)</p> Signup and view all the answers

    Which of the following interventions would be a priority for Pat to help prevent the development of cardiac disease?

    <p>Implement lifestyle modifications such as diet and exercise. (E)</p> Signup and view all the answers

    What is the significance of Pat's waist circumference of 100cm?

    <p>It's considered high and is a risk factor for metabolic syndrome. (A)</p> Signup and view all the answers

    Based on the information provided, which of the following statements is true about the treatment of metabolic syndrome?

    <p>There is no specific treatment for metabolic syndrome, but it can be controlled through lifestyle modifications. (A)</p> Signup and view all the answers

    Which of the following medications is used to control the ventricular response by controlling the refractory period and reducing heart rate?

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

    What is a common adverse effect associated with Digoxin?

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

    Which of the following medications can increase digoxin levels by 50%?

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

    What is the typical oral maintenance dose of Digoxin?

    <p>0.125-0.5 mg/day (C)</p> Signup and view all the answers

    What is the mechanism of action of digoxin in treating heart failure?

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

    Which of the following is a contraindication for the use of Digoxin?

    <p>Aortic stenosis (D)</p> Signup and view all the answers

    What is the normal therapeutic range for Digoxin levels?

    <p>0.5-0.9 ng/ml (C)</p> Signup and view all the answers

    What is the primary treatment for digoxin toxicity?

    <p>Digoxin immune Fab (D)</p> Signup and view all the answers

    What is the primary goal of treating restrictive cardiomyopathy?

    <p>Increase cardiac output (B)</p> Signup and view all the answers

    Which of the following medications are commonly used to decrease preload in patients with restrictive cardiomyopathy?

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

    Which of the following medications are commonly used to increase contractility in patients with restrictive cardiomyopathy?

    <p>Calcium channel blockers (B)</p> Signup and view all the answers

    What is the primary goal of activity management in patients with restrictive cardiomyopathy?

    <p>Reduce the workload on the heart (D)</p> Signup and view all the answers

    Which of the following medications should be avoided in patients with restrictive cardiomyopathy?

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

    What is the primary goal of monitoring for signs of clotting in patients with restrictive cardiomyopathy?

    <p>Decrease the risk of stroke (B)</p> Signup and view all the answers

    Which of the following medications are commonly used to treat dilated cardiomyopathy?

    <p>ACE inhibitors, diuretics, and beta-blockers (D)</p> Signup and view all the answers

    What is the primary goal of surgical treatment for hypertrophic cardiomyopathy?

    <p>Decrease the size of the enlarged septum (D)</p> Signup and view all the answers

    What is the most likely classification of heart failure that Pat is experiencing based on her ejection fraction?

    <p>HFrEF (D)</p> Signup and view all the answers

    Based on the information provided, which of the following medications would be appropriate for Pat?

    <p>Metoprolol (A), Sacubitril/valsartan (C)</p> Signup and view all the answers

    What is the main purpose of the prescribed medication Sacubitril/valsartan?

    <p>Reduce blood pressure and improve heart contractility (D)</p> Signup and view all the answers

    Which of the following laboratory results is most indicative of heart failure in Pat's case?

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

    Which of the following is NOT a potential adverse effect of Sacubitril/valsartan?

    <p>Increased risk of bleeding (C)</p> Signup and view all the answers

    Which of the following is an important nursing consideration related to administering Sacubitril/valsartan to Pat?

    <p>Monitoring blood pressure and potassium levels (A)</p> Signup and view all the answers

    Which of Pat's ECG findings indicates that she has had a previous myocardial infarction?

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

    What is the primary reason for the delay in administering Sacubitril/valsartan to Pat after she has been taking an ACE inhibitor?

    <p>To prevent drug interactions (D)</p> Signup and view all the answers

    Which of the following is a contraindication for treatment in heart failure management?

    <p>Acute decompensated heart failure (C)</p> Signup and view all the answers

    What adverse effect should be closely monitored following treatment for heart failure?

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

    What vital sign indicates potential concern for Pat in the CCU setting?

    <p>Blood pressure of 84/43 (D)</p> Signup and view all the answers

    Which of the following teaching points is essential for a patient with heart failure?

    <p>Monitor daily weights (C)</p> Signup and view all the answers

    What lab finding may be crucial when assessing the treatment of a patient with heart failure?

    <p>Increased troponin levels (D)</p> Signup and view all the answers

    What is a key nursing consideration when administering SGL2T inhibitors?

    <p>Monitor for signs of dehydration (B)</p> Signup and view all the answers

    Which adverse reaction is specifically associated with Canagliflozin?

    <p>Increased risk of urinary tract infections (C)</p> Signup and view all the answers

    Which signs indicate potential hyperkalemia in a patient?

    <p>Feeling dizzy and faint (D)</p> Signup and view all the answers

    What is the mechanism of action of Ivabradine?

    <p>Inhibits the cardiac pacemaker If current (D)</p> Signup and view all the answers

    What should be monitored to prevent acute kidney injury in patients taking SGL2T inhibitors?

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

    Which of the following is an important educational point for patients considering SGL2T inhibitors?

    <p>Monitor blood pressure regularly (A)</p> Signup and view all the answers

    What potential side effect should a nurse monitor for in a patient taking Ivabradine?

    <p>Bradycardia (D)</p> Signup and view all the answers

    Which dietary consideration is important for a patient using SGL2T inhibitors?

    <p>Monitor potassium levels (C)</p> Signup and view all the answers

    Flashcards

    Metabolic Syndrome

    A cluster of conditions increasing heart disease risk.

    Pacemaker Therapy

    A treatment using a device to regulate heart rhythm.

    End-Stage Heart Failure

    Severe heart failure requiring advanced treatment options.

    Left Ventricular Assist Device (LVAD)

    A mechanical pump used for heart failure patients.

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    Immunosuppressive Therapy

    Medications to prevent organ transplant rejection.

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    Cardiac Output

    The amount of blood the heart pumps in a minute.

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    Preload

    The volume of blood in the ventricles before contraction.

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    Afterload

    The resistance the heart must overcome to pump blood.

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    Dilated Cardiomyopathy

    A type of cardiomyopathy where the heart becomes enlarged and weakened, affecting its ability to pump blood.

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    Digoxin

    A cardiac glycoside that increases heart contractility and controls ventricular rate, used for heart failure and atrial fibrillation.

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    Positive Ionotropic Medication

    Drugs that increase the strength of heart muscle contractions.

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    Bradycardia

    A slower than normal heart rate, often a side effect of digoxin.

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    Narrow Therapeutic Window

    A small range between effective and toxic drug levels, significant with digoxin.

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    Digoxin Toxicity

    Occurs when digoxin levels become too high, leading to serious health issues.

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    Contraindications for Digoxin

    Conditions that make digoxin use dangerous, like certain heart arrhythmias and known allergies.

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    Goals of Treatment in Hypertrophic Cardiomyopathy

    Aim to improve cardiac output, manage heart rate, and control preload and afterload.

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    Restrictive Cardiomyopathy

    A condition where the heart muscle becomes rigid, reducing its ability to fill properly with blood.

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    Goals of Treatment

    To improve cardiac output by managing heart rate, preload, afterload, and contractility.

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    Pharmacology Treatments

    Utilized to decrease preload and afterload while increasing contractility through medications.

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    Decrease Preload

    Reduction of the volume of blood the heart fills with before contracting, often using diuretics and nitrates.

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    Increase Contractility

    Enhancing the heart's ability to contract more forcefully, using meds like beta-blockers and digoxin.

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    Assessing Cardiomyopathy

    Nursing intervention that involves monitoring for decreased cardiac output and symptoms like heart failure.

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    Heart Failure Monitoring

    Keeping track of symptoms related to heart failure, such as swelling and shortness of breath.

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    Medications for Different Cardiomyopathies

    Specific medications are indicated for dilated, hypertrophic, and restrictive types, with some to be avoided.

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    Heart Failure

    A condition where the heart cannot pump effectively, leading to shortness of breath and fatigue.

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    BNP (B-type Natriuretic Peptide)

    A protein hormone indicating heart function; elevated levels suggest heart failure.

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    Ejection Fraction

    Percentage of blood the heart pumps out with each beat; key measure in heart failure diagnosis.

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    HFpEF

    Heart failure with preserved ejection fraction; heart pumps normally but struggles with filling.

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    HFrEF

    Heart failure with reduced ejection fraction; heart's pumping ability is diminished.

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    Sacubitril/Valsartan

    An ARNi used to reduce mortality in heart failure patients with decreased EF.

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    Adverse Effects of ARNi

    Potential side effects include dizziness, cough, hypotension, and hyperkalemia.

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    Monitoring for Heart Failure

    Key assessments include orthostatic blood pressure, daily weight, and monitoring for adverse effects.

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    Heart Failure Indications

    Conditions for which heart failure medications are prescribed, including reducing mortality and hospitalizations.

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    Contraindications in Heart Failure

    Situations where certain heart failure medications should not be used, such as acutely decompensated heart conditions.

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    Adverse Effects of Heart Failure Medications

    Negative reactions from heart failure treatments, including bradycardia and hypertension.

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    Heart Failure Patient Education

    Key teaching points for patients with heart failure, including daily weights and fluid restrictions.

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    Fetal Toxicity

    Potential harm to a developing fetus from medications.

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    Monitoring Blood Pressure

    Regularly checking blood pressure to detect changes.

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    Hyperkalemia Signs

    Symptoms indicating high potassium levels in blood.

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    SGLT2 Inhibitors

    A class of antidiabetic drugs that reduce heart stress.

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    Acute Kidney Injury

    Sudden decline in kidney function requiring monitoring.

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    Ivabradine Mechanism

    Reduces heart rate without altering heart contractions.

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    Hypoglycemia

    Abnormally low blood sugar levels requiring intervention.

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    Ketoacidosis Signs

    Complication from insufficient insulin leading to acidosis.

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    Study Notes

    Course Information

    • Course name: NURS 498 Complex Cardiovascular Disorders
    • Topic: Pharmacology and Nursing Interventions
    • Instructors: K. McCartney MN, RN; C. Seneviratne PHD, RN; C. Fox MN, RN; S. De Boer MN, RN
    • Adapted from: K. Sealock and T. Ens

    Learning Objectives

    • Analyze patient predisposition to metabolic syndrome and create an appropriate care plan, including preventative strategies
    • Compare and contrast different methods of pacemaker therapy
    • Demonstrate prioritization of nursing interventions for post-operative open heart surgery patients
    • Determine ongoing care planning for end-stage heart failure patients
    • Establish criteria for patients to receive destination LVAD (Left Ventricular Assist Device) as a treatment for end-stage heart failure
    • Establish knowledge of long-term collaborative care problems for heart transplant recipients
    • Consider the pharmacokinetics and pharmacodynamics of immunosuppressive therapy post-heart transplant

    Table of Contents

    • Check In
    • Cardiomyopathy
    • Pericarditis
    • Device Therapy
    • Heart failure
    • Cardiac Surgery Interventions

    Additional Information

    • Metabolic Syndrome: No specific treatment
    • Pat's initial assessment: BP-150/90, Fasting Glucose- 8.0, Waist- 100cm, HDL- 2.0mmol/L
    • Pharmacology and Nursing Interventions: Lowering LDL, lowering triglycerides, antihypertensives, antidiabetics, and a healthy lifestyle
    • Cardiac Diagnostic Tests: ECG, Lab work (Serum B-type natriuretic peptide (BNP), Troponin (Trop)), Echocardiogram, More advanced cardiac testing (Cardiac MRI, Cardiac catheterization, Myocardial Perfusion Imaging)
    • Heart Disease Statistics (Canadian): 1 in 12 adults age 20+, significantly higher in those with heart attacks or heart failure and at age 40+
    • Coronary Artery Disease: Lab values to help confirm diagnosis
    • Troponin: Myocardial muscle protein released into circulation after myocardial injury (including TnI and TnT)
    • Interventions for Coronary Artery Disease: Diagrams (A, B, C)
    • Coronary Artery Bypass surgery: Diagram showing ascending aorta, saphenous vein graft to the right coronary artery and blockage
    • Goals of medical treatment for Coronary Artery Disease: Prevent plaque buildup, minimize workload on the heart, and lower cholesterol
    • Nursing interventions for coronary artery disease: Pain management, assess cardiac output, knowledge, lifestyle modifications, fluid status education, coping mechanisms, and medication management.
    • Patient Education: Emphasis on lifestyle changes, medication necessity (aspirin and ticagrelor), and mechanisms of action
    • Types of Cardiomyopathy: Diagram showing a normal heart and examples of dilated cardiomyopathy, with emphasis on how these differences affect cardiac output, heart rate, preload, afterload, and contractility.
    • Dilated Cardiomyopathy Pharmacology Treatments: Decrease afterload (ACE, ARB, calcium channel blockers), increase contractility (Digoxin), and decrease preload (diuretics, nitrates)
    • Hypertrophic Cardiomyopathy: Pharmacology Treatments: Decrease contractility (beta-blocker, calcium channel blocker), Decrease Heart Rate (beta-blocker, calcium channel blocker), and varied management for preload and afterload
    • Restrictive Cardiomyopathy: Pharmacology Treatments: decrease preload (diuretics, nitrates), decrease afterload (ACE, ARB, calcium channel blockers), and increase contractility (beta-blockers, calcium channel blockers, digoxin)
    • Cardiac Diagnostic Tests: ECG, Echocardiogram, Lab work (Serum BNP and Troponin), further cardiac tests (Cardiac MRI, Cardiac catheterization, Myocardial Perfusion Imaging)
    • Resources and URL: https://www.youtube.com/watch?v=ithdrJuSj3A, www.heartandstroke.ca/heart/conditions/cardiomyopathy
    • Chronic Cardiac Dysrhythmias: Classification of the types of drugs that are used in treatment, and diagrams of the heart, and what happens during the dysrhythmias event.
    • Nursing care and interventions for EP (electrophysiology)
    • Cardiac Ablation: Explanation of the procedure
    • Cardiac Implantable Devices (Pacemaker and ICD) description of pacemaker codes, illustrations of their placement and how they work, and ICD shocks in emergent situations
    • Pediatric Considerations (Pacemakers): Underlying congenital cardiac defect, possibility of temporary AV block after a structural repair, CPR instructions, and psychological well-being
    • Pacemaker Therapy Nursing Interventions: Post-operative care (infection, hematoma, output, pulse, activity restrictions, pneumothorax or tamponade assessment). Ongoing care (patient teaching, electromagnetic interference, when to call for help, and wearing a medical alert bracelet)
    • Internal Cardioverter-Defibrillator (ICD): Nursing interventions (monitor cardiac output, electrolytes and fluid status, monitor for signs/symptoms of infection, support, and family education
    • Cardiac Resynchronization Therapy (CRT): Brief explanation of the purpose of the device and its components
    • How to deal with a particular rhythm
    • Acute Heart Failure: Medical Management with Medications, nursing considerations, and possible readmission to CCU (Coronary Care Unit).

    Additional Topics

    • B-type Natriuretic Peptide (BNP): How BNP and NT-proBNP are used to detect heart failure, and what test results indicate possible heart failure.
    • Goals of Care: Medical care, comfort care, and resuscitative care, and how they work together in cases of heart failure.
    • Heart Failure Classification: Differentiating between preserved ejection fraction heart failure (HFpEF) and reduced ejection fraction heart failure (HFrEF).
    • Specific Medications: Description of the mechanisms, indications, adverse effects and nursing considerations for each medication including: Dopamine hydrochloride, Norepinephrine, Milrinone, Dobutamine hydrochloride
    • Important Notes: List of adverse reactions to medications, and a list of possible complications from open heart surgery.
    • Valvular Disease and Surgical Interventions: How mechanical valves and tissue valves are used in cardiovascular surgeries and surgical processes.
    • Transcatheter Aortic Valve Implantation: The process and procedure
    • Nursing Implications for Prosthetic Valves: Concerns to assess for during patient care
    • End Stage Heart Failure Symptom Management options and LVAD-related complications.

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    NURS 498 Complex Cardiovascular Disorders PDF

    Description

    Test your knowledge on the key aspects of cardiac output and metabolic syndrome treatment. This quiz covers important components such as HDL cholesterol levels, waist circumference significance, and medications like Digoxin. Assess your understanding of cardiovascular health and its implications.

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