NUR 354 - EXAM 3: Atherosclerotic Cardiovascular Disease

Atherosclerotic Cardiovascular Disease (ASCVD)

• Determines the need for statin therapy in patients and the appropriate dosage levels (low, medium, high).

Antiplatelet Medications

• Common antiplatelets include: Aspirin, Ticagrelor, Clopidogrel, and Tirofiban.

Patient Education for Hyperlipidemia

• Recommendations include weight reduction, increased exercise, and reduced intake of saturated fats.

Medication Adherence for Hyperlipidemia Patients

• Educate patients to take medication at bedtime, maintain a diet and exercise regimen, and routinely check labs.

Medications Improving Cardiac Contractility

• Medications such as Amrinone, Milrinone, Dobutamine, and Digoxin enhance heart contractility.

Concepts of Inotropic and Contractility

• These terms refer to increasing the strength and force of heart contractions.

Classes of Antiarrhythmics

• Includes: Class I (Sodium Channel Blockers), Class II (Beta Blockers), Class III (Potassium Channel Blockers), Class IV (Calcium Channel Blockers).

Adenosine Use

• Primarily used to treat supraventricular tachycardia (SVT) by lowering heart rate.

Mechanism of Action in Antiarrhythmics

• All antiarrhythmics primarily function to reduce heart rate.

Diseases Concerned with Fluid Overload

• Most concern arises in heart failure and kidney disease patients.

Anticoagulant Necessity in Atrial Fibrillation

• To prevent stroke and clot formation.

Reversal Agents

• Warfarin: Vitamin K
• Heparin: Protamine sulfate
• Rivaroxaban: Andexanet alfa
• Dabigatran: Idarucizumab
• General reversal for antiplatelets: Platelets
• General reversal for anticoagulants: Plasma

Amiodarone Black Box Warnings

• Includes pro-arrhythmic effects, pulmonary toxicity, and hepatotoxicity.

Cardiac Output Calculation

• Cardiac output is determined by the formula: Stroke Volume x Heart Rate.

Understanding Preload

• Refers to the volume returning to the heart; optimal levels depend on patient condition.

Understanding Afterload

• Indicates the pressure the heart must work against; managing it depends on the patient's blood pressure status.

Monitoring for Respiratory Infection

• Medications like Betablockers and Amiodarone warrant caution due to risk signs.

Non-Pharmacologic Interventions for Heart Failure

• Recommendations include restricting salt and fluid intake.

Beta Blocker Indications

• Treats conditions such as anxiety, hypertension, heart failure, and dysrhythmias.

Types of Beta Blockers

• Include Non-Selective (e.g., Propranolol), Cardio Selective (e.g., Torsemide), and Cardio Selective with vasodilator effects.

Anticoagulant vs. Antiplatelet Mechanisms

• Anticoagulants prevent clotting, while antiplatelets inhibit platelets from aggregating.

Over-the-Counter Antiplatelet

• Aspirin is commonly available as an OTC option.

Patient Education for Anticoagulants/Antiplatelets

• Includes bleeding precautions and signs like bleeding gums or bruising.

Heparin's Role in Myocardial Infarction

• Prevents further clot formation and reduces damage during myocardial infarction.

Labs to Monitor with Warfarin

• Requires monitoring of PT and INR levels regularly.

Indications for Alteplase

• Used in cases such as stroke, heart attack, and pulmonary embolism.

Digoxin Administration

• Requires assessment of apical pulse beforehand.

Medications to Hold with Bradycardia

• Include Amiodarone, Labetalol, and Digoxin among others.

Teachings related to TPA Administration

• Avoid in patients with recent surgery, trauma, or uncontrolled hypertension.

First-Line Drug Class for Hyperlipidemia

• Statins (HMG-CoA reductase inhibitors) are commonly prescribed.

Foods Rich in Vitamin K

• Includes broccoli and other leafy green vegetables.

Adverse Effects of Ezetimibe

• Common side effect noted is nasopharyngitis.

Monoclonal Antibodies for High LDL Treatment

• Includes Alirocumab and Evolocumab, aimed at lowering LDL levels.

Target Cholesterol Levels

• Total cholesterol: under 200
• LDL: under 100
• Triglycerides: under 150
• HDL: over 50 in females, over 40 in males.

Warfarin Interaction Alerts

• Notable for highly interactive potential with various medications.

DOAC Preference Reasons

• They require less lab monitoring and have fewer interactions.

Common Side Effects of Statins

• Muscle aches and discomfort are frequently observed.

Six Rights of Medication Administration

• Include drug, dose, documentation, patient, route, and timing.

Ejection Fraction

• Refers to the percentage of blood the left ventricle ejects, approximately 55%-70%.

Hypertensive Emergency Threshold

• Defined as a blood pressure reading of 180/120.

Shock Monitoring Priorities

• Blood pressure is the most critical vital sign to monitor in shock conditions.

Gemfibrozil Administration

• Should be taken with food to enhance efficacy.

Digoxin Impact

• It mainly affects potassium levels in the body.

Starting Treatment for Hyperlipidemia

• Usually initiated with HMG-CoA reductase inhibitors like Atorvastatin or Rosuvastatin.

High Afterload Effects

• Result in decreased stroke volume performance.

Assessment of Polyuria

• Important in cases of diabetes, kidney, heart issues, or during fluid administration.

Cardiovascular Diseases Associated with CVD

• Includes myocardial infarction (MI), stroke, and cerebrovascular accident (CVA).

Isosorbide Dinitrate Usage

• Prescribed for heart failure and commonly given alongside hydralazine.

Furosemide Administration Rate

• Recommended to be administered at 20mg/min.

Role of Lifestyle Modifications in Managing Hyperlipidemia

• Helpful, but most patients will still require medication for management.

This quiz covers topics related to Atherosclerotic Cardiovascular Disease (ASCVD) and other health-related concepts. Prepare for your NUR 354 exam with this study guide.