Cardiac Quiz
65 Questions
0 Views

Choose a study mode

Play Quiz
Study Flashcards
Spaced Repetition
Chat to lesson

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

the result of significant decrease in cardiac output or abnormal distribution of blood volume.

  • Cardiac arrest
  • Shortness of breath
  • Shock (correct)

    • Shock is a life-threatening condition due to not getting enough blood flow

    True

    Match the following types of shock with their descriptions:

    Distributive = vasoplegic response, massive vasodilation, Sepsis Hypovolemic = Decreased blood volume Cardiogenic = Decreased Pump Function Obstructive = barrier to perfusion – a clot, tamponade, pneumothorax

    Match the following conditions with their effects on blood flow:

    <p>Vasoplegic response = Massive vasodilation Decreased blood volume = Hypovolemic shock Decreased Pump Function = Cardiogenic shock Barrier to perfusion = Obstructive shock – clot, tamponade, pneumothorax</p> Signup and view all the answers

    Match the following shock types with their primary causes:

    <p>Distributive shock = vasoplegic response, sepsis Hypovolemic shock = Significant decrease in blood volume Cardiogenic shock = Abnormal distribution of blood volume Obstructive shock = Barrier to perfusion – clot, tamponade, pneumothorax</p> Signup and view all the answers

    Rule #1 These drugs should ___ given through periphery .

    Signup and view all the answers

    A nurse is teaching her students about pressors , Which comment needs more teaching?

    <p>The patient should have optimally fluid for pressors to have their maximal effect</p> Signup and view all the answers

    A student sees a patient whos on a vasopressor tissue is having necrosis , what is happening and what should be done ?

    <p>Vasopressors can cause tissue necrosis if extravasated. As such, they should be given through a central line.</p> Signup and view all the answers

    What type of line is commonly used in conjunction with vasopressors ?

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

    Why do we give vasopressors ?

    <p>Shock, Hypotension, Sepsis, Inotropic/Chronotropic Support : Cardiogenic Shock</p> Signup and view all the answers

    A patient comes in with hypotention and shock , Dr orders to give them the medication that Mimic the effect of the sympathetic nervous system and that will RAISE BLOOD PRESSURE . Which medication do we adminster and route ?

    <p>Norepinephrine , Central line</p> Signup and view all the answers

    Patient is taken Norepinephrine Due to the profound vasoconstriction – patient is at ______risk for limb ischemia, ______ (kidney/liver)

    Signup and view all the answers

    A student nurse as their nurse how do we give Norepinephrine and why ?

    Signup and view all the answers

    Which medication is most useful in Anaphylaxis or Profound Refractory Hypotension?

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

    Doctor orders a medication that has potent Alpha1, Beta1, and Beta 2 receptor agonist because he says it will raise BP, Heart Rate, Systemic Vascular, Resistance, Cardiac Index, and Stroke Volume. Which medication was he referring to

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

    Nurse tells student nurse that they need the medication that has action that is dose dependent because it has different receptors alpha vs beta vs dopaminergic are stimulated depending on how much or how little is given. which med does the student get from the med cart?

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

    Dopamine is a precursor of epinephrine and norepinephrine

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

    Match the dose amounts for dopamine

    <p>1-5mcg/kg/min = Increases renal blood flow</p> <blockquote> <p>10mcg/kg/min = Stimulates beta receptors 20 – 50 mcg/kg/min = Beta activity continues + alpha stimulation also occurs =</p> </blockquote> Signup and view all the answers

    Dopamine : At low doses there is ________ effect on heart rate or blood pressure but increased renal perfusion (increased urine output) • At higher doses it can ______ heart rate • At max doses it can ______ heart rate and blood pressure

    Signup and view all the answers

    Dobutamine

    <h1>A sympathomimetic = = Beta 1 agonist, MILD Beta 2, LITTLE to NONE Alpha stimulation Increases INOTROPY (contraction) = has minimal effect on CHRONOTROPY (heart rate) Used when an increase in Cardiac Output is needed = without the increase in Blood Pressure</h1> Signup and view all the answers

    which medication do we use when an increase in Cardiac Output is needed without the increase in Blood Pressure

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

    Dobutamine

    Dobutamine • Caveat: The patient actually needs a little “extra” blood pressure because the vasodilating effects may cause ?

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

    Which drug is A synthetic adrenergic drug that stimulates ALPHA-adrenergic receptors to produce vasoconstriction, Longer duration than epinephrine but less potent effects, Can cause bradycardia

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

    Cardiac drugs

    <h1>RAAS Inhibitors = ACE/ARBs (”-pril” “-sartan”) Sympatholytic Drugs = Beta Blockers (Metoprolol Succinate) Neprilysin Inhibitor = Sacubitril</h1> Signup and view all the answers

    Cardiac drugs

    <h1>Inotropes = Cardiac Glycosides - Digoxin Diuretics = Furosemide, Bumetanide, HCTZ, Sprinolactone Inotropes = Milrinone</h1> Signup and view all the answers

    Patient comes in with Decreased Cardiac Output, Cardiac Dysrhythmias, Edema, Electrolyte imbalances, Acute Exacerbations what type of complications are they experencing ?

    <p>Heart failure</p> Signup and view all the answers

    What is the digoxin safe range ?

    <p>0.8-2</p> Signup and view all the answers

    Patient comes in with heart failure with L ventricular dysfunction what medication would we admister

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

    Patient with HYPOKALEMIA, digoxin _____ can develop

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

    In a patient with HYPERKALEMIA , digoxin can be ___

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

    Digoxin is considered what line of drug choice for heart failure

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

    Patient is lethargy, confusion, GI upset with bradycardia and Yellowish-green discoloration of the vision what is happening and what is the nurses action needed to do ?

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

    What are some nursing considerations needed for Digoxin

    <p>A &amp; C</p> Signup and view all the answers

    Diuretic Therapy

    <h1>Loop Diuretic = POTENT diuretics (lots of urination, lots of risk for electrolyte imbalances (furosemide, bumetanide) Thiazide Diuretics = They’re “mid” – get the job done but not as potent. Still some electrolyte imbalances (HCTZ) Spironolactone = Potassium sparring (increase K+). Hold on to potassium. Low diuretic effects</h1> Signup and view all the answers

    Diuretic Therapy

    <h1>Loop Diuretic = (furosemide, bumetanide) thiazide diuretic = (HCTZ) Potassium sparring = Spironolactone</h1> Signup and view all the answers

    patient comes in with edema, fluid overload in patient’s with moderate to severe heart failure. Which medication do we give

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

    which diuretic medication effects are

    1. Major diuresis
    2. High potential for fluid-electrolyte imbalances
      • ototoxicity + nephrotoxicity

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

    What is a nursing consideration for patients on loop diuretics?

    <p>Weigh the patient daily and report weight gain of more than 2lb in 24 hours</p> Signup and view all the answers

    When should loop diuretics be held for the patient's safety?

    <p>If the patient is at risk of dehydration</p> Signup and view all the answers

    Which parameter should be monitored especially in patients on loop diuretics?

    <p>Serum electrolytes, especially potassium</p> Signup and view all the answers

    What is the primary effect of Beta Blockers in heart failure?

    <p>Decrease mortality rate and suppress the Sympathetic Nervous System</p> Signup and view all the answers

    Which drug is a prototype for heart failure and prevents ventricular fibrillation?

    <p>Metoprolol Succinate</p> Signup and view all the answers

    What is the impact of Beta Blockers on cardiac workload and oxygen consumption?

    <p>Reduce cardiac workload and oxygen consumption</p> Signup and view all the answers

    What is the primary effect of Milrinone in acute heart failure?

    <p>Increased contractility</p> Signup and view all the answers

    What is the main impact of Milrinone on systemic/pulmonary vasculature?

    <p>Smooth muscle relaxation</p> Signup and view all the answers

    Which condition is Milrinone commonly used for?

    <p>Acute heart failure</p> Signup and view all the answers

    What is the primary recommended use of Sacubitril/Valsartan (Entresto)?

    <p>To block RAAS effects and sustain natriuretic peptide activity in severe heart failure (EF &lt; 40%)</p> Signup and view all the answers

    What is a Risk associated with Sacubitril/Valsartan (Entresto)?

    <p>Risk of angioedema, particularly in African American patients</p> Signup and view all the answers

    What patient population should not use Sacubitril/Valsartan (Entresto) due to the black box warning?

    <p>Pregnant women</p> Signup and view all the answers

    Why are vasopressors commonly given through a central line?

    <p>To minimize the risk of tissue necrosis if extravasated</p> Signup and view all the answers

    Why is it important for a patient to be optimally fluid resuscitated before administering vasopressors?

    <p>To maximize the effectiveness of the vasopressors in improving blood flow</p> Signup and view all the answers

    What is the primary purpose of using an arterial line in conjunction with vasopressors?

    <p>To monitor blood pressure and guide titration of vasopressor therapy</p> Signup and view all the answers

    In the context of shock, which type of shock is characterized by a significant decrease in cardiac output or abnormal distribution of blood volume?

    <p>Distributive shock</p> Signup and view all the answers

    Which drug mimics the effect of the sympathetic nervous system, causing vasoconstriction and raising blood pressure?

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

    Which drug has effects that are dose-dependent, with different receptors being stimulated at varying doses?

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

    Which drug is used when an increase in cardiac output is needed without raising blood pressure?

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

    Which drug stimulates alpha-adrenergic receptors to produce vasoconstriction, with longer duration but less potent effects than epinephrine?

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

    Which drug is indicated for use in heart failure with left ventricular dysfunction and has a narrow therapeutic index?

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

    What are the symptoms of digoxin toxicity?

    <p>Bradycardia, confusion, and visual disturbances</p> Signup and view all the answers

    Which drug is commonly used for managing edema and fluid overload in heart failure, with potent effects and requiring close monitoring of electrolytes?

    <p>Loop diuretics</p> Signup and view all the answers

    Which type of heart failure can result from structural damage, decreased cardiac output, cardiac dysrhythmias, and complications like edema and electrolyte imbalances?

    <p>Chronic heart failure</p> Signup and view all the answers

    Which drug mimics endogenous catecholamines, raising blood pressure, heart rate, systemic vascular resistance, cardiac index, and stroke volume?

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

    Which drug is a sympatholytic drug commonly used in heart failure management?

    <p>Beta blockers</p> Signup and view all the answers

    Which drug is used to reverse or assist the detrimental effects of heart failure and is also a neprilysin inhibitor?

    <p>Neprilysin inhibitors</p> Signup and view all the answers

    Which drug is most commonly used for managing edema and fluid overload in heart failure, with high potential for fluid-electrolyte imbalances and ototoxicity?

    <p>Loop diuretics</p> Signup and view all the answers

    Study Notes

    Inotropic/Chronotropic Support in Cardiogenic Shock

    • Inotropic/chronotropic support drugs include norepinephrine, dobutamine, epinephrine, dopamine, phenylephrine
    • Norepinephrine mimics the effect of the sympathetic nervous system, causing vasoconstriction and raising blood pressure
    • Epinephrine mimics endogenous catecholamines, raising BP, heart rate, systemic vascular resistance, cardiac index, and stroke volume
    • Dopamine's effects are dose-dependent, with different receptors being stimulated at varying doses
    • Dobutamine increases inotropy but has minimal effect on chronotropy, used when an increase in cardiac output is needed without raising blood pressure
    • Phenylephrine stimulates alpha-adrenergic receptors to produce vasoconstriction, with longer duration but less potent effects than epinephrine
    • Heart failure drugs include RAAS inhibitors, sympatholytic drugs, neprilysin inhibitor, inotropes, and diuretics
    • Heart failure can result from structural damage, decreased cardiac output, cardiac dysrhythmias, and complications like edema and electrolyte imbalances
    • Drugs used to reverse or assist the detrimental effects of heart failure include digoxin, diuretics, beta blockers, neprilysin inhibitors, and milrinone
    • Digoxin is indicated for use in heart failure with left ventricular dysfunction and has a narrow therapeutic index
    • Digoxin toxicity symptoms include lethargy, confusion, GI upset, dysrhythmias, and yellowish-green discoloration of vision
    • Diuretics like loop diuretics and thiazides are used for managing edema and fluid overload in heart failure, with loop diuretics being potent and requiring close monitoring of electrolytes

    Studying That Suits You

    Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

    Quiz Team

    Related Documents

    Cardiac Lecture Part 2 PDF

    More Like This

    Use Quizgecko on...
    Browser
    Open
    Browser
    Browser