Billie's cards Cardiac

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  1. What is responsible for actual cardiac contractions/depolarization?
  2. Describe what happens with sodium, calciumm and potassium during depolarization (contraction) of the cardiac muscle.
    Sodium and Calcium goes in and potassium is forced out
  3. Describe what happens to Sodium, calcium, and potassium during repolarization (relax)?
    Sodium and calcium are forced out and potassium moves into cell
  4. To pump blood, the heart muscle needs three things. What are they?
    • Action potential to begin depolarization (sodium)
    • Mechanical activation by Calcium
    • Energy in form of ATP that acts as the mechanism for contration
  5. Describe the order of the conduction system/electrical impulse of the heart.
    • SA node
    • AV node
    • Bundle of HIS
    • Bundle branches
    • Purkinjie fibers
  6. What stimulates the electrical impulse (action potential)?
    Sodium is responsible
  7. OTC meds that can counteract the effects of diuretics include:
    a) acetaminophen
    d) mulitple vitamins
  8. The recommended diuretic for initial therapy of essential hypertension is a(n):
    a)high ceiling (loop)
    c)potassium sparing
  9. Drugs that block the Renin-angiotensin aldosterone System lower blood pressure by:
    a)constricting arteries
    b)constricting Veins
    c)increase excretion of potassium
    d)increase excretion of water
  10. Most diuretics work by:
    a)blocking synthesis of pumps responsible for sodium adn potassium transport in the distal nephron
    b)acting on the collecting duct to increase permeability to water
    c)blocking sodium and chloride reabsoption
    d)blocking reabsorption of sodium in the distal nephron and increase potassium reabsorption
  11. The older term "esential hypertension" is synonymous with:
    a)isolated systolic hypertension
    c)Primary hypertension
    d)secondary hypertension
  12. Th RN would expect pharmacotherapy for an African American patient with hypertension to include a(n):
    a) ACE inhibitor
  13. Match the action of the following antihypertensive with the logical adverse effects for which the RN should assess.
    a)Arterial dilators
    Adverse Effects
    1) Dizziness
    2)Peripheral edema
    3)Slow heart rate
    4)urinary output, electrolyte levels, and dehydration
    • a 1
    • b 3
    • c 4
    • d 2
  14. Which of the following drugs might be prescribed to counteract the reflex tachycardia associasted with administration of CCB?
    a) Digoxin (Lanoxin)
    b)Enalapril (Vasotec)
    c)Furosememide (Lasix)
    d)Metopsolol (Lopressor)
  15. A pt taking both verapamil & digoxin is at greater risk for digitalis toxicity. The RN should assess & monitor the pt for early symptoms of digitalis toxicity, which include:
    a) Anorexia & Nausea
    b) Confusion & slurred vision
    c) Hypertension & tachycardia
    d) photophobia & halos around bright objects
  16. Which of the following statements, if made by a patient with heart failure, would indicate need for futher teaching?
    A) "If blood cannot get through my heart the backup of fluid will make it hard for me to breathe."
    B) My heart is stretching so much it is loosing the ability to squeeze out the blood."
    C) "The changes in my heart started when I began to feel tired & Shortness of Breath"
    D) "When my heart beats too fast, it cannot fill properly."
  17. Loop diuretics are the type of diuretic most commonly administered to hospitalized patients in heart failure because they:
    A) are effective when Kidney function declines
    B) Block receptors for aldosterone
    C) do not increase the risk of digitalis toxicity
    D) Seldom cause hypotension
  18. A patient asks the nurse why she is receiving a different treatment for her dysrhythmia than her husband. The RN's response should be based on the fact that selection is based on the patient's:
    A) Age
    B) Family history of dysrhythmia
    C) Response to drug therapy
    D Sex
  19. The RN responds quickly when a ventricular tachydysrhythmia is identified because this type of dysrhythmia impairs the ability of the heart:
    A) to contract rapidly enough to meet the body needs
    B) to eject an adequate amount of blood
    C) Valves to close properly
    D) Valves to open properly
  20. Matching: Antidysrhythmic drugs & Action
    A. Class I
    B. Class II
    C. Class III
    D. Class IV
    1. Delay repolarization of fast potentials by blocking potassium channels
    2. Reduce calcium entry during fast and slow depolarization and depress phase 4 repolarization of slow potentials
    3. Slow impulse conduction in atria and ventricles by blocking sodium channels
    • A 3
    • B 2
    • C 1
    • D 2
  21. A priority nursing concern for a patient with angina pectoris is:
    A) Alteration in cardiac output
    B) Impaired gas exchange
    C) Inadequate mycardial tissue perfusion
    D) Ineffective breathing pattern
  22. The goal of drug therapy for chronic stable angina is to:
    A) constrict coronary arteries to increase blood pressure during stress
    B) decrease myocardial need for oxygen during stress
    C) increase myocardial blood flow during systole
    D) prevent coronary artery spasms
  23. Match:
    A) Antiplatelet
    B) Anticoagulant
    C) Nitroglycerin

    1) Decrease venous thrombus formation
    2) Prevent thrombocytes from sticking to plaque in arteries
    3) Reduce blood returning to heart by venous
    • B 1
    • A 2
    • C 3
  24. Match:

    A. ACE Inhibitor
    B. Beta Blocker
    C. Morphine

    1. Relieve pain, which decreases sympathatic stimulation and myocardial workload
    2. Slow heart rate, decreasing myocardial need for oxygen
    3. Vasodilate and increase fluid excretion, decreasing blood pressure
    • A 3
    • B 2
    • C 1
  25. Nitroglycerin has myocardial vasodilation effects in varient (Prinzmetal's) angina but not in chronic stable angina because in chronic stable angina myocardial arterioles are:
    A) Already maximally dilated
    B) Experiencing spastic vasoconstriction
    C) Occluded with thrombi
    D) unable to diffuse oxygen in the cell
  26. The nurse recognizes that a drug is a beta blocker if the generic name of the drug ends in:
    A) -cillin
    B) -lol
    C) -pril
    D) -sartan
  27. The RN would consult the prescriber of a patient with heart failure in prescribed:

    A) acetaminophen
    B) Aspirin
    C) Celecoxib
    D) Morphine
  28. A nurse is teaching how drugs that block the effects of angiotension II can be beneficial for heart failure patients. Which statements, if made by the patient would indicate the need foe further teacher?
    A) "The drug helps the heart function primarily by slowing the heart rate."
    B) "The drug can help heart function by zero sodium and water retention by the kidneys, which would increase blood pressure"
    C) "The drug can decrease the formation of extra heart muscle mass."
    D) "The drug can help heart function by zero thickening of the arterial wall and resultant hypertension."
  29. A possible explanation for why digoxin has not demonstrated an improvement in mortality is that the drug does not:

    A) decrease heart rate
    B) Improve heart remodeling
    C) increase cardiac output
    D) Increase urine production
  30. If water and sodium are held in then what happens to blood volume, does it increase or decrease?
  31. What is the most powerful vasoconstrictor?
    ACE inhibitors
  32. Benefits fo ACE inhibitors in heart failure include: (Select all that apply)
    A) Improving renal blood flow
    B) Increase renal excretion of sodium, potassium, and water
    C) Promoting proper functioning of baroreceptors
    D) Reducing periphreral vascular resistance
    E) Reducing venous congestion and edema
    F) Stimulating the release of aldosterone
    • A
    • C
    • D
    • E
  33. Beta blockers are useful to improve myocardial oxygen supply in angina because they:
    A) dilate coronary arteries
    B) dilate veins
    C) lengthen diastole
    D) reduce cardiac Preload
  34. Regular use of which OTC med's may be contributing to lack of therapeutic effect of the ACE inhibitor?
    A) Aspirin
    B) Calcium Carbonate
    C) Ibuprofen
    D) Milk of magnesia
  35. Protamine sulfate acts as an atidote to heparin by:

    A) activating clotting factor Xa
    B) activating thrombi
    C) binding with the negatively charged groups on the heparin molecule
    D) suppressing the antithrombin activity
  36. Heparin therapy is concidered therapeutic when the results of the PTT or the APTT are:

    A) 30-40 seconds (Normal)
    B) 40-50 seconds (1-1.5 times normal)
    C) 60-80 seconds (2 times normal)
    D) 90-120 seconds (3 times normal)
  37. For what period of time should the RN take precautions to prevent bleeding, including applying pressure to puncture sites for 5 minutes, after coumadin therapy has been discontinued?

    A) 6 hours
    B) 8-12 hours
    C) 2.5 days
    D) 5 Days
  38. Which of the following blood pressure findings would be classified as prehypertension?
    (Select all that apply)
    A) 110/70
    B) 118/86
    C) 120/80
    D) 128/92
    E) 130/85
    F) 137/74
    G) 138/92
    H) 146/76
    • B
    • C
    • E
    • F
  39. Statins benefit patients with atherosclerosis by:

    A) increase serum LDL
    B) promoting the production of the thrombin
    C) reducing serum HDL
    D) stability endrothelial plaque
  40. The prototypr drug for angiotensin- converting enzyme inhibitors and it prevents Angio I from turning into Angio II.
    Capoten or captopril
  41. Is the oxygen supply greater than or less than oxygen demand when talking about angina?
    Less than
  42. SNS releases norepi which stimulates ? receptor. Does this have a positive or negative effect?
    • Beta
    • Positive
  43. What causes primary hypertension?
    No known cause
  44. What is the cause of secondary hypertension?
    tumors or disease
  45. A 45 year old female smoker with a family history of coronary heart disease has been prescribed a lipid-lowering medication. Which of these outcomes would be most important for this patient?

    A) cholesterol, total 170 mg/dL
    B) HDL 50 mg/dL
    C) LDL 90 mg/dL
    D) Triglycerides 120 mg/dL
  46. Moderate CHD (coranary heart disease) manifests as what?
    anginal pain
  47. Severe CHD (Coronary sets the stage for what?
    Myocardial Infarction of MI
  48. Antiplatelet drugs, cholesterol-lowering drugs, Ace inhibitors are an drugs used to prevent what?
    MI and Death
  49. Sodium channel blockers are what class of antidysrhythmic drug?
    Class I
  50. Is the following a Beta blocker or Diuretic?
    *Not as effective with African Americans
    *Decreases rate, contractility, renin, and peripheral resistance
    Beta blocker
  51. Is the following an ARB or CCB?
    Blocks calcium going inside cell, less contractility, less peripheral resistance.
    CCB (Calcium Channel Blocker)
  52. Name the type of angina:

    Part of the problem referred to as Acute Coronary Syndrome, Also called Prinzmetal's
    Variant angina
  53. Name the type of angina:

    Triggered by physical activity; also called classical or exertional
    chronic stable angina
  54. Name the type of angina:

    Medical emergency; platelets clump
    Unstable Angina
  55. Is the following ACE or ARBS?
    Inhibits enzyme from changing Angio I to Angio II. For a diabetic, it is the standard of care. Slows kidney disease.
  56. Is the following a Beta blocker or ARBS?
    Newer than ACE, blocke actions of angiotension, causes angioedema.
  57. Which drug classification is the following drug?

    Aldosterone antagonist
  58. Which drug classification is the following drug?

  59. Which drug classification is the following drug?

    Enalapril (vasotec)
  60. Which drug classification is the following drug?

    CCB (Calcium Channel Blocker)
  61. Which drug classification is the following drug?

    High Ceiling Loop
    Potassium Sparing
  62. Name an ARB.
  63. Name 3 ACE inhibitors.
    • Enalapril (vasotec)
    • Nitropress
    • Capoten
  64. Name an Aldosterone antagonist.
  65. Name 2 Calcium channel blockers.
    • Verapamil
    • Cardizem
  66. Name 3 types fo Diuretics.
    • Thiazides
    • High ceiling loop
    • potassium sparing
  67. The nurse recognizes that the generic names of angiotension II receptor blocker (ARB) drugs end in:

    A) -mycin
    B) -olol
    C) -pril
    D) -sartan
  68. The suffix of the generic name of most CCB's is:

    A) -azosin
    B) -lol
    C) -pine
    D) -sartan
  69. Matching:
    Drugs affecting the renin-angiotensin aldosterone system (RAAS)

    A) ACE inhibitor
    B) Aldosterone
    C) ARBs
    D) Beta blockers

    1) Suppress renin release by the kidneys
    2) Prevent activation of angiotension blockers
    3) Prevent activation of angiotension receptors
    4) Block receptors in kidney that alter excretion of water, sodium, and potassium
    • A 2
    • B 4
    • C 3
    • D 1
  70. What are the 8 crital characteristics of Pain?
    • Location
    • Character or quality (describing terms)
    • Quantity ot severity (pain scale)
    • Timing (onset, duration, frequency)
    • Setting
    • Aggrivating/relieving factors
    • Associated factors (other symptoms)
    • Patien perception (what does the client think it means?)
  71. Name the blood pressure classification:

    A) 120 to 139
    80 to 89

    B) 120

    C) 140 to 159
    90 to 99

    D) 160 or greater
    100 or greater
    A) prehypertensive

    B) Normal

    C) Stage I hypertension

    D) Stage II hypertension
  72. LDL is directly related to developing what?
    • CHD
    • Coronary atherosclerosis
  73. What drug has the following beneficial actions:
    *reducing LDL
    *increasing HDL
    *Increase bone formation
    Statin or Lipitor
  74. Statins undergo rapid hepatic (a) followed by excretion primarily in (b) .
    • a)metabolism
    • b)Bile
  75. Myopathy, rhabdomyolysis, myositis, hepatotoxicity, and peripheral neuropathy are what?
    Adverse effects of statin drugs
  76. Statins are contraindicated for who?
    Patients with viral or alcohol hepatitis, or for women who are pregnant
  77. Name the route of statins.
  78. Do statins need to be taken with meals?
  79. When assessing, name baseline data needed for statins?
    Lipid profile, vitals, and weight
Card Set
Billie's cards Cardiac
Billie's cards Cardiac
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