Nur 155 Test 2

Front 1

Plavix is approved for?

Back 1

Prevention of stroke and MI

Front 2

Most common and predictable angina is?

Back 2

Stable Angina

Front 3

Pt. is most at risk for ____ when they have unstable angina

Back 3

Heart Attack

Front 4

Atypical, and caused by coronary artery spasm with or without atheroscleroric lesion is _____angina

Back 4

Prinzmetals Angina

Front 5

Which is more severe? ACS or Angina?

Back 5

ACS (acute coronary syndrome)

Front 6

This inversion can occur as a result of decreased oxygen

Back 6

T-wave inversion

Front 7

What EKG abnormality is specific to MI

Back 7

ST segment elevation

Front 8

What occurs with Pathologic Q-wave? Indicates?

Back 8

Q wave is longer than R wave. Indicates past MI

Front 9

Which enzymes are SPECIFIC TO CARDIAC MUSCLES?

Back 9

CK-MB and Troponin

Front 10

Marker that measures for presence of inflammation=

Back 10

C-reactive protien

Front 11

You're 3x more likely to develop CAD if your total cholesterol is

Back 11

>260

Front 12

Desirable LDL is

Back 12

<130

Front 13

Optimal LDL is

Back 13

<100

Front 14

MD needs to check motion of pt's heart, valve function and EF. What test will he preform?

Back 14

Echocardiogram

Front 15

Nitrates act on what? to produce what?

Back 15

Vascular smooth muscle to produce dilation.

Front 16

Explain reflex tachycardia

Back 16

As BP drops, our bodies will become
tachy to try and compensate for the low BP

Front 17

How do Beta Blockers help with MI?

Back 17

Reduces pain, infarct size, mortality and risk for re-infarction.

Front 18

How fast would you expect sub-lingual nitrates to work?

Back 18

1-3 minutes

Front 19

How do Beta blockers relieve angina?

Back 19

Bring O2 demand back in balance with O2 supply

Front 20

3 main uses of ACE inhibitors

Back 20

Hypertension, heart failure, MI

Front 21

Pt. comes in with headache, orthostatic hypotension and reflex tachycardia. You take a look at this meds and realize he is having adverse affects of what medication?

Back 21

Nitrates

Front 22

Nitrates primarily act on?

Back 22

veins

Front 23

When is Nitroglycerin used in IV drip?

Back 23

Acute MI and perioperative hypertension

Front 24

Immediate actions in the ER when a pt comes in with chest pain is?

Back 24

M-Morphine Sulfate
O- Oxygen
N- Nitroglycerin
A- Asa

Front 25

What types of people have the greatest risk of restenosis?

Back 25

Diabetics

Front 26

Which heart procedure is also called myocardial revascularization?

Back 26

CABG (coronary artery bypass graft)

Front 27

Name all heart procedures where the heart is beating "off pump"

Back 27

MIDCAB (minimally invasive direct cornary bypass graft)

OPCAB (off pump coronary artery bypass)

Front 28

Pt. has too much plaque, it too many arteries, the doctors can do nothing else. The try one last effort to restore O2 to the heart. What will they perform?

Back 28

Transmyocardial laser revascularization (TMLR)

Front 29

Phase 3 of Cardiac rehab would be?

Back 29

At home

Front 30

What is considered the "silent disease"

Back 30

Hypertension

Front 31

What makes hypertension so dangerous?

Back 31

Target organ damage

Front 32

Which diuretic is the first choice to treat hypertension?

Back 32

HCTZ Hydrochlorothiazide

Front 33

"Bs" Are Funny...LOL

Back 33

Beta Blockers

Front 34

Nitrates - Action

Back 34

Nitroglycerinst pain
Dilation of arteries and primarily VEINS
Acts on vascular smooth muscle
= vasodialation
decreases cardiac O2 demand
slows down venous return to heart

Front 35

Nitrates
Nitroglycerin - 4 types of ingestion

Back 35

sublingual: Nitrostat, Nitroquick
transdermal: Nitro-dur, Transderm-Nitro
topical ointment: Nitrobid
IV: Nitro-bid IIV

Front 36

Isosorbide mononitrate

Back 36

Nitroglycerin
Oral tablet IR: ISMO, Monoket
Oral Tablet ER: Imdur

Front 37

Isosorbide dinatrate

Back 37

Nitroglycerin
Sublingual: Isordil, Sorbitrate
Chewable tablets: Sorbitrate
Oral tablet IR: Isordil titradose, Sorbitrate
Oral Tablet SR:I Isoril Tembids

Front 38

Nitrates
Adverse Effects

Back 38

Headache
Orthostatic hypotension
Reflex tachycardia

Front 39

Nitrates
Uses

Back 39

Angina Pain
Angina Prophylaxis
Acute MI and perioperative hypertension (IV)

Front 40

Nitrates
When to go to hospital

Back 40

3 doses 5 minutes apart.... if not working...no pain relief...call 911!

Front 41

"B's" are Funny...LOL

Back 41

Beta Blockers

Anti Hypertensive

Front 42

Beta Blockers... name them

Back 42

Inderal (propranolol)
Lopressor (metoprolol)
Tenormin (Atenolol)
Troprol/Lopressor (metoprolol)
Timoptic (timolol)
Coreg (carvedilol)
Normodyne/Trandate (labetalol)

Front 43

Beta Blockers
Action

Back 43

block beta receptors=reduces heart rate, reducing the workload
Reduces force of contraction
Reduces speed of conduction thru AV Node

Front 44

Beta Blockers
Used for...?

Back 44

Angina
MI
CHF (Coreg - carvedilol)
Hypertension

Front 45

Beta Blockers
Actions on Angina

Back 45

Decrease workload on heart

Evens out supply/demand for O2 - prevents angina pain

Front 46

Beta Blockers
Actions on MI

Back 46

Reduces pain, infarct size, mortality

Prevents re-infarction in ER

Protects heart from stress hormones & adrenaline

Front 47

Beta Blockers
Actions on CHF

Back 47

COREG - (carvedilol)

deb's point!

Front 48

Intermost layer of the heart, thin membrane composed of 3 layers=

Back 48

Endocardium

Front 49

What is catecholamine?

Back 49

Stress hormone stimulated by nicotine

Front 50

"Gold standard of heart surgeries"

Back 50

CABG

Front 51

Stents that are coated with a medication, emits microscopic particles into the artery and helps with plaque. What is this called?

Back 51

Drug-eluting stents

Front 52

2 reasons pt would need CABG

Back 52

Client failed medical management
Advanced disease

Front 53

What nursing consideration should you think about when taking a radial artery and using it for harvesting?

Back 53

Test ULNAR artery first! Make sure it works properly, (risky harvest)

Front 54

Why is the pt's blooded cooled?

Back 54

Cooled blood requires less O2

Front 55

Beta Blockers
Caution - Contraindications

Back 55

Diabetics - masks symptoms of hypoglycemia

Asthma - can cause bronchospasms or bronchodilation

Front 56

CCB = CCP

Back 56

Calcium Channel Blockers

Front 57

Calcium Channel Blockers
Name 'em

Back 57

Calcium Channel Blockers
Calan ( verapamil)
Cardizen (diltiazem)
Procardia (nifedipine)

Front 58

Calcium Channel Blockers
Action

Back 58

Calcium Channel Blockers
Antihypertensive
Block Ca channels in heart
Arteriolar dilation = reduced afterload
Works on arteries only
increase coronary perfusion
Reduces HR
Decreases Myocardial force of contraction=reduced workload

Front 59

Calcium Channel Blockers
Used for....?

Back 59

Stable angina - reduces O2 demand

Prinzmetal angina - reduces arterial spasms

Hypertension

Cardiac arrhythmia - Cardizem (diltiazem)

Front 60

Calcium Channel Blockers

Which one is used mainly for cardiac arrhythmia?

Back 60

Cardizem (diltiazem)

Front 61

If you got CHF and Hypertension.... chances are, you're gonna get...

Back 61

Beta blockers

Front 62

Ace-Pril

Back 62

Ace Inhibitors

Front 63

Ace Inhibitors
Name 'em

Back 63

Ace Inhibitors
Capoten (captopril)
Vasotec (enalapril)
Zestril or Prinivil (lisnopril)
Altace (ramipril)
Mavik (trandoalpril)

Front 64

Ace Inhibitors
Action

Back 64

Ace Inhibitors
Reduces preload and afterload
Promotes H2O lose through kidneys- decreases blood volume ((preload)
Prevents or reduce pathologic changes in heart and vessels
Dilates vessels - mostly arterial (afterload)

Front 65

Systolic BP > ____ and diastolic > _____ can diagnose hypertension

Back 65

>140 and >90

Front 66

Pt's BP is 122/84 what BP category are they in?

Back 66

Prehypertension

Front 67

Ace Inhibitors

Used for?

Back 67

Ace Inhibitors

Hypertension - lisinopril

CHF - reduces workload on heart

MI - reduces mortality, decreases chance of heart failure

Neuropathy - diabetic and non-diabetic - slows renal disease

Can prevents MI, Stroke, death (Altace - ramipril)

Front 68

Ace Inhibitors

What's up with Altace (ramipril)

Back 68

Ace Inhibitors

Reduces mortality in pt with hx of stroke, MI,diabetes and PVD

Front 69

Ace Inhibitors

Adverse Affects

Back 69

Ace Inhibitors

First dose hypertension

Cough - annoying

Hyperkalemia

Renal failure - rare

Front 70

Anti -Platelet Agents

Name 'em

oral - 4 drugs
IV - 3 drugs

Back 70

Anti -Platelet Agents

Oral - long term use
Aspirin (ASA)
Ticlid ( ticlopidine)
Plavix (clopidogrel bisulfide)
Persantine (dipyridamole)

IV - short term use
Aggrastat (tirofiban)
Integrilin (eptifibatide)
ReoPro (abciximab)

Front 71

Anti -Platelet Agents

Action

Back 71

Anti -Platelet Agents

Suppress platelet aggregation

Prevent clots in ARTERIES (not veins)

Oral - lasts 7-10 days after last dose

IV- stops within 4 hrs.

Front 72

Anti -Platelet Agents

Aspirin

Back 72

Anti -Platelet Agents

Prevention of first MI - prophylaxis

Prevents re-infarction after previous MI

Prevents stroke - hx of TIA's

Give at first symptoms of MI - MONA

Front 73

MONA

Back 73

Treatment of MI

Morphine
Oxygen
Nitroglycerin
Aspirin

Front 74

Anti -Platelet Agents

Plavix and Ticlid

Back 74

Anti -Platelet Agents

Ticlid - approved for stroke

Plavex - Approved for stroke & MI

Front 75

Anti -Platelet Agents

Persantine (dipyridamole)

Back 75

Anti -Platelet Agents

Approved for use after heart valve replacement
ONLY

Front 76

Anti -Platelet Agents

Aggrastat
Integrilin
ReoPro

Back 76

Anti -Platelet Agents

IV short term use

prevents ischemic events ACS

Following pertinacious coronary interventions

Front 77

Vytorin (Ezetimibelsimvastain) is a combination of what 2 drugs?

Back 77

Zocor (Simvastain)
Zetia (Exetimibe)

Front 78

Pt. needs a drug that will block cholesterol. What is the best drug?

Back 78

Vytorin (Ezetimibelsimvastian)

Front 79

Pt. has increase triglycerides, which lipid lowering agent is the best choice?

Back 79

Niacin (Nicotinic acid)

Front 80

When pt is on "statins" what should you monitor?

Back 80

Liver function test. (b/c these drugs can cause hepatotoxicity)

Front 81

GI disturbances, gallstones, myopathy and liver injury are adverse effects of what lipid lowering agents? HINT: There are 2

Back 81

Lopid (Genfibrozil)
Tricor (Fenofibrate)

Front 82

Anti -Platelet Agents

Adverse effects - ASA

Back 82

Anti -Platelet Agents

GI Bleeding

Hemorrhagic stroke

Front 83

Anti -Platelet Agents

Adverse effects - Ticlid

Back 83

Anti -Platelet Agents

Potential life threatening hematologic reactions

Front 84

Anti -Platelet Agents

Adverse effects - Plavix

Back 84

Anti -Platelet Agents

Same as ASA

GI Bleeding

Hemorrhagic stroke

Front 85

Anti -Platelet Agents

Adverse effects

Aggrastat
Integrilin
Reopro

Back 85

Anti -Platelet Agents

Risk for hemmorrhage

Front 86

Opioid Analgesic

Back 86

Opioid Analgesic

Morphine Sulfate

Front 87

Not very many people can handle taking Niacin. What is making them feel uncomfortable?

Back 87

Intense flushing (they feel BURNING all over their body)

Front 88

What is the most common symptom of Dig Toxicity?

Back 88

Bradycardia

Front 89

2 HUGE/MAIN symptoms of Dig toxicity.

Back 89

Anorexia N/V
Change in mental status

Front 90

Opioid Analgesic

Action

Back 90

Opioid Analgesic

Pain relief


Arterial some dialation - reduce afterload

Relaxes pt

Reduces anxiety

Front 91

Opioid Analgesic

Adverse effects

Back 91

Opioid Analgesic

Hypotension

Sedation

Nausea & vomiting

Urinary retention

Front 92

"ASE"

Clot Busters

Back 92

Thrombolytic (fibrinolytic) Therapy

Front 93

Thrombolytic (fibrinolytic) Therapy

Name 'Em

Back 93

Thrombolytic (fibrinolytic) Therapy

Streptase (streptokinase)
Activase (altepase tPA)
Retavase (retaplase)
Eminase (antistreplase)
Abbokinase (Urokinase)
TTNKase (tenecteplase)

Front 94

Thrombolytic (fibrinolytic) Therapy

Action

Back 94

Thrombolytic (fibrinolytic) Therapy

Lyse existing clots

Digest fibrin in clots - degrades fibrinogen & other clotting agents

Front 95

Thrombolytic (fibrinolytic) Therapy

Use

Back 95

Thrombolytic (fibrinolytic) Therapy

Early MI - Time is muscle

Pulmonary embolism

Ischemic stroke

Clearance of catheters - central or PICC lines

Front 96

"Statin"

Back 96

Lipid lowering agents

Front 97

Lipid lowering agents

Name the "statins"
(6 of 'em)

Back 97

Lipid lowering agents - "statins"
Zocor (simvastatin)
Lipitor (atovastatin)
Lescol (fluvastatin)
Mevacor (lovastatin)
Pravachol (pravastatin)
Vytorin (ezetimbelsimvastatin)

Front 98

Lipid lowering agents

Name the Non "statins"
6of 'em

Back 98

Lipid lowering agents

Questran (cholestyramine)
Colestid (colestipol)
Lipid (gemfibrozil)
Tricor (fenofibrate)
Zetia (ezetimibe
Niacin (nicotinic acid)

Front 99

Lipid lowering agents

Good for pts with very high cholesterol

( Zocor + Zetia)

Back 99

Lipid lowering agents

Vytorin (ezetimbelsimvastatin)

Front 100

Lipid lowering agents

Overall action

Back 100

Lipid lowering agents

Lower lipid levels

Prevent atherosclerosis

Front 101

Lipid lowering agents

Bile acid sequestrates
(fat sticks to it)

Back 101

Lipid lowering agents

Questran (cholestyramine)
Colestid (colestipol)

Front 102

Lipid lowering agents

Fibrates

Back 102

Lipid lowering agents

Lopid (gemfibrozil)
Tricor ( fenofibrate)

Front 103

Lipid lowering agents

Fibrates - Action

Back 103

Lipid lowering agents

Decreases triglycerides

Increases HDL

Front 104

Lipid lowering agents

Action of Zetia and Niacin

Back 104

Lipid lowering agents

Zetia - Block cholesterol absorption in GI track

Niacin - Drug of choice for high Triglycerides

Front 105

Lipid lowering agents

Adverse effect of Statins

Back 105

Lipid lowering agents

Hepatotoxicity

Myopathy - rare enlargement of heart muscle

Front 106

Lipid lowering agents

Adverse effect of Bile acid sequestrants

Back 106

Lipid lowering agents

Constipation

Bloating

Front 107

Lipid lowering agents

Adverse effect of Fibrates

Back 107

Lipid lowering agents

GI disturbances
Gallstones
Myopathy
Liver damage

Front 108

Lipid lowering agents

Adverse effect of Niacin

Back 108

Lipid lowering agents

Intense flushing
Hepatotoxicity
elevate homecysteine (giving false reading for inflammation)