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What meds will be given to inhibit the RAAS system during HF?
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When the left ventricle is stretched, this is released. How does it help the heart?
BNP: it gets rid of salt and water to help prevent overstretching
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What is normal BNP range?
- <125
- <450 for 75yo and older
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This term is The heart muscle becomes enlarged, thick or rigid
Cardiomyopathy
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Is JVD caused from left or right ventricular failure?
right
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What are:
1. Hepatomegaly
2. Splenomegaly
- 1. is the condition of having an enlarged liver
- 2. is defined as enlargement of the spleen
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Systolic/diastolic failure can lead to left ventricle losing its ability to contract.
Systolic
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Systolic/diastolic failure s the ventricle loses its ability to relax because the muscle has become stiff
Diastolic failure
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What can occur if the heart becomes to stiff to relax?
- The heart won't properly fill with blood during the rest period.
- May lead to fluid accumulation in the body (limbs or lungs)
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Match:
1. Heart failure with reduced ejection fraction. ____
2. Heart failure with preserved ejection fraction and reduced ability to relax. ____
a. systolic HF
b. diastolic HF
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This diag. study shows sense of ejection fraction, heart wall syncing (together instead of separately) and ventricular size.
Echocardiogram
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90% of pts with a BNP of ___ pg/ml have HF.
>500
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When treating HF, what does UNLOAD FAST stand for?
- U - upright position
- N - nitrates
- L - Lasix
- O - O2
- A - ACE inhibitors
- D - dig
- F - fluids (decrease fluids in body)
- A - Afterload (decrease it)
- S - Sodium restriction
- T - Test levels
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This drug is the number 1 choice to treat HF that is also used for HTN
Ace inhibitors: increases perfusion and CO
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What are s/e of ACE you must look for? 3
- Cough
- K+ level (increases)
- angioedema
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What is the next drug of choice after ACE?
ARB (Losartan (Cozaar))
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How do Beta blockers (Carvedilol/Coreg) with HF?
Works against the SNS to help protect the heart; heart beats slower with better efficiency
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Patients with COPD/asthma should not be on Beta 1 or 2 blockers
Beta2
-
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Which lead will show the best picture of the top of the heart -> down?
Lead 1
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5 small squares of a strip equals:
B. 5mm (5 small squares) = 0.2 secs
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One small square of a strip equals:
D.
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Ischemia on a strip will present as:
B.
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Injury on a strip will present as:
B.
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A patient is showing palpitations and SOB. No signs of HTN or warm, flushed skin. Would you expect the patient to be in sinus brady or sinus tachy?
sinus brady
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PR interval should be:
C.
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QRS complex should be between ____ secs.
0.04-0.12 sec
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Meds like TCA and Erythromycin can prolong this part of the EKG waves:
C.
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Fill in: To calculate HR, count the number of ___ waves in ____ seconds.
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P wave is atrial ____.
atrial depolarization
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This part of the EKG is the time for impulse to travel from SA node to AV node.
B.
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Which part of the EKG do you assess for myocardial damage?
A.
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How many little boxes should a normal QRS take?
1-3
-
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This drug is used to treat PSVT to return heart back to NSR. (antiarrythmic)
Adenosine
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Adenosine that is used to treat PSVT, must be administered in what way?
- rapid IV bolus
- Initial dose 6mg, and if no response, a second dose 1 minute later of 12 mg. Not to exceed this.
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If patient is not tolerating atrial flutter, what can be given to slow down the HR?
Calcium channel blocker: Diltiazem (Cardizem)
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What is Bigeminy PVC?
Premature ventricular contractions happening every other beat
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A patient with a prolonged QT from CYP450 goes into Torsades heart arrhythmia. What can be used to treat this?
Magnesium
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This drug is for Life-threatening ventricular arrhythmias unresponsive to less toxic agents.
Amiodarone
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This drug is the reduction of ventricular contraction in atrial flutter or afib
B.
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This drug counts as a class II and class III
A.
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How does Class 1a help with the extra HR?
Prolongs Action potential required for a heart beat, lowering HR.
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