Heart Failure

  1. What meds will be given to inhibit the RAAS system during HF?
    • Lasix
    • ace inhibitors
  2. 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
  3. What is normal BNP range?
    • <125
    • <450 for 75yo and older
  4. This term is  The heart muscle becomes enlarged, thick or rigid
  5. Is JVD caused from left or right ventricular failure?
  6. What are:
    1. Hepatomegaly
    2. Splenomegaly
    • 1. is the condition of having an enlarged liver
    • 2. is defined as enlargement of the spleen
  7. Systolic/diastolic failure can lead to left ventricle losing its ability to contract.
  8. Systolic/diastolic failure s the ventricle loses its ability to relax because the muscle has become stiff
    Diastolic failure
  9. 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)
  10. 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
    • 1. b
    • 2. a
  11. This diag. study shows sense of ejection fraction, heart wall syncing (together instead of separately) and ventricular size.
  12. 90% of pts with a BNP of ___ pg/ml have HF.
  13. 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
  14. This drug is the number 1 choice to treat HF that is also used for HTN
    Ace inhibitors: increases perfusion and CO
  15. What are s/e of ACE you must look for? 3
    • Cough
    • K+ level (increases)
    • angioedema
  16. What is the next drug of choice after ACE?
    ARB (Losartan (Cozaar))
  17. How do Beta blockers (Carvedilol/Coreg) with HF?
    Works against the SNS to help protect the heart; heart beats slower with better efficiency
  18. Patients with COPD/asthma should not be on Beta 1 or 2 blockers
  19. EKG%2BLead%2BQuestion%2B01
    Lead II
  20. Which lead will show the best picture of the top of the heart -> down?
    Lead 1
  21. 5 small squares of a strip equals:

    B. 5mm (5 small squares) = 0.2 secs
  22. One small square of a strip equals:

  23. Ischemia on a strip will present as:

  24. Injury on a strip will present as:

  25. 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
  26. PR interval should be:

  27. QRS complex should be between ____ secs.
    0.04-0.12 sec
  28. Meds like TCA and Erythromycin can prolong this part of the EKG waves:

  29. Fill in: To calculate HR, count the number of ___ waves in ____ seconds.
    • R waves
    • 6 seconds
  30. P wave is atrial ____.
    atrial depolarization
  31. This part of the EKG is the time for impulse to travel from SA node to AV node.

  32. Which part of the EKG do you assess for myocardial damage? 

  33. How many little boxes should a normal QRS take?
  34. diagram-1-ekg-wave-quiz
  35. This drug is used to treat PSVT to return heart back to NSR. (antiarrythmic)
  36. 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.
  37. If patient is not tolerating atrial flutter, what can be given to slow down the HR?
    Calcium channel blocker: Diltiazem (Cardizem)
  38. What is Bigeminy PVC?
    Premature ventricular contractions happening every other beat
  39. A patient with a prolonged QT from CYP450 goes into Torsades heart arrhythmia. What can be used to treat this?
  40. This drug is for Life-threatening ventricular arrhythmias unresponsive to less toxic agents.
  41. This drug is the reduction of ventricular contraction in atrial flutter or afib

  42. This drug counts as a class II and class III

  43. How does Class 1a help with the extra HR?
    Prolongs Action potential required for a heart beat, lowering HR.
Card Set
Heart Failure
Lecture notes