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NUR 663 CHF Exam with Questions and Answers | Answers 100% Correct and Verified
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NUR 663 CHF Exam with Questions and Answers | Answers 100% Correct and Verified
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NUR 663 CHF Exam with Questions andAnswers | Answers 100% Correct and Verified
First med is an ACEI, been shown to reduce mortality in HF patients - ✔✔What should a
heathy man with chest pain and EF 38 be started on?
on 2 classes of drugs (ACEI to help prevent cardiac remodeling and need to be on BB!!) -
✔✔If asymptomatic, what should pt be on?
when first initiated, cardiac output goes down initially (when started when the patient is
symptomatic, there is an increase in mortality), so it is recommended to start the BB when
asymptomatic (beta blocker will help reset beta receptors and be more susceptible to
epinephrine again). - ✔✔Why give a BB to a patient asymptomatic?
NEVER - ✔✔When should you start an unstable pt on a BB?
•Present around Left Ventricle
•Converts Angiotensin I to Angiotensin II
•But not related to angiotensin converting enzyme (ACE).
-ACE don't affect
-Angiotensin blockers do block these, though - ✔✔Where is Human Heart Chymase and
what is it's purpose?
clinically individuals with HFrEF have a better outcome related to death with ACEI than with
ARBs - ✔✔What has shown a better outcome with HFrEF?
At first, it looked like ARBs could increase MIs, but when looked at closer, they found HFrEF
ONLY, ACEI prevented MIs (why its believed to have a better outcome. ARBs don't increase
likelihood of MI, but don't protect as well as ACEI either and it's only on patients with HFrEF) -
✔✔What is controversial and conflicting info for ACEI vs ARB and HFrEF?
, •candisartan (Adican)-true once a day ARB—usually use this one in place of an ACEI if you need
to change
•valsartan (Diovan)-BID
•losartan (Cozaar)-if you try to go to higher dose, it has extensive P-450 metabolism and may
not be as effective at the higher dosages - ✔✔What are the three ARBs OK'd for HFrEF?
•ACE Inhibitors preferred over ARBs
•vs (new) Neprilisin inhibition - ✔✔What is the standard treatment in SYMPATOMATIC HF
patients?
False - ✔✔TRUE or FALSE: Neprilisin is indicated for asymptomatic HF.
should be on 2 classes of drugs if EF<40 should be on ACEI and BB - ✔✔What med should
asymptomatic HF patients be on?
when BB started initially CO goes down, to reset beta receptors and increase response to epi -
✔✔Why should BB be started with HF pts are asymptomatic?
Entresto, a combination of the neprilysin inhibitor sacubitril and the ARB valsartan (Class is an
"ARNI") - ✔✔What is Neprilysin Inhibitors?
hypotension(vasodilation) and angioedema - ✔✔What are s/s of Entresto (Neprilysin
inhibitor)?
•In patients with chronic symptomatic HFrEF NYHA class II or III who tolerate an ACE inhibitor
or ARB, replacement by an ARNI is recommended to further reduce morbidity and mortality -
✔✔When is an ARNI recommended?
-There must be a 36 hour washout period switching FROM an ACE Inhibitor to Entresto.
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