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CASAL II OA (Live Cohorts) – Questions With Solutions
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CASAL II OA (Live Cohorts) – Questions With Solutions
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CASAL II OA (Live Cohorts) – Questions With SolutionsSA node Right Ans - pacemaker, 60-100bpm, Depolarization R atria, p
wave,
AV node Right Ans - Gatekeeper, intraseptal, Allows delay for blood so no
back up, 40-60 bpm
Bundle of His Right Ans - Intraventricular, 40-60bpm, sends to purkinje
fibers for ventricular depolarization
L and R bundle branches Right Ans - 20-40bpm,
Purkinje fibers Right Ans - 20-40bpm, ventricular depolarization (QRS)
complex
Preload Right Ans - LVEDP determined by LVEDV
Afterload Right Ans - Vascular resistance
Cardiac output = Right Ans - heart rate x stroke volume
Normal QRS complex Right Ans - 0.06-0.12 sec. (1.5-3 small boxes)
P wave Right Ans - atrial depolarization
QRS complex Right Ans - ventricular depolarization
T wave Right Ans - ventricular repolarization
U wave Right Ans - hypokalemia, depolarization purkinje fibers
A Fib on EKG Right Ans - 1. P waves? No
2. P waves regular? U/A to determine
3. R waves regular? No irregular
4. How many R waves in 6 sec?
5. PR interval length? No, no p waves
Saw tooth
No p waves
,R waves irregular
Stroke volume Right Ans - the volume of blood pumped out by a ventricle
with each heartbeat
Cardiac output Right Ans - Amount of blood pumped through body per min
3 things that affect stroke volume Right Ans - preload, afterload,
contractility
What increases vascular resistance Right Ans - pHTN (R❤️),
vasoconstriction/HTN (L❤️), aortic stenosis (L ventricle)
What can decrease afterload Right Ans - Vasodilation
Sympathomemetics/ adrenergic agonist Right Ans - Dopamine ⬆️BP & CO
norepinephrine ⬆️BP
epinephrine ⬆️Bronchodilation
beta 2 adrenergic agonist -inhaled for cold/asthma albuterol (short)
solmedrol (long)
Sympatholytic/ andrenergic antagonist Right Ans - Beta blockers ⬇️HR,
⬇️BP, constrict airway
Parasympatholytic/anticholenergic Right Ans - Airway: Ipratropium
bronchodilator
HR: Atropine ⬆️HR or dilate pupils
nonselective beta blockers
beta 1 ❤️Kidneys
beta 2 lungs, GI, vascular muscle, skeletal Right Ans - propranolol, timolol,
nadolol, pindolol, carvidolol
Nursing implications non selective Beta blocker Right Ans - Not for: COPD,
asthma, PVD
Selective Beta blockers Right Ans - Atenolol, esmolol, metoprolol
beta 1 found in ❤️And kidneys-blocks RAAS
,Beta blockers treat Right Ans - HTN, stable angina, dysthymia (SVT, tachy),
compensated heart failure, glaucoma, migraines, tremors, anxiety
Monitor with beta blockers Right Ans - -Bradycardia-check physician
desired -parameters
-EKG-heart block 2nd and 3rd degree
-watch for S&S ❤️Failure don't want contraction to get too weak
-monitor BG masks ⬆️HR of hypoglycemia/hyperglycemia
-ortho htn
- circulation impairment
-OD S&S bradycardia, lethargic, ❤️Block, hypotension
Teach pt with beta blockers Right Ans - Bradycardia
❤️Failure exacerbation
taper off-rebound htn/angina
ortho htn
know OD S&S
blood glucose w/non selective
Calcium Channel Blockers Right Ans - blocks L type channels in:
vascular smooth muscle
cardiac myocytes
cardiac nodal tissue (SA & AV nodual tissue)
Calcium Channel Blockers (vascular selective) Right Ans -
Dihydropyridines: "Pines"
amlodipine, felodipine, nifedipine
Mainly for HTN and angina
Calcium Channel Blockers-effects on vascular smooth muscle Right Ans -
coronary and peripheral arteries:
Vasodilation: decrease BP, relax coronary arteries, decrease SVR = decrease
afterload
Calcium Channel Blockers-effects on myocytes Right Ans - decrease heart
contraction strength (- inrotropic effect)
decrease O2 demand
Treats angina-NOT for heart failure pt
, Calcium Channel Blockers- effects on cardiac nodal tissue Right Ans - SA
node- decrease heart rate (neg chronotropic effect)
AV node- speed up conduction (positive dromotrophic)
treats arrhythmia: SVTs, Afib
Myocardial Selective Calcium Channel Blockers Right Ans - Non-
Dihydropyridines
phenlalkylamines-Verapamil
benzothiazepine- Diltiasem
mainly for anti-arrhythmic htn/angina
Misc. treatment with Calcium Channel Blockers Right Ans - Rhanud's
migraines
cerebral spasms
Nursing Implications Right Ans - *monitor for bradycardia especially
Verapamil & Diltiazem
*monitor EKG for 1st degree especially for Verapamil & Diltiazem
*Never give verapamil/Diltiazem with 2nd or 3rd degree HB
*monitor S&S heart failure (dyspnea, weight gain, crackles, edema)
*No grapefruit
*High fiber diet -verapamil and diltiazem
*Good oral hygiene with the "Pines"
*monitor reflex tachycardia, ortho htn
Teach pt on Calcium Channel Blocker Right Ans - monitor HR and BP at
home
S&S of CHF exacerbation
good oral hygiene for "pines"
high fiber diet for varapamil and diltiazem
orthostatic htn-change positions slowly
Angiotensin Converting Enzyme Inhibitors Right Ans - "Prils"
Captorpil, lisinopril, enalapril, quinipril, ramipril
Action of ACE inhibitor Right Ans - Inhibits the enzyme that converts
angiotension I to angiotension II
No conversion = No vasoconstriction and no increase in BP
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