2022 PRACTICE EXAM SOLUTION FOR PHARMACOLOGY II
(CARDIAC LECTURES)
What is an echocardiogram? - ultrasound of the heart; visualize chambers, valves, EF
What are the types of echocardiogram? - external v. transesophageal (conscious
sedation)
What is a normal EF? - 55-65%
What is a decreased EF? - <45%
What is a severely decreased EF? - <35%
What is an angiogram? - 1. x-ray w/dye to visualize arteries or veins for
blockages/narrowing
2. conscious sedation
What are the nursing considerations for an angiogram? - 1. bleeding and clots
-hold anticoags and antiplatelet meds
2. IV contrast concerns
What are the lab studies done for cardiac function? - 1. cardiac enzymes
2. electrolytes
3. lipid panel
What cardiac enzymes do you monitor? - 1. troponin
-successive tests diagnose MI
-gold standard--> more specific to cardiac muscle damage
2. CK, CK-MB, and myoglobin
,-second line tests, not specific for cardiac muscle
When are cardiac enzymes release? - when muscle tissue is damaged
What cardiac electrolytes are monitored? - 1. K
2. Ca
3. Mg
4. Na
What is the cardiac lipid panel? - 1. TC
2. HDL
3. LDL
4. Triglycerides
What is the goal for TC levels? - <200 mg/dl
What is the goal for HDL levels? - >40 mg/dl
What is the goal for LDL levels? - <130 mg/dl
What is the goal for triglycerides? - <150
What are the lab studies done for the heart? - 1. CBC
2. C-reactive protein--> elevated w/infection or inflammation
3.B-type natriuretic peptide (BNP)
-released in response to cardiac muscle "stretch" (heart failure)
-expected <100 pg/mL
-abnormal 100-400 pg/mL
,-high >400 pg/mL
4. Coagulation studies--> PT, INR, aPTT
What is the expected PT? - 10-13 sec
What is the expected INR? - 0.9-1.2
What is the expected aPTT? - 30-50 sec
What is a normal BP? - <120/80
What is pre-htn BP? - 120-139/80-89
What is htn stage 1 BP? - 140-159/90-99
What is htn stage 2 BP? - >160/100
What are the drug classes for cardiac? - 1. thiazide diuretics
2. angiotensin converting enzyme inhibitor
3. angiotensin receptor blocker
4. beta-blocker
5. Ca channel blocker
6. aldosterone antagonists
What do thiazide diuretics do? - 1. inhibit reabsorption of Na and H2O; less water to
move, heart doesn't work as hard, BP drops
2. Hydrochlorothiazide (contraindications for CRF w/ low GFR)
What is hydrochlorothiazide used for? - first line for HTN
, What are the side effects of hydrochlorothiazide? - 1. Na and K wasting
2. increase Ca reabsorption
3. can't use with NSAIDs
What do ACE inhibitors do? - 1. inhibit PRODUCTION of angiotensin II--> relaxes blood
vessles --> reduce water absorption in kidneys--> BP drops
2. "prils"--> CAPTOPRIL, LISINOPRIL
What is LISINOPRIL used for? - 1. HTN
2. HF
What are the adverse effects of LISINOPRIL? - 1. hypotension
2. hyperkalemia
3. cough
What are the teaching points for LISINOPRIL? - 1. many drug interactions
2. limit K in food and meds
3. monitor BP
4. falls risk, orthostatic hypotension
What are the uses for CAPTOPRIL? - 1. HTN
2. HF
What are the adverse effects of CAPTOPRIL? - 1. hypotension
2. hyperkalemia
3. cough
What are the teaching points for CAPTOPRIL? - 1. limit K intake
(CARDIAC LECTURES)
What is an echocardiogram? - ultrasound of the heart; visualize chambers, valves, EF
What are the types of echocardiogram? - external v. transesophageal (conscious
sedation)
What is a normal EF? - 55-65%
What is a decreased EF? - <45%
What is a severely decreased EF? - <35%
What is an angiogram? - 1. x-ray w/dye to visualize arteries or veins for
blockages/narrowing
2. conscious sedation
What are the nursing considerations for an angiogram? - 1. bleeding and clots
-hold anticoags and antiplatelet meds
2. IV contrast concerns
What are the lab studies done for cardiac function? - 1. cardiac enzymes
2. electrolytes
3. lipid panel
What cardiac enzymes do you monitor? - 1. troponin
-successive tests diagnose MI
-gold standard--> more specific to cardiac muscle damage
2. CK, CK-MB, and myoglobin
,-second line tests, not specific for cardiac muscle
When are cardiac enzymes release? - when muscle tissue is damaged
What cardiac electrolytes are monitored? - 1. K
2. Ca
3. Mg
4. Na
What is the cardiac lipid panel? - 1. TC
2. HDL
3. LDL
4. Triglycerides
What is the goal for TC levels? - <200 mg/dl
What is the goal for HDL levels? - >40 mg/dl
What is the goal for LDL levels? - <130 mg/dl
What is the goal for triglycerides? - <150
What are the lab studies done for the heart? - 1. CBC
2. C-reactive protein--> elevated w/infection or inflammation
3.B-type natriuretic peptide (BNP)
-released in response to cardiac muscle "stretch" (heart failure)
-expected <100 pg/mL
-abnormal 100-400 pg/mL
,-high >400 pg/mL
4. Coagulation studies--> PT, INR, aPTT
What is the expected PT? - 10-13 sec
What is the expected INR? - 0.9-1.2
What is the expected aPTT? - 30-50 sec
What is a normal BP? - <120/80
What is pre-htn BP? - 120-139/80-89
What is htn stage 1 BP? - 140-159/90-99
What is htn stage 2 BP? - >160/100
What are the drug classes for cardiac? - 1. thiazide diuretics
2. angiotensin converting enzyme inhibitor
3. angiotensin receptor blocker
4. beta-blocker
5. Ca channel blocker
6. aldosterone antagonists
What do thiazide diuretics do? - 1. inhibit reabsorption of Na and H2O; less water to
move, heart doesn't work as hard, BP drops
2. Hydrochlorothiazide (contraindications for CRF w/ low GFR)
What is hydrochlorothiazide used for? - first line for HTN
, What are the side effects of hydrochlorothiazide? - 1. Na and K wasting
2. increase Ca reabsorption
3. can't use with NSAIDs
What do ACE inhibitors do? - 1. inhibit PRODUCTION of angiotensin II--> relaxes blood
vessles --> reduce water absorption in kidneys--> BP drops
2. "prils"--> CAPTOPRIL, LISINOPRIL
What is LISINOPRIL used for? - 1. HTN
2. HF
What are the adverse effects of LISINOPRIL? - 1. hypotension
2. hyperkalemia
3. cough
What are the teaching points for LISINOPRIL? - 1. many drug interactions
2. limit K in food and meds
3. monitor BP
4. falls risk, orthostatic hypotension
What are the uses for CAPTOPRIL? - 1. HTN
2. HF
What are the adverse effects of CAPTOPRIL? - 1. hypotension
2. hyperkalemia
3. cough
What are the teaching points for CAPTOPRIL? - 1. limit K intake
