Science Medicine Cardiology
FNP CARDIO
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Cardiovascular NR 661-Cardiovascular Anatomy 2
97 terms 114 terms 88 terms
mariaaa97 Preview stephanie_shanks1 Preview kmoney237
Increase K+
ACE inhibitor =
A common lab findings with ACE retention of potassium.
Inhibitors
Measure potassium one month after starting and one month after
changing a dose
If these are at maximum doses, consideration should be given to
adding a medication from a different class.
What should you do?
Pt on Monopril and HCTZ for
CALCIUM CHANNEL BLOCKER
hypertension. His blood
pressure is 160-170/92-98 on
NOT ARB - Adding an ARB may result in a precipitous decrease
several blood pressure checks
in his blood pressure because he takes an ACE inhibitor and both
? Would you add an ARB?
of these medications work in the renin-angiotensin-aldosterone
system.
Any antihypertensive medication ... could have an additive effect
with sildenafil (or another medication in this
A specific drug-drug interaction to be aware of is the one that
Significance of sildenafil and any
can occur with sildenafil and alpha blockers like tamsulosin,
blood pressure meds
alfuzosin, prazosin, doxazosin, or terazosin. This combination of
medications may increase the risk of symptomatic hypotension
because the effect of these two drugs is additive
Consider two meds
low dose HCTZ and ARB or ace
This patient's blood pressure goal is < 140/90 according to JNC
VIII. Since he is more than 20 points above systolic goal (or
greater than 10 points above diastolic goal) it is reasonable to
consider two medications
, Start at age 2
Dyslipidemia assessment does not necessarily mean a
Risk assessment for
Dyslipidemia assessment refers to assessing family history of
dyslipidemia- what age to start
dyslipidemia, premature cardiovascular disease, or diabetes,
assessment
body mass index > 85% for age and sex, or history of other
systemic diseases like Kawasaki Disease or treatment, or renal
disease.
When to start lipid profiles recommended between 18 and 21 years of age.
No K supplements
ACE inhibitor potentially can produce hyperkalemia because its
A patient taking an ACE inhibitor mechanism of action is in the renin-angiotensin-aldosterone
should avoid: system where potassium is spared. If potassium is taken in the
form of potassium supplements, the effect will be additive and
the risk of hyperkalemia can be great.
CCB
This patient has isolated systolic hypertension (ISH). This is
An 80 year-old female who is
common in older adults and is associated with tragic cardiac and
otherwise well, has a blood
cerebrovascular events. The drug class of choice to treat these
pressure of 176/80. How should
patients is a long-acting calcium channel blocker. The class of
she be managed
calcium channel blockers recommended for ISH has the suffix
pharmacologically?
"pine" (amlodipine, felodipine, etc).
Remember
ISH = PINE
See an expert-written answer!
ACE inhibitor is specifically hypertension, diabetes with proteinuria, heart failure.
indicated in patients who have ...
CCB
77 year-old patient has had an This patient is 77 years old and should have a goal blood
increase in blood pressure since pressure of < 150/90. A thiazide diuretic is not a good first choice
the last exam. The blood in this patient because it will not be potent enough to decrease
pressure has risen to 168/88 with blood pressure by 25 points to get him to goal. A long acting
2 readings. The last exam's calcium channel blocker is appropriate for patients with isolated
reading was 144/90. If systolic hypertension and will be more likely to get this patient to
medication is to be started on goal pressure than HCTZ. Beta-blockers are no longer
this patient, what would be a recommended first line for uncomplicated hypertension. ACE
good first choice? inhibitors are very effective in patients who are high renin
producers. Elderly patients tend to produce lower amounts of
renin.
, A 63 year-old male has been Order CBC, BMP, TSH, u/a
your patient for several years.
He is a former smoker who takes Fatigue is a difficult complaint to assess and diagnose. This
simvastatin, ramipril, and an patient's exam and vital signs are normal. There is no reason to
aspirin daily. His blood pressure think that he is infected or is bleeding, so a lone CBC, offers little
and lipids are well controlled. diagnostic help. However, in addition to a CBC, adding a
He presents to your clinic with metabolic panel, TSH, and urine (to screen for blood in this
complaints of fatigue and "just former smoker) is a more thorough laboratory assessment of his
not feeling well" for the last few fatigue.
days. His vital signs and exam
are normal. What should be
done next?
Order a CBC and consider
waiting a few days if normal.
Inquire about feelings of
depression and hopelessness.
Order a CBC, metabolic panel,
TSH, and urine analysis.
Order a B12 level, TSH, CBC, and
chest x-ray
See an expert-written answer!
BNP CHEAPER
BNP is a hormone involved in regulation of blood pressure and
fluid volume. When the BNP level is 80 pg/mL or greater, the
A patient with shortness of
sensitivity and specificity is 98% and 92%, favoring a diagnosis of
breath has suspected heart
heart failure. Alternatively, BNP levels less than 80 pg/mL
failure. What diagnostic test
strongly suggest that heart failure is not present (Some US
would best help determine this?
institutions use 100 pg/mL). Other conditions may cause elevated
BNP levels: thoracic and abdominal surgery, renal failure, and
subarachnoid hemorrhage. Consequently, careful assessment of
Echocardiogram
the patient is prudent. Echocardiograms mechanically evaluate
B type natriuretic peptide (BNP)
the heart and establish an ejection fraction. If <35-40%, then HF
EKG
can usually be diagnosed. Ejection fractions do not always
Chest x-ray
correlate with patient symptoms. EKG evaluates the electrical
activity of the heart. Chest x-ray can indicate heart failure but a
BNP is a more sensitive measure.
An 80 year-old patient with long add CCB
standing hypertension takes
Monopril and HCTZ for This patient takes medications from 2 different classes of
hypertension. His blood antihypertensives. If these are at maximum doses, consideration
pressure is 160-170/92-98 on should be given to adding a medication from a different class.
several blood pressure checks. Adding an ARB may result in a precipitous decrease in his blood
What should be done about his pressure because he takes an ACE inhibitor and both of these
blood pressure? medications work in the renin-angiotensin-aldosterone system.
Adding another diuretic will likely produce hypokalemia with a
small decrease in blood pressure. The calcium channel blocker is
Add an angiotensin receptor a good choice because it will have an additive effect with the
blocker (ARB) other medications he is taking. A beta blocker will slow the heart
Add another diuretic rate, not a preferred outcome in an elderly patient unless he has
Add a calcium channel blocker underlying angina or a heart rate problem.
Stop the HCTZ and add a beta
blocker
FNP CARDIO
Save
Students also studied
Flashcard sets Study guides
Cardiovascular NR 661-Cardiovascular Anatomy 2
97 terms 114 terms 88 terms
mariaaa97 Preview stephanie_shanks1 Preview kmoney237
Increase K+
ACE inhibitor =
A common lab findings with ACE retention of potassium.
Inhibitors
Measure potassium one month after starting and one month after
changing a dose
If these are at maximum doses, consideration should be given to
adding a medication from a different class.
What should you do?
Pt on Monopril and HCTZ for
CALCIUM CHANNEL BLOCKER
hypertension. His blood
pressure is 160-170/92-98 on
NOT ARB - Adding an ARB may result in a precipitous decrease
several blood pressure checks
in his blood pressure because he takes an ACE inhibitor and both
? Would you add an ARB?
of these medications work in the renin-angiotensin-aldosterone
system.
Any antihypertensive medication ... could have an additive effect
with sildenafil (or another medication in this
A specific drug-drug interaction to be aware of is the one that
Significance of sildenafil and any
can occur with sildenafil and alpha blockers like tamsulosin,
blood pressure meds
alfuzosin, prazosin, doxazosin, or terazosin. This combination of
medications may increase the risk of symptomatic hypotension
because the effect of these two drugs is additive
Consider two meds
low dose HCTZ and ARB or ace
This patient's blood pressure goal is < 140/90 according to JNC
VIII. Since he is more than 20 points above systolic goal (or
greater than 10 points above diastolic goal) it is reasonable to
consider two medications
, Start at age 2
Dyslipidemia assessment does not necessarily mean a
Risk assessment for
Dyslipidemia assessment refers to assessing family history of
dyslipidemia- what age to start
dyslipidemia, premature cardiovascular disease, or diabetes,
assessment
body mass index > 85% for age and sex, or history of other
systemic diseases like Kawasaki Disease or treatment, or renal
disease.
When to start lipid profiles recommended between 18 and 21 years of age.
No K supplements
ACE inhibitor potentially can produce hyperkalemia because its
A patient taking an ACE inhibitor mechanism of action is in the renin-angiotensin-aldosterone
should avoid: system where potassium is spared. If potassium is taken in the
form of potassium supplements, the effect will be additive and
the risk of hyperkalemia can be great.
CCB
This patient has isolated systolic hypertension (ISH). This is
An 80 year-old female who is
common in older adults and is associated with tragic cardiac and
otherwise well, has a blood
cerebrovascular events. The drug class of choice to treat these
pressure of 176/80. How should
patients is a long-acting calcium channel blocker. The class of
she be managed
calcium channel blockers recommended for ISH has the suffix
pharmacologically?
"pine" (amlodipine, felodipine, etc).
Remember
ISH = PINE
See an expert-written answer!
ACE inhibitor is specifically hypertension, diabetes with proteinuria, heart failure.
indicated in patients who have ...
CCB
77 year-old patient has had an This patient is 77 years old and should have a goal blood
increase in blood pressure since pressure of < 150/90. A thiazide diuretic is not a good first choice
the last exam. The blood in this patient because it will not be potent enough to decrease
pressure has risen to 168/88 with blood pressure by 25 points to get him to goal. A long acting
2 readings. The last exam's calcium channel blocker is appropriate for patients with isolated
reading was 144/90. If systolic hypertension and will be more likely to get this patient to
medication is to be started on goal pressure than HCTZ. Beta-blockers are no longer
this patient, what would be a recommended first line for uncomplicated hypertension. ACE
good first choice? inhibitors are very effective in patients who are high renin
producers. Elderly patients tend to produce lower amounts of
renin.
, A 63 year-old male has been Order CBC, BMP, TSH, u/a
your patient for several years.
He is a former smoker who takes Fatigue is a difficult complaint to assess and diagnose. This
simvastatin, ramipril, and an patient's exam and vital signs are normal. There is no reason to
aspirin daily. His blood pressure think that he is infected or is bleeding, so a lone CBC, offers little
and lipids are well controlled. diagnostic help. However, in addition to a CBC, adding a
He presents to your clinic with metabolic panel, TSH, and urine (to screen for blood in this
complaints of fatigue and "just former smoker) is a more thorough laboratory assessment of his
not feeling well" for the last few fatigue.
days. His vital signs and exam
are normal. What should be
done next?
Order a CBC and consider
waiting a few days if normal.
Inquire about feelings of
depression and hopelessness.
Order a CBC, metabolic panel,
TSH, and urine analysis.
Order a B12 level, TSH, CBC, and
chest x-ray
See an expert-written answer!
BNP CHEAPER
BNP is a hormone involved in regulation of blood pressure and
fluid volume. When the BNP level is 80 pg/mL or greater, the
A patient with shortness of
sensitivity and specificity is 98% and 92%, favoring a diagnosis of
breath has suspected heart
heart failure. Alternatively, BNP levels less than 80 pg/mL
failure. What diagnostic test
strongly suggest that heart failure is not present (Some US
would best help determine this?
institutions use 100 pg/mL). Other conditions may cause elevated
BNP levels: thoracic and abdominal surgery, renal failure, and
subarachnoid hemorrhage. Consequently, careful assessment of
Echocardiogram
the patient is prudent. Echocardiograms mechanically evaluate
B type natriuretic peptide (BNP)
the heart and establish an ejection fraction. If <35-40%, then HF
EKG
can usually be diagnosed. Ejection fractions do not always
Chest x-ray
correlate with patient symptoms. EKG evaluates the electrical
activity of the heart. Chest x-ray can indicate heart failure but a
BNP is a more sensitive measure.
An 80 year-old patient with long add CCB
standing hypertension takes
Monopril and HCTZ for This patient takes medications from 2 different classes of
hypertension. His blood antihypertensives. If these are at maximum doses, consideration
pressure is 160-170/92-98 on should be given to adding a medication from a different class.
several blood pressure checks. Adding an ARB may result in a precipitous decrease in his blood
What should be done about his pressure because he takes an ACE inhibitor and both of these
blood pressure? medications work in the renin-angiotensin-aldosterone system.
Adding another diuretic will likely produce hypokalemia with a
small decrease in blood pressure. The calcium channel blocker is
Add an angiotensin receptor a good choice because it will have an additive effect with the
blocker (ARB) other medications he is taking. A beta blocker will slow the heart
Add another diuretic rate, not a preferred outcome in an elderly patient unless he has
Add a calcium channel blocker underlying angina or a heart rate problem.
Stop the HCTZ and add a beta
blocker
