Nursing 251 Exam 2 Questions and Correct Answers Updated Version 2023
- main classes of drugs to treat angina - Correct AnsNitrates/Nitrites, Beta Blockers,
Calcium Channel Blockers
- classes of diuretics - Correct Ans- osmotic
- carbonic anhydrase inhibitors
- loop diuretics
- thiazide diuretics
- potassium sparing diuretics
ACCF/AHA stages of CHF - Correct AnsStage A: At high risk but no symptoms or
structural heart disease
Stage B: Structural heart disease present but no signs or symptoms
Stage C: Structural heart disease with past or current symptoms
Stage D: Refractory heart failure requiring interventions
ACE Inhibitors (mechanism of action & example) - Correct Ans- Prevent angiotensin I from being converted to angiotensin II. Angiotensin II is a potent vasoconstrictor. It also stimulates the reabsorption of water and sodium into the body. Both of these actions raise blood pressure. Therefore, by blocking, blood pressure is reduced.
- Lisinopril (Prinivil)
ACE-inhibitors/ARBs with CHF - Correct AnsWork in CHF by preventing sodium and water reabsorbing into the body they decrease blood volume and blood return to the heart. This decreased the preload and work load required of the hear
Angina pectoris - Correct Anschest pain that results when the heart does not get enough oxygen
Antihypertensive therapy - Correct Ans-goal is to decrease morbidity and mortality without decreasing quality of life
Antihypertensive therapy should be started in patients - Correct Ans· 60+ if their blood pressure >150/90mm/Hg.· 59- or those with chronic kidney disease or diabetes used when the blood pressure >140/90mm/Hg.
ARBs (mechanism of action & example) - Correct Ans- Block the binding of Angiotensin II to type 1 Angiotensin II receptors. This blocks vasoconstriction and the secretion of aldosterone. Aldosterone causes sodium and water to be reabsorbed into the body, which can raise BP. Therefore, by blocking this receptor, blood pressure is reduced.
- Losartan (Cozzar)
Arteries that deliver oxygen to the heart - Correct Anscoronary arteries 1 / 2
Beta Blockers with angina (mechanism of action of, use, adverse events) - Correct Ans- Mechanism of action: work by blocking beta-1 receptors in the heart. Blockage leads to a decrease in the heart rate as well as the force of the heart's contraction.These two actions lower the heart's workload and oxygen need. Since the heart needs less oxygen, the patient experiences less chest pain.
- Use: used on a daily basis when used for angina. They have been shown to prevent or
at least delay pain. The preferred beta blockers for angina pain include: nadolol, propranolol, atenolol, and metoprolol.
- Adverse Events: Drowsiness, tiredness, nausea, and diarrhea. If the dose is too high,
patients can experience an unwanted drop (too low) in blood pressure or heart rate.
Beta blockers with CHF - Correct Ans-In CHF the heart is trying to meet the demands of the body patients are often tachycardic (increased heart rate). Despite working so hard, the heart is unable to meet the demands of the body and beating faster is just making it worse. So, when they take a beta blocker, that slows the heart rate, it actually allows the heart to fill and function more efficiently.
CAD - Correct Ansany one of the abnormal conditions that can affect the arteries of the heart and produce various pathologic effects especially a reduced supply of oxygen and nutrients to the heart.
Calcium Channel Blockers with angina (mechanism of action of, forms, use, adverse events) - Correct Ans- Mechanism of Action: Block calcium from entering vascular smooth muscle. This leads to vasodilation and reduced blood pressure. Lowers the overall workload of the heart. The non-dihydropyridines (verapamil and diltiazem) also directly work on the heart, blocking calcium in the heart muscle itself and decrease the heart rate leading to lower workload for the heart and antianginal activity.
- Use: CCB are also taken on a daily basis to prevent angina attacks. Both non-
dihydropyridines and dihydropyridines can have antianginal effect. CCBs typically used for angina include: verapamil, diltiazem, amlodipine, nifedipine, and nicardipine.
- Adverse Events: headache, facial flushing, dizziness, low blood pressure. Verapamil
specifically can cause constipation. Both verapamil and diltiazem at too high of dosages can cause a dangerously low drop in heart rate.
Cardiac output - Correct Ansamount of blood ejected from the heart's left ventricle in one minute (heart rate x stroke volume)
CCBs (mechanism of action & example) - Correct Ans- Blocks Calcium from binding to receptors which causes smooth muscles to relax, thereby preventing contraction
- Amlodipine (Norvasc)
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