Heart Failure
What is the 5 year survival in VAD patients less than 50 years old?
What is 73%
What are the 4 pillars of GDMT?
What is
1. beta blockers
2. Mineralcortecoid Receptor Antagonist (MRAs)
3. ACE inhibitors/ARB/ARNI
4. SGLT2 inhibitors
Based on the ARIES study results, what medication is removed from anticoagulation protocol?
What is the most common cause of a low flow?
What is hypertension
A nurse calls to report a red heart alarm. What 3 things should you consider to resolve this alarm?
What is control blood pressure, give volume and replace power source
Once diagnosed with heart failure, what is the mortality rate within 5 years?
What is a good indication to refer for VAD?
What is
1. progressive intolerance to GDMT
2. Escalating diuretics
3. 2 or more hospitalizations per year
What 3 things are used to calculate flow?
What is speed, power and hematocrit
On the controller, what 2 buttons can be pressed simultaneously to view last 6 alarms?
What is the display button and alarm silence button
Patient calls with low flow alarms, asymptomatic, MAP 80, taken meds, no recent changes.
VAD Parameters:
Speed 5200 RPMs, Flow 1.8, PI 11.5, Power 3.5
What might you consider?
What is patient should be evaluated for recovery
What is the average number of VAD implants per year?
What is ~3500
What is the average length of stay for a newly implanted VAD patient who went into surgery as an Intermacs 4?
what is 10-14 days
Based on the ASPIRE data, what two items were best at reducing driveline exit site infection?
What is silver and CHG
What is the MAP goal for a patient with a LVAD?
What is 65-90
Nurse reports patient is having low flows, c/o dizziness, MAP 60, medications given, no recent changes.
VAD parameters-
speed 5000 RPMs, flow 1.6, PI 2.0, power 3.5
You instructed nurse to give fluids. The alarms continue. What else should be considered?
What is get a CTA to rule out obstruction
What is the latest median survival rate with a Heartmate 3?
What is 7 years
What is event logs show the last 256 events and periodic logs are a snapshot of the patients daily parameters.
What might cause an increase in PI events?
What is (can answer any of the below)
1. increase in speed
2. hypovolemia/suction
3. VT
4. IABP
A VAD patient arrives to the ER with an alarming controller. The display screen says "driveline disconnect" with a timer of 10 minutes. What should you consider?
What is (can answer any of the below)
1. notify MD
2. get INR
3. reconnect driveline if INR therapeutic
4. If patient stable, get echo and determine plan of care for future with VAD
For every 1 patient transplanted, how many will die waiting?
What is 21 people
You are following a heart failure patient who is progressively hypotensive on GDMT. What is your plan of action?
What is advocate for advanced therapy options
When does a PI event occur?
What is when there is a 45% change in the per second PI and average PI
What factors determine the most optimum speed setting for a patient?
What is a decompressed left ventricle, septum midline, and aortic valve opening
*ideal for aortic valve to open every second or third beat
The nurse calls you to report an unresponsive VAD patient with inadequate perfusion. The patient is <10 days post op. What is your plan of action?
What is STAT page the surgeon and perform ACLS. Plan for emergency re-sternotomy.