CARDIAC

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100

First line hypertension medications?

Thiazide diuretics (HCTZ)

ACEs

ARBs

CCBs 

200

Give me the stages of blood pressure NEOW (just normal, 1 and 2)

Normal: <120/80

stage 1: 130-139/80-89

stage 2: >=140 or >=90

300

Nursing assessment of hypertension?

Detailed family history

Dietary habits

Physical activity level

Weight history and body consumption

Alcohol consumption

Sleep patterns and quality

Stress lvels and coping mechanisms

400

Most common death in US?

CAD :(

500

STEMI v NSTEMI?

STEMI-

total, prolonged blockage causing heart muscle damage

requiring immediate emergency intervention (angioplasty or thrombolytics)

ST segment elevation 

NSTEMI-

partial or temp blockage

ST segment depression or T wave inversion

causes damage to inner layer of heart

treated w/ meds first, cardiac catherization within 24-48hrs

imma freak out

100

Which systems help regulate blood pressure? (4)

Sympathetic nervous system, RAAS, baroreceptors, vascular endothelium 

200

Acute care of chronic stable angina?

Position upright; apply oxygen 

Assess: VS, heart & breath sounds

Continuous 12 lead EKG monitoring

Pain relief (NTG; IV opioid if needed)

Obtain cardiac biomarkers (troponin?)

Obtain chest xray

Provide support; reduce anxiety

Patient teaching

300

Second line hypertension meds?

Diuretics (loop, K sparing)

Beta Blockers

Alpha 1 blockers

Centrally acting drugs (alpha antagonists, clonidine, guanfacine)

400

Myocardial infarction (acute coronary syndrome) clinical presentation?

Severe chest pain not relived by rest, position change, or nitrate administration 

pts feel a crushing, heaviness, pressure, tightness, or burning sensation

Radiating pain is also common to neck, jaw, arms, back. substernal or epigastric regions are most commonly where they are felt

often occurs in the morning time and greater than 20 min in duration 

500

Treatment for STEMI v NSTEMI?

STEMI:

• Primary PCI: Gold standard treatment (door-to-balloon time minutes). within 90 min
• Fibrinolysis: If PCI is not available within 120 minutes, fibrinolytic therapy (e.g., alteplase) should be administered, ideally within 30 minutes of arrival (door-to-needle).
• Medication: Dual Antiplatelet Therapy (DAPT) with aspirin and a P2Y12 inhibitor (ticagrelor or prasugrel preferred) plus anticoagulation.
• 
  NSTEMI
• Immediate Assessment: Risk assessment determines the urgency of invasive management.
• Invasive Strategy: Angiography and potential PCI within 24–48 hours for stable patients, or immediately for high-risk individuals.
• Medical Therapy: Aggressive anti-ischemic medications (beta-blockers, nitroglycerin, anticoagulants like enoxaparin or unfractionated heparin, and statins). 

toilet presha

100

Explain DROWNS and SWELLS. Which one belongs to right sided and left sided HF?

DROWNS- left sided

Dyspnea, rales, orthopnea, weakness, noctural dyspnea, sputum (pink/frothy)

SWELLS- right sided

swollen legs, weight gain, edema, liver enlargement, large neck veins (JVD), stomach distention (ascites)

200

Treatment approach to stage 1 hypertension?

lifestyle modifications for 3-6 months, then if still high move to medications. (one first line drug + lifestyle changes)

300

What is target SBP for the elderly?

<130mmHG

400

Outpatient care of chronic stable angina?

Stress testing, cardiac cath, CTA, echocardiogram

500

Treatment approach to stage 2 hypertension? (or if stage 1 with other comorbidies)

Two drugs from different classes plus lifestyle modifications. Requires more frequent follow up than stage 1

sloppy on sum joe

100

mmk so how in the world do we manage a hypertensive crisis (EMERGENCY!)?

IV drugs titrated SLOWLY

we dont want MAP reduction more than 25% in the first few hours 

the body is used to that high bp, so if we drop it too fast we risk vital organs not perfusing correctly 

200

Explain biventricular failure.

both right and left ventricular dysfunction.

fluid build up and venous engorgement, decreased perfusion to vital organs, inability for both ventricles to pump effectively 

300

ok so we know the patient has ACS, what diagnostics do we do?

detailed health history

12 lead ECG (we're looking for how old ecg compares to new one, changes in QRS complexes, ST segments, T waves, because this is gonna help us determine if its STEMI or NSTEMI)

chest xray (can show signs of HF)

400

serum cardiac biomarkers for ACS diagnostics GO!

Troponins, CK-MB, myoglobin

cardiac specific troponin is best indicator for MI (Cardiac specific troponin T & cardiac specific troponin I)

Increased 4-6hrs after onset of MI, peak 10-24hrs after, return to baseline 10-14days

BIOMARKERS NEGATIVE FOR UA; POSITIVE FOR NSTEMI

500

What assessments and test do nurses utilize for heart failure?

Assessments:

vital signs

lung sounds

heart, rate and rhythm 

extremities, cyanosis and edema

weight, usual daily

abdominal swelling

JVD

i&os

Tests:

chest xray

cardiac cath

brain natriuretic peptide

cardiac enzymes 

CBC, CMP

echocardiogram

bluple

100

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ok phew i thought youd say no

200

Nursing care & non pharmacologic management of HF?

DAILEY WEIGHTS!

fluid monitoring

low sodium diet

MEDICATION COMPLIANCE

close lab monitoring (electrolytes, liver, renal)

edema monitoring 

300

Difference between hypertensive crisis and urgency?

Crisis is an EMERGENCY! Target organ damage! Hospitalization! GET DAT PATIENT CURED STAT (SBP>180 and/or DBP >120 )

Urgency isnt great, but more common. Usually no hospitalization required and no target organ damage. ASSOCIATED WITH CHRONIC STABLE DISORDERS.

400

Mechanisms that can affect cardiac output (leading to HF)?

preload

afterload

myocardial contractility

HR 

500

management of ACS?

IMMEDIATE:

ABCs, ADPIE, MONA

ADDITIONAL:

dual antiplatelet therapy, anticoagulation, beta blockers, ACE/ARBs, statins