Clickity Clack
Name this condition, in which patients may be asymptomatic, with a click or low-pitched murmur that might be heard as a rumbling sound over the heart apex during diastole.
What is mitral valve stenosis?
Name this condition that occurs primarily in hearts with artificial or damaged valves and in those who inject drugs.
What is infective endocarditis?
Name this condition that occurs as the formation of a clot, followed by inflammation within a vein.
What is thrombophlebitis?
Name these drugs that act to block the binding of angiotensin II at various receptor sites in the vascular smooth muscle and adrenal glands, which block the vasoconstrictive effects of the renin-angiotensin system and the release of aldosterone, resulting in a lowering of the blood pressure.
What are angiotensin II receptor antagonists?
Candesartan, telmirsartan, losartan, diovan, avapro
Scenario: A physician orders minoxidil 0.1 mg/kg/day PO in two divided doses. A 44 lbs pediatric patient needs a weight-based dose of an antihypertensive medication. The pharmacy dispenses minoxidil 2.5 mg tablets.
Solve: How many tablets will the nurse administer per dose?
What is 0.4 tab?
1. Convert pounds to kilograms
44lbs / 2.2lbs x kg = 20kg
2. Calculate the total daily dose
0.1mg/kg/day x 20kg = 2mg/day
3. Calculate the individual dose
2mg/day / 2 doses = 1mg/dose
4. Use the desired over have formula
D = 1mg
H = 2.5mg
Q = 1 tab
1mg/2.5mg x 1 tab = 0.4 tab
Name this medical condition that is seen in older adults who have mitral valve stenosis.
What is rheumatic fever?
Name this condition that may be acute or chronic inflammation of the pericardium.
What is pericarditis?
List nursing interventions for deep vein thrombosis.
What are warm, moist heat, elevation of the leg above the heart to decrease swelling, compression stockings to the unaffected leg, and anticoagulants (per provider order)?
Explain the action of calcium channel blockers.
What is their role in inhibiting the movement of calcium ions across the cell membranes of cardiac and arterial muscle cells?
Amlodipine (Norvasc), Felodipine (Plendil), Nicardipine (Cardene), Nifedipine (Procardia), Nisoldipine (Sular)
Scenario: A physician orders clonidine 10 mcg/kg/day PO divided every 8 hours. A 55 lbs pediatric patient needs a weight-based dose of an antihypertensive medication. The pharmacy dispenses clonidine oral solution 100 mcg/mL.
Solve: How many milliliters will the nurse administer per dose?
What is 0.83 mL per dose?
1. Convert pounds to kilograms
55lbs / 2.2lbs x kg = 25kg
2. Calculate the total daily dose
10mcg/kg/day x 25kg = 250mcg/day
3. Calculate the individual dose
250mcg/day / 3 doses = 83.33 mcg/dose
4. Use the desired over have formula
D = 83.33mcg
H = 100mcg
Q = 1 mL
83.33mcg/100mcg x 1 mL = 0.833mL = 0.83mL
Name three lesser common causes of mitral stenosis.
What are congenital defects of the mitral valve, systemic lupus erythematosus, and calcium deposits?
Name this rare heart condition that most commonly develops after a viral infection, including Covid-19 in some cases.
What is myocarditis?
List three nursing diagnoses for a patient with thrombophlebitis.
What are acute pain r/t inflammation of the vein, impaired skin integrity r/t venous stasis, and anxiety?
Name the first-line medication the HCP usually provides for hypertension.
What is a thiazide-type diuretic?
Hydrochlorothiazide (HCTZ)
Scenario: A patient's dose requires an adjustment. The physician orders diltiazem 120 mg PO daily. The pharmacy dispenses diltiazem 60 mg capsules.
Solve: How many capsules should the nurse administer per dose?
What is 2 capsules?
1. Calculate using the desired over have formula
D = 120 mg
H = 60 mg
Q = 1 capsule
120mg / 60mg x 1 capsule = 2 capsules
Name the two major causes of aortic stenosis.
What are congenital defects and/or rheumatic heart disease?
Name this condition, which is often a genetic disorder that causes an abnormality and enlargement of the heart muscle, leading to ineffective blood pumping.
What is cardiomyopathy?
What are pulmonary embolism, chronic venous insufficiency, and recurrent deep vein thrombosis?
Name the antihypertensive drug class that medications such as lisinopril (Zestril), enalapril (Vasotec), and benazepril (Lotensin) treat conditions like high blood pressure and heart failure by relaxing blood vessels and reducing the heart's workload.
What are Angiotensin-Converting Enzyme inhibitors (ACEI)s?
Scenario: The physician orders hydralazine 25 mg PO three times daily. The medication is not available in a standard tablet form and must be prepared from a concentrated solution. The pharmacy dispenses Hydralazine oral solution 20 mg/5 mL.
Solve: How many milliliters will the nurse administer per dose?
What is 6.25 mLs?
1. Calculate using the desired over have formula
D = 25 mg
H = 20 mg
Q = 5mL
25mg / 20mg x 5mL = 1.25mL x 5mL = 6.25mL
List the early signs or symptoms of aortic stenosis.
What are exertional: angina, dyspnea or activity intolerance, and dizziness or syncope?
List the three types of cardiomyopathies.
What are dilated, hypertrophic, and restrictive cardiomyopathies?
Other than the d-Dimer blood test, name a diagnostic tool in determining thrombophlebitis.
What is compression ultrasonography?
Name the antihypertensive medication class used cautiously in patients with sodium depletion, hypovolemia, or coronary or cerebrovascular insufficiency, and in patients receiving diuretic therapy or dialysis.
What are Angiotensin-Converting Enzyme inhibitors (ACEI)s?
Scenario: A physician orders labetalol 1.5 mg/kg/day PO in two divided doses. A 75 lbs pediatric patient needs a weight-based dose of an antihypertensive medication. The pharmacy dispenses labetalol 100 mg scored tablets.
Solve: How many tablets will the nurse administer per dose?
What is 0.25 tab?
1. Convert pounds to kilograms
75lbs / 2.2lbs x kg = 34.09kg
2. Calculate the total daily dose
1.5mg/kg/day x 34.09kg = 51.14mg/day
3. Calculate the individual dose
51.14mg/day / 2 doses = 25.57 mg/dose
4. Use the desired over have formula
D = 25.57mg
H = 100mg
Q = 1 tab
25.57mg/100mg x 1 tab = 0.26 tab = 0.25tab 1/4tab