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Nurse Practitioner Certification Examination and Practice Preparation 4th Edition, Fitzgerald, 2015/
Cardiac DisordersAce Your Nurse Practitioner Certification Examination and Practice Preparation 4th Edition, Fitzgerald, 2015 Classes and Exams with Picmonic: #1 Visual Mnemonic Study Tool for Nurse Practitioner (NP) Students
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Nurse Practitioner Certification Examination and Practice Preparation 4th Edition, Fitzgerald, 2015 | Nurse Practitioner (NP) School Study Aid
High Blood Pressure Response
- Characteristics
- Atria Release Atrial Natriuretic Peptide
- Vasodilation
- Antagonizes Aldosterone
- Na+ and Water Excreted
1 min
Blood Pressure Classification (JNC 7)
- Classifications
- Normal
- Systolic (<120)
- Diastolic (< 80)
- Prehypertension
- Systolic +20 (120-139)
- Diastolic +10 (80-89)
- Stage 1 Hypertension
- Systolic +20 (140-159)
- Diastolic +10 (90-99)
- Stage 2 Hypertension
- Systolic + > 20 (160)
- Diastolic + > 10 (100)
- Hypertensive Crisis
- Systolic > 180
- Diastolic > 110
4 mins
Hypertension Management (JNC-8)
- Goal of Treatment
- Age Over 60 years (and Healthy)
- 150/90
- Age Under 60 years (and Healthy)
- Any Age with Diabetes or CKD
- 140/90
- Treatment
- ARB/ACE-I/Thiazide/CCB (Primary or Combo)
- CKD (w/wo Diabetes)
- ARB or ACE-I Primary
- African American
- Thiazide or CCB Primary
3 mins
Hypertension Intervention
- Lifestyle Modifications
- Weight Reduction and Exercise
- Diet Changes
- Relaxation Techniques
- Smoking Cessation
- Medications
- Encourage Self Monitoring
1 min
Hypertension Assessment
- Mechanism
- Essential Hypertension
- Secondary Hypertension
- Assessment
- Headache
- Vision Changes
- Nosebleed (Epistaxis)
- Chest Pain
- Syncope (Fainting)
- Diagnosis
- Average 2 Sets, 2 Minutes Apart
- After 2 or More Visits (within 1-4 weeks)
- Nursing Considerations
- Take BP Both Arms
- Common in African Americans
2 mins
Primary Hypertension Risk Factors
- Excessive Alcohol Consumption
- High Sodium Diet
- Dyslipidemia
- Obesity
- People of African Descent
- Advanced Age
- Vitamin D Deficiency
- Reduced Nephron Number
- Diabetes
- Lack of Physical Activity
2 mins
Thiazide Diuretics
- Early Distal Tubule
- Inhibits Na/Cl Reabsorption
- Sulfa Drug
- Hyperglycemia
- Hyperlipidemia
- Hypercalcemia
- Hyperuricemia
- Hyponatremia
- Hypokalemic Metabolic Alkalosis
2 mins
Angiotensin Receptor Blockers (ARBs)
- -sartan suffix
- Indications
- Hypertension
- CHF
- Diabetic Nephropathy
- Mechanism of Action
- Angiotensin II Receptor Blockers
- Side Effect
- Hyperkalemia
- Contraindication
- Pregnancy
1 min
ACE Inhibitors
- -Pril Suffix
- Indications
- Hypertension
- CHF
- Diabetic Nephropathy
- Mechanism of Action
- Inhibits ACE
- Decreases GFR
- Inhibits Constriction of Efferent Arteriole
- Side Effect
- Increased Bradykinin
- Cough
1 min
Systemic Effects of Beta-Blockers
- Respiratory
- Bronchoconstriction
- Metabolic
- Decreased Insulin
- Decreased Glycolysis and Lipolysis
- Eye
- Reduces Intraocular Pressure
1 min
Cardiovascular Effects of Beta-Blockers
- Cardiac Myocytes and Vasculature
- Decrease cAMP
- Decreases SA and AV Node Conduction Velocity
- Lower Blood Pressure
- Decrease O2 Consumption
- Decreases Mortality Post-MI
2 mins
Selective Beta-1 Blockers
- Characteristics
- "-olol" Suffix
- Drug Names
- Beta-1 Selective
- Atenolol
- Esmolol
- Metoprolol
- Partial Beta agonists
- Acebutolol
1 min
Nonselective Beta-Blockers
- "-olol" Suffix
- Nonselective
- Propranolol
- Timolol
- Nadolol
- Partial β Agonist
- Pindolol
- Nonselective β with α Blocking
- Carvedilol
- Labetalol
2 mins
Calcium Channel Blockers (Verapamil and Diltiazem)
- Mechanism of Action
- Slows AV Conduction
- Indications
- Angina Pectoris
- Arrhythmias
- Essential Hypertension
- Side Effects
- Bradycardia
- Hypotension
- Constipation
- Peripheral Edema
- Gingival Hyperplasia
- Nursing Consideration
- Medication Education
2 mins
Aortic Regurgitation
- Auscultation
- Diastolic Murmur
- Immediate High-pitched
- Blowing Murmur
- Clinical Findings
- Wide Pulse Pressure
- Water Hammer Pulse
- Head Bobbing
- Pulsating Nail Bed
- Considerations
- Can Cause Austin Flint Murmur
1 min
Mitral Stenosis
- Characteristics
- Murmur Follows Opening Snap
- Late Diastolic Murmur
- Enhanced by Expiration
- Low-Pitched Rumbling
- Dilation of Left Atrium (LA)
- Recurrent Attacks of Rheumatic Fever
2 mins
Mitral Regurgitation
- Characteristics
- Holosystolic
- Blowing Murmur
- Loudest at Apex
- Radiates toward Axilla
- Louder by Squatting
- Hand Grip
- Expiration
1 min
Endocarditis Assessment
- Infection of Inner Layer and Valves
- Assessment
- Fever
- Fatigue
- New or Changed Murmurs
- Roth's Spots
- Splinter Hemorrhages
- Janeway Lesions
- Osler's Nodes
- Considerations
- Heart Failure
- Embolization
2 mins
Endocarditis Interventions
- Interventions
- IV Antibiotics
- 4-6 Weeks
- Anticoagulants
- Good Hygiene
- Considerations
- Closely Monitor
- Antibiotic Prophylaxis
- Dental Procedures
- Invasive Procedures
1 min
Hypertrophic Cardiomyopathy Mechanisms
- Pathophysiology
- 2/3 Autosomal-Dominant
- 1/3 Sporadic Type
- Mutation in Gene for Sarcomere Protein
- Cardiac Myosin Binding Protein C
- Asymmetric Septal Hypertrophy
- Outflow Tract Obstruction
- Diastolic Dysfunction
2 mins
Hypertrophic Cardiomyopathy Signs, Symptoms and Treatment
- Signs and Symptoms
- Sudden Death Of Young Athlete
- Heart Failure
- Angina
- Arrhythmias
- Syncope
- Harsh Systolic Ejection Murmur
- S4 Heart Sound
- Treatment
- Beta Blocker
- Non-dihydropyridine Calcium Channel Blocker
2 mins
Ampicillin and Amoxicillin
- Mechanism
- Aminopenicillin
- Broad Spectrum Penicillin
- Indications
- Gram-Positive and Some Gram-Negative Infections
- Side Effects
- Rash
- Diarrhea
- Considerations
- No Effect Against Staph Aureus
- Often combined with Beta Lactamase Inhibitor
- Allergic Reaction
2 mins
Clindamycin
- Mechanism of Action
- Bacteriostatic
- Binds 50S Ribosomal Subunit
- Blocks Translocation
- Indications
- Anaerobic Infections above the Diaphragm
- Aspiration Pneumonia
- Lung Abscess
- Side Effects
- Can Cause Pseudomembranous Colitis
1 min
Cardiac Cycle - Diastole
- Characteristics
- Aortic Valve Closes
- Pulmonary Valve Closes
- Ventricles Relax
- Mitral Valve Opens
- Tricuspid Valve Opens
- Ventricles Fill
- Sinoatrial (SA) Node Fires
- Atrial Contraction
3 mins
Cardiac Cycle - Systole
- Characteristics
- AV Node
- AV Node Conducts Signal to Bundle of His
- Bundle of His Signals Purkinje Fibers to Contract Ventricles
- Tricuspid Valve Closes
- Pulmonary Valve Opens
- Mitral Valve Closes
- Aortic Valve Opens
2 mins
Streptococcus Pneumoniae Characteristics
- Characteristics
- Gram-Positive
- Diplococci
- Lancet-Shaped
- Catalase-Negative
- Optochin-Sensitive
- Bile Soluble
- Alpha-Hemolytic
- Polysaccharide Capsule
- Positive Quellung Reaction
- IgA Protease
1 min
Streptococcus Pneumoniae Disease
- Signs and Symptoms
- Sickle Cell Anemia
- Sepsis in Patients with Splenectomy
- Rusty Sputum
- MOPS
- Meningitis
- Otitis Media
- Pneumonia
- Sinusitis
2 mins
Unstable Angina
- Assessment
- Chest Pain with Rest or Exertion
- Limits ADLs
- > 15 Minutes
- Less Likely Relieved by Nitroglycerin
- ST Depression
- Fatigue
- Considerations
- Acute Coronary Syndrome (ACS) Treatment
- Emergency Treatment
2 mins
Myocardial Infarction Assessment
- Assessment
- Substernal Chest Pain
- Crushing or Dull Sensation
- Arm, Jaw, and Neck
- > 20 Minutes
- Unrelieved by Nitro
- Palpitations
- Diaphoresis
- Fear of Impending Doom
- Nausea and Vomiting
- Shortness of Breath
- Considerations
- Monitor for Arrhythmias
2 mins
Myocardial Infarction Diagnosis
- Diagnosis
- 12 Lead ECG
- ST Elevation
- Q Wave
- T Wave Inversion
- Troponin T and I
- CK-MB
- Considerations
- Early ECG
- Cardiac Stress Test
2 mins
Myocardial Infarction Interventions
- MONA
- Morphine
- Oxygen
- Nitrates
- Aspirin
- Thrombolytics (tPA)
- Invasive Procedures
- Cardiac Catheterization
- Stent Placement
- Angioplasty
- Coronary Artery Bypass Grafting (CABG)
- Considerations
- Decrease Modifiable Risk Factors
- Resuming Activity (Physical, Sexual)
2 mins
Clopidogrel (Plavix)
- Mechanism
- ADP Receptor Antagonist
- Prevent Platelet Aggregation
- Indications
- Acute Coronary Syndrome (ACS)
- Prevention of Thrombotic Events
- Side Effects
- Bleeding
- Thrombotic Thrombocytopenic Purpura (TTP)
- Pancytopenia
- Abdominal Pain
- Considerations
- Withhold Before Surgery
2 mins
Aspirin
- Indications
- Fever
- Pain and Headache
- Cardiovascular Disease (CAD)
- Mechanism of Action
- Irreversible inhibition of COX-1 and COX-2
- Suppress Thromboxanes and Prostaglandins
- NSAID
- Side Effects
- Reye's Syndrome
- Tinnitus
- Peptic Ulceration
- Mixed Acidosis/Alkalosis
- Nephropathy
2 mins
Aspirin Poisoning (Salicylism) Assessment
- Early Symptoms
- Nausea and Vomiting
- Tinnitus
- Confusion
- Hyperventilation
- Respiratory Alkalosis
- Late Symptoms
- Metabolic Acidosis
- Coma
- Hyperthermia
1 min
Cardiac Enzyme Evaluation: Creatine Kinase CK-MB
- Measures
- Skeletal or Cardiac Muscle Injury
- Time Ranges
- Onset: 4-8 Hours
- Peak: 12-24 Hours
- Return to Normal: 2-3 Days
1 min
Cardiac Enzyme Evaluation: Troponin
- Measures
- Cardiac Muscle Injury
- Time Ranges
- Detection in Blood: 4 Hours
- Peak: 24 - 36 Hours
- Return to Normal: 5 - 14 Days
- Considerations
- Most Specific for Cardiac Muscle
- Treat Aggressively
2 mins
Nitroglycerin
- Indications
- Pulmonary Edema
- Angina
- Mechanism of Action
- Decreases Preload
- Releases NO in Blood
- Side Effects
- Hypotension
- Reflex Tachycardia
- Flushing
- Monday Disease
- Contraindications
- Viagra (Sildenafil)
2 mins
Heart Failure Interventions
- Diagnostic Tests
- Echocardiogram
- Invasive Hemodynamic Monitoring
- Improve Gas Exchange
- High Fowler's Position
- Oxygen
- Advanced Airway
- Drugs and Devices
- Diuretics
- Beta Blockers
- Angiotensin II Receptor Blockers (ARBs)
- ACE Inhibitors
- Digoxin (Lanoxin)
- Pacemaker
2 mins
Spironolactone (Aldactone)
- Mechanisms
- Inhibition of Aldosterone
- Potassium Retention
- Indications
- Hypertension
- Edema
- Heart Failure
- Side Effects
- Hyperkalemia
- Endocrine Effects
- Consideration
- Avoid Potassium Supplements
2 mins
Cyclosporine (Sandimmune) Overview
- Mechanism
- Immunosuppressant
- Inhibits Calcineurin, Decreasing IL-2
- Indications
- Prevent Transplant Rejection
- Psoriasis
- Rheumatoid Arthritis
- Considerations
- Monitor Plasma Levels
- Avoid Grapefruit Juice
- Increased Risk of Lymphoma
2 mins
Digoxin Mechanism and Indication
- Direct inhibition of Na K ATPase
- Indirect inhibition of Na Ca exchanger
- Increase Ca in cell
- Positive Inotropy
- CHF
- Stimulates Vagus Nerve
- Decreased conduction at AV node
- Atrial Fibrillation
1 min
Acute Digoxin Toxicity
- Clinical Symptoms
- Hyperkalemia
- Cholinergic (Nausea, Vomiting, Diarrhea)
- Blurry Yellow Green Vision with Halo of Light
- Arrhythmia
- Bradycardia
- EKG Changes
- Prolonged PR interval
- Decreased QT
- Scooping on EKG
- T Wave Inversion
2 mins
Digoxin Toxicity Treatment
- Activated Charcoal
- Slowly Normalize K+
- Digibind (Anti-Digoxin Fab)
- Magnesium Sulfate
- Lidocaine
- Cardiac Pacing
2 mins
