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Exam 1 - Med & Pharm management of CVD
Exam 1 - Medical & Pharmacological management of Cardiovascular Disease
38
Health Care
Graduate
02/17/2013

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Term
examples of Thrombolytic meds
Definition
streptokinase
lanoteplase
reteplase
staphylokinase
Term
examples of Anti-thrombotic meds
Definition
coumadin
warfarin
plavix
aspirin
heparin
Term
Statins >>
Definition
cholesterol/lipid management
Term
ACE inhibitors >>
Definition
decr BP
Term
Beta blockers >>
Definition
decr HR (block epinephrine)
Term
calcium channel blockers >>
Definition
decr vasospasm
Term
cardiac glycosides >>
Definition
incr force of contraction (ex: digoxin)
Term
nitrates >>
Definition
vasodilation
Term
examples of Anti-arrhythmic meds (3)
Definition
sodium channel blockers (litocain, trochantomide)
antisympathetics (beta blockers)
unknown (adenosine, digoxin)
Term
mech of action of anti-arrhythmics (2)
Definition
affect K+
affect Ca++ at AV node
Term
Vein commonly used for CABG
Definition
saphenous v
Term
Criteria for CABG selection (4)
Definition
2 occluded vessels
L ventricular dysfxn
USA
emergency p MI
Term
CABG Post-op complications (10)
Definition
bleeding
altered BP
cardiac arrhythmia
renal dysfxn
infection
fluid/electrolyte imbalance
hemodynamic instability
pulmonary dysfxn
neurologic events
blood clots
Term
PTCA
Definition
percutaneous transluminal coronary angioplasty
Term
PTCA: procedure
Definition
inflate balloon in stenotic area for 1-3 min @ 60-80psi
Term
PTCA: effectiveness
Definition
restenosis occurs in 25-50% of pts
Term
Criteria for PTCA selection
Definition
single vessel disease
Term
PTCA: post-op complications (5)
Definition
CA occlusion
MI
CA dissection
bleeding
circulatory compromise
Term
Heart transplant: orthotopic
Definition
old heart removed to be replaced by new heart
Term
Heart transplant: heterotopic
Definition
old heart left in chest cavity to support new heart
Term
Cardiac denervation >>
Definition
blunted HR changes (slower incr, slower decr)
Term
Criteria for heart transplant selection (6)
Definition
2nd stage myocardial disease (ordinary activity >> symptoms)
ejection fraction <20%
medical Rx not effective
survival prognosis 6-12 mos
cardiomyopathy or ischemic disease
40-50 yo (upper age = 60-65 yo)
Term
Types of pacemakers (4)
Definition
dual chamber (both atria, both ventricles)
single chamber
temporary
permanent c defibrillator (for pt c hx of heart failure)
Term
Pacemakers: Mode of pacing (2)
Definition
Fixed (incl asynchronous)
Demand (incl inhibited)
Term
Pacemakers: complications (4)
Definition
local infection
arrhythmias from ventricle
loss of capture (current doesn't stimulate)
perforation of ventricle
Term
**Pacemaker: exercise precautions** (3)
Definition
know mode of pacing (settings)
monitor response
fixed rate pacer = relative contraindication (can't meet system needs)
Term
Types of replacement valves (2)
Definition
mechanical (last 25 yr)
biological prosthesis (last 10-15 yr, but may work better)
Term
Types of mechanical replacement valves (2)
Definition
mechanical
ball and cage
Term
Risks of mechanical replacement valve
Definition
emboli
Term
Ventricular assistive device
Definition
blood bypasses L ventricle;
no heart beat bc it is a continuous flow
Term
Pre-op care (2x3)
Definition
education: post-sx expectations, nutrition, smoking, risk factors

begin ex: submax, establish routine, look at post-op options
Term
Pt kept in recovery room (immediate post-op) until... (3)
Definition
stable vitals
no apparent internal bleeding
pt responds to name
Term
IMPORTANT in ICU:
Definition
sleep
Term
Complications of acute cardiac care (3)
Definition
reduced arousal
sx pain
difficulty breathing
Term
**what ICU preventative PT does** (4)
Definition
reduce effect of restricted mobility
reduce risk of musculoskeletal deformity (contractures)
reduce risk of decubitus ulcer
teach breathing/coughing techniques
Term
Goals of early post-op PT: provide treatment based on...
Definition
needs and post-op status of pt (NOT based on sx)
Term
Early post-op PT: major areas (3)
Definition
breathing
embolus prevention
return to fxn
Term
Components of "return to fxn" area of early post-op PT (2)
Definition
decisions about what pt will need in community (inpt rehab? outpt rehab at home?)
home needs (distance to bathroom, help from family, etc)
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