PNM300 - Test 2 (CH 25,27) Exam Questions With Correct Answers
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Course
PNM300
Institution
PNM300
PNM300 - Test 2 (CH 25,27) Exam Questions
With Correct Answers
What is heart failure? - answerThe heart is unable to pump blood in sufficient amounts from
the ventricles to meet the body's metabolic needs
What are symptoms of heart failure dependent on? - answersymptoms depend on cardiac area
...
What is ejection fraction? - answer✔The proportion of blood that is ejected during each
ventricular contraction compared with the total ventricular filling volume.
What is refractory period? - answer✔The period during which a pulse generator (i.e., the
sinoatrial node of the heart) is unresponsive to an electrical input signal, and during which it is
impossible for the myocardium to respond; during this period, the cardiac cell is readjusting its
sodium and potassium levels and cannot be depolarized again.
What are positive inotropic drugs? - answer✔- Phosphodiesterase inhibitors
- Cardiac glycosides (DIGOXIN)
- B-type natriuretic peptides
What drugs are usually used to treat early heart failure? - answer✔- ACE Inhibitors
- ARBs
- Certain ß-blockers (bisoprolol, extended-release metoprolol tartrate, and carvedilol)
- loop diuretics
- aldosterone inhibits
Loop Diuretics and Heart Failure - answer✔Loop diuretics (furosemide) are used to reduce the
symptoms of heart failure secondary to fluid overload.
Aldosterone Inhibitors and Heart Failure - answer✔- spironolactone, eplerenone
- used as heart failure progresses
When is digoxin introduced in heart failure? - answer✔after first line of early treatment meds
fail to manage heart failure
Heart Failure medications recommended for black patients with HF - answer✔Hydralazine and
isosorbide dinitrate are approved specifically for individuals who are Black.
How does hydralazine work? - answer✔causes arterial vasodilation
Dobutamine Hydrochloride and HF - answer✔- is available only as an intravenous drug and is
given by continuous infusion
What is a inodilators? - answer✔inotropes + dilators
There is only one phosphodiesterase inhibitor available in Canada what is it? - answer✔-
milrinone
- only available as an injection
- Short-term management of heart failure for patients in the Critical Care Unit
not meant for long term
What is Digoxin used for? - answer✔Used in heart failure and to control ventricular response to
atrial fibrillation
What is a positive +inotropic effect? - answer✔- Increased force and velocity of myocardial
contraction (without an increase in oxygen consumption)
What is a negative -chronotropic effect? - answer✔- Reduced heart rate
What is a Negative -dromotropic effect? - answer✔Decreased automaticity at sinoatrial node,
decreased atrioventricular nodal conduction, and other effects
A patient is in the emergency department with new-onset atrial fibrillation. Which order for
digoxin would most likely have the fastest therapeutic effect?
A)Digoxin 0.25 mg PO daily
B) Digoxin 1 mg PO now, then 0.25 mg PO daily
C) Digoxin 0.5 mg IV push daily
D) Digoxin 0.75 mg IV push now, then 0.125 mg IV tid - answer✔D) Digoxin 0.75 mg IV push
now, then 0.125 mg IV tid
Rationale: A digitalizing dose (0.5 - 0.75 mg IV) is often used to quickly bring serum levels of
the drug up to a therapeutic level. IV doses would accomplish this more quickly.
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