WGU D027 STUDY GUIDE WITH 100% CORRECT ANSWERS 2023.

Autosomal Dominant 1 parent has, 50% change of child having Autosomal Recessive Both parents are carriers, 25% change of child having, 50% chance child is a carrier. Cystic Fibrosis affects pancreas causing secretions in lungs 21st Trisomy Down Syndrome Klinefelter Syndrome (XXY) male has extra X, female like qualities Turner Syndrome Missing X in females Alpha Thalassemia inherited blood disorder; mild to severe anemia Beta Thallasemia low hemoglobin; contraindicated medication ferrous sulfate Prevalence Risk proportion of the population affected at a certain time Incidence rate number of new cases divided by population Innate immunity inflammation; increased vascular permeability B&T lymphocytes immune response primary malignant tumor lack of organization of cells glucocorticoids used in combination with other agent to treat lymphoid tissue (leukemia). glucocorticoids are directly toxic to lymphoid tissues. Selective estrogen receptor modulators (SERM) for hormone receptor positive and advanced breast cancer. (Tamoxifin reduces risk and recurrence risk) Heart failure impairment of the ventricle to fill with or eject blood; heart cannot meet metabolic need of the body. CHF heart cannot keep up with metabolic needs; volume overload in pulmonary area Left Ventricular Dysfunction reduced ejection fraction; ventricle having issue ejecting blood. normal ejection fraction 55 - 60 % (blood pumped out with each heartbeat) Ejection fraction of 50% - reduced or preserved? preserved Diastolic CHF preserved ejection fraction, problem is with filling Systolic CHF reduced ejection fraction, problem is with ejecting Left sided CHF pulmonary (JVD, fluid volume overload, rails, S-3 murmurs) ** #1 cause of Right sided CHF BNP gold standard lab test to diagnose CHF Echocardiogram Diagnostic tool, evaluates heart structure and function At Risk for HF - Stage A no structural heart disease or symptoms of heart failure Stage A HF co-morbidities htn, atherosclerotic disease, diabetes, metabolic syndrome, patients using cardiotoxins with family history Therapy goals of stage A HF treat htn, encourage smoking cessation, encourage regular exercise, treat lipid disorders, discourage alcohol intake/drug use, control metabolic syndrome Meds: ACEI or Angiotensin II RB for vascular disease or diabetes (avapro, losartan, benicar, diovan, etc) At Risk for HF - Stage B structural heart disease but no symptoms of heart failure Stage B HF co-morbidities previous MI, LV remodeling with LV hypertrophy and low EF, asymptomatic valvular disease Therapy goals of Stage B HF Meds: ACEI or ARB, Beta-blockers, inplantable defibrillators Stage C heart failure structural heart disease with prior or current symptoms of HF Presentation of Stage C HF known structural heart disease and shortness of breath and fatigue, reduced exercise tolerance Therapy for Stage C HF dietary salt restriction, MEDS: diuretic, ACEI, beta blockers. Some patients: aldosterone antagonist, ARBs, digitalis, hydralazine/nitrates, biventricular pacing, inplantable defibrillators Stage D heart failure refractory HF requiring specialized interventions Presentation of Stage D HF marked symptoms at rest despite maximal medical therapy (recurrently hospitalized or cannot be safely discharged without specialized interventions) Therapy goals for Stage D HF compassionate end-of-life care/hospice, extraordinary measures ,heart transplant, chronic inotropes, permanent mechanical support, experimental drugs or surgery Ischemic heart Disease (CAD, MI) presentation chest discomfort, pain in neck/jaw/chest (crushing, squeezing, sharp), pain worse with exertion (demand requirement is higher), abnormal heart sounds, hypoxia, arrhythmias (afib, ST elevation) Stable angina goal decrease cardiac oxygen demand Meds for stable angina nitro first choice, then beta blockers (beta blockers if angina occurs with effort) nitroglycerine dose sublingual, acts within 5 minutes, max of 3 doses Cardiac glycosides (Digoxin) Increased myocardial contractile force (increases output), used in ED, exerts positive inotropic action, can cause severe dysrhythmias Digoxin Dosing therapeutic - 0.5-0.8 ng/ml. ASSESS apical pulse before administering, If lethargic and not acting right, see patient FIRST Goal of Anticoagulant and Antiplatelet Drugs inactivate and suppress formation of thrombin Warfarin (coumadin) PO to prevent blood clots; start with half a dose