WGU D027 Study Guide | Questions and
Answers| Latest Update | A grade Guaranteed
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
Anticoagulants - ✔✔Warfarin, heparin, lovenox; Caution about hemorrhage, any patients
with risks for bleeding
Pneumonia Patho - ✔✔pathogen reaches airway and overwhelms defenses causing
inflammatory cascade; fluid forms, blocking diffusion (gas exchange) causing hypoxia,
ultimately leads to respiratory failure
Diagnosing pneumonia - ✔✔Chest X-ray: viral - diffuse widespread whitening; bacterial -
patchy, consolidated, lobar
Emphysema - ✔✔destruction of alveolar walls; air goes into lungs, can't get out; leads to
hyperinflation
Bronchitis - ✔✔excess mucus production, smooth muscle hypertrophy
asthma - ✔✔chronic inflammatory obstruction of bronchi; trigger causing mucus clogging
bronchial tubes; is reversable, give beta antagonists and steroids
Foundation meds of asthma and COPD - ✔✔glucocorticosteroids: Pulmicort and Flovent;
taken daily for long term control to suppress inflammation.
Oral glucocorticoids - methylprednisone, prednisone; gradually decrease dose
Bronchodilators (Beta 2-Adrenergic Agonists) - ✔✔provide symptomatic relief, do not effect
inflammation of disease process; taken PRN during attack (Albuterol), long actinb Beta2 can be
used in combo with glucocorticoids
Answers| Latest Update | A grade Guaranteed
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
Anticoagulants - ✔✔Warfarin, heparin, lovenox; Caution about hemorrhage, any patients
with risks for bleeding
Pneumonia Patho - ✔✔pathogen reaches airway and overwhelms defenses causing
inflammatory cascade; fluid forms, blocking diffusion (gas exchange) causing hypoxia,
ultimately leads to respiratory failure
Diagnosing pneumonia - ✔✔Chest X-ray: viral - diffuse widespread whitening; bacterial -
patchy, consolidated, lobar
Emphysema - ✔✔destruction of alveolar walls; air goes into lungs, can't get out; leads to
hyperinflation
Bronchitis - ✔✔excess mucus production, smooth muscle hypertrophy
asthma - ✔✔chronic inflammatory obstruction of bronchi; trigger causing mucus clogging
bronchial tubes; is reversable, give beta antagonists and steroids
Foundation meds of asthma and COPD - ✔✔glucocorticosteroids: Pulmicort and Flovent;
taken daily for long term control to suppress inflammation.
Oral glucocorticoids - methylprednisone, prednisone; gradually decrease dose
Bronchodilators (Beta 2-Adrenergic Agonists) - ✔✔provide symptomatic relief, do not effect
inflammation of disease process; taken PRN during attack (Albuterol), long actinb Beta2 can be
used in combo with glucocorticoids
