CSC Nursing

What does the RCA perfuse? What does the LMA perfuse? What does the LAD perfuse? What is the most commonly occluded artery? What does the Left Circumflex perfuse? Ramus artery SVR PVR S1 S2 S3 S3 is normal in which popuation(s)? S4 Causes of S4 Inferior wall, RA, SA Node, AV node, RV, Posterior portion of the septum, Posterior wall, Bundle of His Bifurcates into the: LAD (Left Anterior Descending), Left Circumflex Artery Septal & Anterior Wall, Front & apex of LV, Interventricular septum, anterior pap muscle, most of the R & L bundle branch- es, Bundle of His LMA Lateral Wall, LA, Back of LV, Posterior wall in 10% of pop 20% of the population has it. Tertiary left main; runs along the LV, between the LAD & circumflex SystemicVascular Resistance- the resis￾tance the LV has to overcome to eject. (Afterload) Peripheral vascular resistance: the resis￾tance the RV has to overcome to eject Closure of the MV and TV; Systole; 1/3 of the cardiac cycle "Lub" Closure of the pulmonic and aortic valve; Diastole; 2/3 of the cardiac cycle; DUB Auscultated in fluid overload; when pre￾load is elevated; KENTUCKY Normal in kids, high CO like pregnancy (3rd trimester) Atrial gallop (pre-systolic); sound caused by vibration of atria ejecting into non compliant ventricle; Tennessee Ischemia, HTN, pulmonary stenosis, CAD, AS, LV Hypertrophy CSC Certification Exam Prep 2 / 8 When are Split Heart sounds heard best? Inspiration Split S1 Causes of Split S1 Split S2 Causes of Split S2 Indications for ACE Inhibitors Effects of ACE Inhibitors What do you want to monitor for in ACE inhibitor administration? Cardioselective B-Blockers Alpha & Beta Blocking Medications Non-selective Beta Blocking Medica￾tions Indications for Beta Blockers Effects of B Blockers What should you monitor for in B blocker administration? B blocker reversal agent MV closes b/f tricuspid RBBB, PVCs, Ventricular Paced rhythms Aortic closes b/f pulmonic valve Overfilled RV, ASD CHF/Systolic Failure, AMI (EF 40%), Anterior wall MI, HTN, Diabetic Renal Nephropathy -prils Angiotensin Converting Enzyme Vasodilation, decrease preload & af￾terload, prevention of myocardial re- modeling, reduce progress of diabetic nephropathy Hypotension, hyperk, cough/angioede- ma, renal function Blocks B1-- Bisoprolol, metoprolol SR, Atenolol, Esmolol, Acebutolol, Nebivolol Labetalol, Carvedilol (Coreg) Blocks B1 + B2; Propanolol, Timolol, Nadolol, Sotalol HTN, Secondary prevention of MI (meto- prolol + carvedilol), Cardiac arrhythmias, angina, Afib, CHF/Systolic HF Decreases HR/BP, negative inotrope by decreasing myocardial workload, de- creases preload, blocks stress cate- cholamines (epi + NE), decreases mor- bidity/mortality, decreases arrhythmias Low HR, Low BP, AV Blocks, HF, signs of shock, bronchospasm; cocaine use Glucagon CSC Certification Exam Prep 3 / 8 How do Angiotensin Receptor Blockers work? Examples of ARBS Indications for ARBs Effects of ARBs Watch out for these s/sx of ARBs Examples of Aldosterone Blockers Indications of Aldosterone Blockers S/sx of Aldosterone Blockers What to watch out for with aldosterone blockers Calcium Channel Blockers Indications for CCBs They block AT1 receptors that hormones act on which are found in the heart, blood vessels, and kidneys. Block Angiotensin 2 to help lower BP "sartans"; Losartan, valsartan, can- desartan, olmesartan, telmisartan HTN, CHF/Systolic failure, diabetic re- nal nephropathy, intolerance of ACE in- hibotors Vasodilation, decreases preload and afterload, reduces secretion of vaso- pressin. Hypotension, HyperK, HA, caution in MI; second line drug use for pts that cant tolerate ACE inhibitors Spironolactone and eplerenone Adjunctive therapy in HF Diuresis, Blocks Na reabsorption, de- creases preload and afterload, In combo with other diuretics, decreases Cardiac workload, k sparing diuretic HyperK especially when used with ACE or Arbs Dihydropyridines: Amlodipine, nimodipine, nicardipine, nifedipine, felodipine (little effect on contractility or HR) Benzothiazepine: Diltiazem (HR control) Phenylalkylamine: Verapamil (HR control) HTN, Reduce HR, SVT, Afib/aflutter, Angina (prinzmetals for vasospasm), hy- pertrophic CM, prevent cerebral artery vasospasm (nimodipine) Arterial vasodilation (decreased afterload), decrease the force of my