N163 Quiz 4 Concepts

What lab is used to assess for heart failure and indicates fluid overload?

BNP (Brain Natriuretic Peptide)

Which lab indicates cardiac muscle damage and is elevated during a heart attack?

Troponin

What labs should be monitored for clotting risk and potential thrombotic events?

PT/INR and D-Dimer

Which lab values indicate systemic inflammation and potential cardiovascular risk?

ESR and CRP (C-reactive protein)

What labs assess lipid-related cardiovascular risk?

Cholesterol and Triglycerides

What electrolyte imbalances can contribute to hypertension and arrhythmias?

Sodium (Na⁺) and Potassium (K⁺)

What labs reflect renal function, which is critical in managing cardiovascular disease?

BUN and Creatinine

Which labs assess anemia, which can increase cardiac workload?

Hemoglobin (Hgb), Hematocrit (Hct), and RBC count

What lab is checked to identify thyroid dysfunctions that may affect the heart?

TSH (Thyroid Stimulating Hormone)

What glucose-related lab is associated with increased cardiovascular risk if elevated?

Fasting Glucose (and HbA1c, if available)

Why does having multiple chronic conditions increase the risk of polypharmacy?

Because each condition may require its own set of medications (e.g., diabetes, HTN, CHF).

How do clinical guidelines contribute to polypharmacy in older adults?

Guidelines often recommend multiple drugs to manage a single condition effectively.

How can seeing multiple specialists lead to polypharmacy?

Each specialist may prescribe medications without coordinating with other providers.

What role do preventive medications play in polypharmacy?

Drugs like statins or aspirin are added for long-term disease prevention.

How does symptom management contribute to polypharmacy?

Extra drugs may be prescribed to manage pain, insomnia, or mood symptoms.

Why does over-the-counter or herbal supplement use increase polypharmacy risk?

Patients may self-medicate, adding drugs not reviewed by their providers.

How can longer life expectancy be an indication for polypharmacy?

More medications are used to maintain function and prevent disease progression.

What is the BEERS Criteria used for?

It identifies potentially inappropriate medications for older adults to improve safety.

Why are anticholinergic drugs on the BEERS list?

They can cause confusion, dry mouth, constipation, and urinary retention.

Why are benzodiazepines (e.g., lorazepam, diazepam) risky in elders?

They increase fall risk, sedation, and cognitive impairment.

Why should antipsychotics be avoided in older adults, especially those with dementia?

They raise the risk of stroke, death, and worsen cognitive decline.

Why are NSAIDs like ibuprofen or naproxen considered high risk?

They can cause GI bleeding, kidney injury, and increase blood pressure.

Why avoid long-acting sulfonylureas like glyburide in elders?

They increase the risk of prolonged hypoglycemia.

What is the concern with digoxin in older adults?

Increased sensitivity and narrow therapeutic range raise toxicity risk.

Why are muscle relaxants (e.g., cyclobenzaprine) on the BEERS list?

They are poorly tolerated and cause sedation, weakness, and falls.

What GI medication class should be used cautiously due to fall risk and fractures?

Proton Pump Inhibitors (PPIs) if used long-term.

Why avoid first-generation antihistamines (e.g., diphenhydramine)?

Strong anticholinergic effects lead to confusion and drowsiness.

What are labs to be on the look out for?

• RBCs

• H&H

• WBCs

• Folic acid

• B12

• Iron

• Uric acid

• PT

• INR

• D-Dime

• ESR

• C-reactive protein

• Platelets

What are some issues that can arise with electrolytes?

Older adults have issues with electrolyte imbalance with dehydration being the most common form of imbalance. Attributed to excess of water or altered fluid intake

What are the side effects with sodium excess/lack of?

• Hyponatremia → Malaise, confusion, headache, nausea, may progress to coma + seizure

• Hypernatremia → Lethargy, weakness, progress to altered consciousness, coma

What are side effects with potassium excess/lack of?

• Hyperkalemia → Muscle twitching, arrhythmia, GI symptoms

• Hypokakalemia → Muscle weakness, confusion, absence of bowel sounds

What are some other labs to monitor?

• Calcium

• Magnesium

• Glucose

• Triglycerides and cholesterol

• Brain Natriuretic Peptide