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Heart Failure
Digitalis
| Question | Answer |
|---|---|
| What drug names are under the category digitalis? | Digoxin (lanoxin, novodigoxin) all cardiac glycosides and positive inotropics |
| what type of clients is digoxin (lanoxin, novodigoxin) prescribed to? | clients with heart failure with sinus rhythm and atrial fibrillation (AF) |
| What drugs when combined with digoxin help reduce exacerbations of HF | 1. ace inhibitors 2. beta blockers 3. diuretics |
| What benefits does digoxin have on the failing heart? | increases functional capacity and improves clients symptoms (decreased dyspnea and improved activity) |
| How does digoxin increase the functional capacity of the heart? | 1) increases contractility of the heart 2) reduces heart rate (HR) 3) slow conduction through AV node 4) Decreases sympathetic activity; increases parasympathetic activity 5) may have mild diuretic effect |
| What cardiac cell characteristic is increased with toxic levels of digoxin or hypokalemia? | automaticity |
| What can happen with increased automaticity due to digoxin toxicity or hypokalemia? | ectopic beats; possibly resulting in PVCs |
| What possible effects can hypokalemia have on a client who is taking dig? | increased sensitivity to dig |
| Where is digoxin absorbed within the body? | GI tract (erratically absorbed) |
| What can interfere with dig absorption? | drugs, especially antacids |
| How is digoxin excreted? | renal (kidney) excretion |
| Presenting signs of dig toxicity are vague/obvious? | vague |
| Some presenting signs of dig toxicity include? | 1) anorexia 2) fatigue 3) change in mental status 4) any dysrhythmia (PVCs most common) |
| What assessments are important to make when giving dig? | 1) apical pulse 2) heart rhythm |
| What is an acceptable HR with dig? | It is determined by MD, many prefer a rate less then 60 bpm |
| What do you report to physician in regards to HR? | development of irregular rhythm or a regular rhythm in a client with a previous irregular rhythm |
| What lab values are important to monitor dig levels? | 1) serum dig levels 2) serum potassium levels |
| Does dig increase the workload of the heart? | Yes: which causes the heart to require more oxygen. Client may experience angina in response to this. |
| What is the half life of dig in middle aged adults? | 36 hours |
| what is the half life of dig in the elderly? | may be 48 hours or longer (if have impaired renal function) making them more prone to toxicity. toxicity may be fatal in elderly hypokalemic patients. |
Created by:
kristenbsurdynski
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