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MSII U.3 PHARM
Chap 38,42,46 Care of a pt w/ Cardiovascular or a peripheral vascular Disorder
| Question | Answer |
|---|---|
| what are the uses for digoxin??(pg396) | HF, atrial fibrillation, atrial flutter, paroxysmal atrial tachycardia, but mainly HF & A. Fibrillation |
| The digitalis or cardiac glycosides are obtained from the leaves of??(pg.397) | The foxglove plant |
| Miscellaneous w/ positive inotrpic action, such as inamrinine and milrinone (Primacor, are nonglycosides used in the short term management of???(pg.396) | Heart Failure (HF) |
| Cardiotonics such as digoxin increase cardio output through positive inotropic activity.. which means??(pg.396) | an increase in the force of the contractions |
| Atrial fibrillation is??(pg.396) | a cardiac arrhythmia characterized by rapid contractions and quivering of the atrial myocardium, resulting in an irregular and often rappid ventricular rate. |
| Adverse reactions associated w/ cardiotonics??(pg.397) | CNS: Headache, weakness, drowsiness, visual disturbances. CV and GI: arrythmias, GI upset and anorexia. |
| Contraindications w/ Cardiotonic drugs..(pg.397) | presence of digitalis toxicity and in pts w/ UK hypersensitivity, ventricular tachycardia, or AV block. |
| digoxin is pregnancy cat??(pg.398) | C (a hint to remember: that comes before d in the alphabet??...C!) |
| w/ BOTH inamriNONE and milriNONE are giving in what route of administering?? (drug names do not usually have NONE capitalized!!)(pg.389,399) | IV (Hint to remember: none other route but IV) |
| when taking Miscellaneous Inotropic Drugs it is important for the nurse to monitor??(pg.399) | heart rate and blood pressure. |
| if apical pulse in a Pediatric pt taking a Miscellaneous Inotropic Drug is below 70 bpm, or below 90 bpm, the drug should???(pg.399) | drug is withheld and primary health care provider is notified. |
| Digoxin tablets are used for??(pg.400) | maintenance therapy |
| Rapid digitalization is??(pg.400) | accomplished by administering a loading dose (fast:rapid)doctor usually starts out w/ a loading dose.. observe for signs of digitalis toxicity every 2-4 hrs. |
| Gradual digatalization is??(pg.400) | a maintenance dose is given, allowing therapeutic drug blood levels to accumulate GRADUALLY*) observe for digitalis toxicity at one-two times daily. |
| Diuretics along w/ other conditions or factors, such as GI suction, diarrhea, and old age, may produce??(pg.400) | low serum POTASSIUM levels (HYPOKALEMIA) |
| When a Cardiotonic Drug is given by IV, it is administered SLOWLY and the administration site is assessed for??(pg.401) | redness and infiltration. |
| life-threatening* toxicity is treated w/??(pg.402) | digoxin immune fab (Digibind)..used as an antidote in treatment of digoxin overdose. |
| a pt taking a Cardiac glycoside drug should avoid??(pg.402) | antacids, and nonproscribed cough, cold, allergy, antidiarrheal, and diet (weight reducing) drugs. |
| Ejection fraction below 40% is commonly associated with?? | (L) Ventricular systolic dysfunction. |
| What serum digoxin LEVELS* in an adult would be most indicative that the pt may be experiencing digoxin toxicity?? | 2.0 nanograms/ml |
| what would be A reason for the nurse to withhold a dose of digoxin and notify the primary health care provider?? | A pulse rate of 50 bpm |
| During RAPID digitaliszation, the nurse expects the first dose to be?? | approximately half of the total digitalization. (do u understand?? i sure the heck don't lol) |
| Low-density lipoproteins (LDL) transport?(pg.451) | cholesterol to the peripheral cells. |
| Triglycerides and cholesterol are insoluble in??(pg.451) | in WATER and must be bonded to a lipid-containing protein (lipoprotein) |
| REMEMBER: LDL is a HARMFUL lipoprotein | REMEMBER: HDL is the PROTECTIVE lipoprotein |
| An HDL level less than 40 mg/dL is low and considered a major risk factor for?(pg.452) | Heart disease |
| The main goal of treatment in pts w/ HYPERLIPIDEMIA is to??(pg.452) | lower the LDL to a level that will reduce the risk of heart disease |
| antihyperlipidemic drug therapy is used to?(pg.452) | lower serum levels of cholesterol and triglycerides. |
| the various types of drugs used to treat hyperlipidemia are? | Bile acid sequestrants, HMG-CoA reductase inhibitors, Fibric acid derivatives |
| lipid levels are monitored?(pg.452) | every 4 months |
| the Bile Sequestrant cholestyramine is used for?(pg.455) | Pruritus associated w/ partial biliary obstruction. |
| An adverse reaction w/ administration of a Bile Sequestrant is that it?(pg.455) | Increases bleeding tendencies related to vitamin K malabsorption, and Vitamin A and D deficiencies. |
| Bile Sequestrants are pregnancy cat?(pg.455) | C |
| the Bile acid sequestrants should be administered?(pg.456) | ALONE and other drugs given at least ONE HOUR before or FOUR HOURS after administration of bile acid sequestrants. |
| HMG-CoA Reductase inhibitors is a?(pg.456) | antihyperlipidemic drug. |
| Pts on HMG-CoA Reductase inhibitors are on what kind of a diet?(pg.456) | a diet restricted in saturated fat and cholesterol, are used. |
| HMG-CoA Reductase inhibitors are pregnancy cat?(pg.456) | X |
| Cardiotonic drugs, particularly digoxin increase?(pg.396) | cadiac output through positive inotropic activity (an increase in the force of the contraction) |
| HYPOkalemia makes the heart more sensitive to?(pg.400) | administration of digitalis, thereby increasing the possability of developing DIGITALIS TOXICITY. |
| the nytrates (nitro) acts by?(pg.420) | relaxing the smooth muscle layer of the blood vessels, increasing the lumen of the artery or arteriole and increasing the amount of blood flowing through the vessels. |
| Nitrates are used to?(pg.420) | relieve pain of acute anginal attacks, prevent (prophylaxis) angina attacks, Treat chronic stable angina pectoris, Control postoperative hypertension associated with surgical procedures-(IV nito) |
| Adverse reactions to nitrates are?(pg.420) | CNS: headache, dizziness, weakness and restlessness. Other body system reactions are: hypotension, flushing, and rash. |
| Nitrates are pregnancy category?(pb.423) | X |
| nitrates are used cautiously in pts with?(pg.423) | severe hepatic or renal diease, severe head trauma, and hypothyroidism. |
| sublingual nitroglycerin may be repeated q?(pg.425) | every five minutes until pain relived or until pt has received three doses with in 15 min. |
| what shouldnt the nurse do while applying nitroglycerin OINTMENT?(pg.425) | rub into pts skin, and use gloves |
| Nitroglycerin TABLETS should be administered?(pg.426) | to pt with an empty stomach |
| the nurse administers IV nitroglycerin diluted in?(pg.426) | normal saline or 5% dextrose in water (D5W) by continuous infusion using an infusion pump. |
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