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Cardiac meds LPN

LPN Goodcare 2018

Chest discomfort arising from the heart due to lack of oxygen to the heart muscle Angina Pectoris
Squeezing in the chest, pressure, tightness; choking; burning; heaviness; may radiate to neck, shoulder, jaw Signs Angina Pectoris
Physical activity, exposure to cold, drinking caffeine-containing beverages, smoking, emotional stress, sexual intercourse, eating large meals Precipitating factors Angina Pectoris
plaque buildup in blood vessels Atherosclerosis
Attacks may last from 30 seconds to 30 minutes and are often described as feeling like someone or something is sitting on the chest. Angina Pectoris
Precipitated by stress or exertion, short duration; Probable cause: fixed atherosclerotic obstruction Chronic stable angina
Relieved by rest or nitroglycerin Chronic stable angina
Unpredictable; changes in frequency, duration, and onset Unstable angina
Probable cause: atherosclerosis and thrombus formation Unstable angina
Occurs at rest, characteristic ECG changes Variant angina
Probable cause: vasospasm of the coronary artery Variant angina
Risk factors include diabetes mellitus, hypertension, and dyslipidemia Angina Pectoris
Nitrates are the oldest of all the drugs and are very effective Treatment of Angina
Nitrates Beta-adrenergic blocking agents ACE inhibitors Calcium channel blockers Fatty oxidase enzyme inhibitors Statins Platelet-active agents Drugs for Treatment of Angina
Statins are not a standard in drug therapy t or F False
Obtain history of attacks Precipitating factors Characterize attacks CNS involvement Cardiovascular signs Obtain medication history Prescription and nonprescription Effect of agents used on attacks Obtain nutritional history History of high chole Nursing Process for Anginal Therapy
Manifests as confusion, restlessness, or irritability, as well as syncope and anxiety in Angina CNS involvement
Signs include palpitations, peripheral pulses, and vital signs Cardiovascular signs in Angina
Nitroglycerin—most common drug Nitrates
Decreases oxygen demand on heart; dilates arteries and veins; reduces blood volume; decreases preload on heart Actions ofNitrates
Drug of choice to treat angina pectoris Uses if Nitrates
Excessive hypotension, prolonged headache, tolerance (with longer-acting nitrates) Common adverse effects of Nitrates
ED drugs [sildenafil (Viagra)] can potentially lower blood pressure Nitrate drug interactions
Patients can develop tolerance, especially when large doses are administered frequently. Nitrate-free periods are necessary. t or F True
May diminish ass patients become adjusted to nitrate therapy headaches
Reason drugs used for erectile dysfunction such as sildenafil (Viagra) are contraindicated May cause a fatal drop in blood pressure may occur.
Sublingual tablets—dissolve rapidly, primarily for acute attacks Sustained-release capsules, tablets, ointment, transmucosal tablets, and transdermal patches—used prophylactically to prevent anginal attacks Intravenous form Nitrate forms of administration
Inform the patient of medication deterioration every 6 months, nitroglycerin prescriptions should be refilled and a dark-colored glass container should be used for storage
Have patient sit or lie down ;Place nitro tablet under the tongue, allow to dissolve without swallowing saliva immediately If chest pain not relieved within 5 minutes, seek medical attention ;While waiting for emergency care, take 1 tablet 5 minutes late Sublingual use for emergencies
Carry nitroglycerin at all times, but NOT in pocket directly next to the body Determine if agency policy permits nitroglycerin at bedside. Nurse still responsible for determining effectiveness Sublingual nitro may be given for acute attack Nitrate patient ed
Allows for control release of nitroglycerin Don gloves and apply disk to clean, dry, hairless intact skin. Don’t shave hair or apply to scars, skinfolds or wounds. If disk dislodges, replace with new disk Dispose used patches out of the reach of childr Transdermal disk administration
Remove for 8 to 12 hours to avoid tolerance Transdermal disk administration
Therapy should start at low doses and work upward for patient tolerance. Beta-Adrenergic Blocking Agents
Combination therapy with nitrates is more effective than using either drug alone Beta-Adrenergic Blocking Agents
Block beta-adrenergic receptors in heart Reduce myocardial oxygen demand Reduce blood pressure Actions of Beta-Adrenergic Blocking Agents
Reduce the number of anginal attacks Reduce nitroglycerin use Uses of Beta-Adrenergic Blocking Agents
Patients with acute MI should receive beta blocker T or F True
Potent vasodilators; have an overall effect on myocardial activity. Calcium Channel Blockers
Should be used with caution in patients who may be developing heart failure Calcium Channel Blockers
Inhibit flow of calcium ions across cell membrane Reduce peripheral vascular resistance Improve coronary blood flow Actions of Calcium Channel Blockers
Reduce incidence of MI, secondary prevention for patients with known coronary artery disease Uses of Calcium Channel Blockers
Also recommended for patients with acute MI or heart failure with left systolic dysfunction. ACE Inhibitors
Adverse effects such as dizziness, tachycardia, and fainting may occur within 3 hours after the first several doses ACE Inhibitors
Promote vasodilation, minimize cellular aggregation, prevent thrombus formation Actions of ACE Inhibitors
Reduce incidence of MI; secondary prevention for patients with known coronary artery disease (CAD Uses of ACE Inhibitors
Created by: TutorDavis17