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N126-U3-I. MI/CHF #6
Dobrisky-Cardiac Module: Meds #1
| Question | Answer |
|---|---|
| Major difference between loop diuretics and thiazides | Furosemide (Lasix) is a potent diuretic which works best during renal failure to reduce the cardiac workload. |
| How do the angiotensin receptor blockers decrease the workload on the heart | they help reverse ventricular remodeling, blocks action of angiotensin II, reduces fluid retention, vasodilates and lowers BP. |
| What are the nursing implications for giving drugs that will cause fluid excretion | Monitor for dehydration. Monitor heart rate and electrolytes especially potassium. |
| What group of patients should NOT receive beta blockers and why | COPD, asthma because of bronchoconstriction. |
| How do calcium channel blockers affect preload and afterload | They decrease both preload and afterload. |
| How does digoxin work | increases cardiac contractility (increases the force of contraction, decreases ventricular pressure buildup promoting diuresis. It also decreases SOA, slows heat rate and conduction velocity. |
| List 3 areas the nurse should assess prior to giving digoxin | The nurse should assess heart rate, potassium levels, serum digoxin levels (if done). In addition the nurse should assess anorexia, nausea and vomiting, RR, UO, and fatigue. |
| How can nitroglycerin help a failing heart | Decreases preload by causing vasodilation and venous pooling. |
| How can morphine sulfate help a heart in acute failure | Causes venous pooling which decreases preload and thus decreases workload on the heart. It acts as a vasodilator. |
| What do drugs for CHF have in common | decrease preload, fluid retention & BP, vasodilator |
| What is the main goal of Angina medications? | reduce O2 requirements of the heart & increase blood flow to the heart |
| Name the major angina medication used to relieve attacks | nitroglycerin |
| What is the most frequent side effect of nitro? | headache |
| What must the nurse assess before administering nitroglycerin? | BP & pulse |
| A systolic BP of ______ indicates nitroglycerin should be held and the physician called. | <90 |
| Nitroglycerin's onset is | 1-3 minutes |
| Nitroglycerin's duration is | 1-2 hours |
| Nitroglycerin is administered | one tablet every 5-10 minutes |
| what is the maximum of consecutive doses of nitroglycerin? | three |
| What form of nitroglycerin relieves the symptoms of headache and systolic BP <90? | IV |
| What position should a patient be in when given nitroglycerin? | lying or sitting |
| What are the side effects of nitroglycerin? | headache (most common), syncope, dizziness or weakness, hypotension, n/v |
| These drugs are used to prevent and control angina, dysrhythmias, high blood pressure and after an MI | beta blockers |
| Common beta blockers include | inderal, atenolol and metoprolol |
| Metoprolol is a | beta blocker |
| inderol is a | beta blocker |
| atenolol is a | beta blocker |
| nitgroglycerin is an | angina medication |
| Beta blockers' primary function is to | decrease myocardial oxygen demand |
| IV metoprolol should be given in what increments and over what time span? | 5mg increments over 1-2 minutes |
| Cardiac monitoring while taking beta blockers is important due to the risk for | atrioventricular block (AV block) and bronchospasm |
| How should beta blockers be stopped? | patients should be weaned |
| Patients who abruptly stop beta blockers are 4x at greater risk of developing _______ or _______ within 30 days after discontinuation. | anginal attack or mild MI |
| Patients taking beta blockers should avoid _____ and _________ | alcohol and OTC decongestants |
| What may also be prescribed for a patient taking beta blockers? Why? | diuretics; edema is a side effect |
| What affect could beta blockers have on diabetic patients? | could cause hypoglycemia |
| Beta blockers should be used with caution in patients with ________ and _______ | COPD and asthma |
| This drugs side effects include edema, bradycardia, orthostatic BP, diarrhea, broncospasm and hypoglycemia. | beta blockers |
| which type of drug can cause broncospasm and hypoglycemia? | beta blockers |
| What assessments should be made by the RN during treatment of a patient with beta blockers? | monitor bp, pulse, hypoglycemia, weight and I & Os |
| calcium channel blockers decrease | the workload of the heart and remodeling of the left ventricle |
| which cardiac drug decreases remodeling of the left ventricle along with the workload of the heart? | calcium channel blockers |
| Diltiazem, Verapamil, Procardia, Norvasc and Cardizem are common | calcium channel blockers |
| What cardiac drug is often prescribed when vasospasm & significant hypertension exist? | calcium channel blockers |
| Cardiac monitoring during calcium channel blockers will help identify symptomatic | bradycardia, prolonged PR intervals, advanced heart blocks, low BP and heart failure |
| Calcium channel blockers should be discontinued | gradually |
| Patients with liver or renal disease, heart block, low blood pressure, arotic stenosis, severe left ventricular dysfunction and women who are pregnant or lactating should not be given this type of drug | calcium channel blocker |
| Diltiazem is a | calcium channel blocker |
| Verapamil is a | calcium channel blocker |
| Procardia is a | calcium channel blocker |
| Norvasc is a | calcium channel blocker |
| Cardizem is a | calcium channel blocker |
| Administer calcium channel blockers | with food to prevent gastric discomfort |
| Heart block and constipation are two of the side effects for these drugs | calcium channel blockers |
| Bradycardia, nausea, dizziness, heart block, hypotension, constipation, headache and edema are side effects of this type of drug | calcium channel blockers |
| What assessments should be made by the RN when administering calcium channel blockers? | Monitoring BP, apical pulse and I & Os |
| This cardiac drug requires the systolic BP to be greater than 90 | nitroglycerin |
| This cardiac drug requires monitoring for hypoglycemia | beta blockers |
| this cardiac drug requires monitoring of the apical pulse | calcium channel blockers |
| These drugs are used to decrease myocardial oxygen demand, decrease preload and treat high blood pressure. | ACE inhibitors |
| Common ACE inhibitors all end in | "pril" |
| When monitoring a patient on ACE inhibitors it is important to check electrolytes in what areas? | magnesium, potassium |
| What conditions should be watched for with blood count in ACE inhibitors? | neutropenia and agrulocytosis |
| When a patient taking ACE inhibitors exhibits this side effect it is important to immediately report it to the physcian. | facial edema |
| A rash, facial edema and/or a cough are side effects of this cardiac drug | aCE inhibitors |
| Because magnesium and potassium levels should be monitored closely and are a concern for patients taking ACE inhibitors, they should be used cautiously in patients with | renal disease and coronary insufficiency, sodium depletion and hypovolemia |
| The nurse should be a ware of the signs/symptoms of neutropenia and agranulocytosis in patients taking this cardiac drug | ACE inhibitors |
| This drug is used to treat pain and relieve anxiety caused by myocardial infarction | morphine sulfate |
| Morphine sulfate is a ____________, it creates a ________ in the preload. | vasodilator, decrease |
| Morphine sulfaste alleviates pain but also | alters the perception of pain. |
| Doses of morphine are usually given in | 2 to 5 mg |
| Side effects of this drug include decreased rate and depth of respirations | morphine sulfate |
| What affect can morphine have on a patient's pupils? | pupil constriction, pinpoint pupils |
| What is the antidote for morphine? | Narcan |
| What are the signs and symptoms of severe sedation in patients taking morphine? | respirations less than 10, low BP, change in conciousness |
| What are two priority nursing actions to take when a patient is experiencing severe sedation? | call the dr and administer Narcan |
| The purpose of administering oxygen is to | increase arterial oxygen saturation |
| oxygen saturation levels should be maintained at what level? | above 90% |
| These meds reduce the substrate for lipid deposition in the coronary artery | cholesterol-lowering agents |
| Atrorvastin, Lovastatin, Pravastatin, Simvastatin, Gemfibrozil and Nicotinc acid are all common | cholesterol-lowering agents |
| -vastatins are | cholesterol-lowering agents |
| Gemfibrozil & Nicotinc acid and -vastastins are all | cholesterol-lowering agents |
| Nicotinc acid is a | cholesterol-lowering agent |
| Lovastatin is a | cholesterol-lowering agent |
| Pravastatin is a | cholesterol-lowering agent |
| Atrorvastin is a | cholesterol-lowering agent |
| Gemfibrozil is a | cholesterol-lowering agent |
| Simvastatin is a | cholesterol-lowering agent |
| when monitoring for success of cholesterol-lowering agents what levels should be obtained at regular intervals? | lipid levels |
Created by:
Lori Dobrisky
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