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VN 140 cardiovascula
| Question | Answer |
|---|---|
| CARDIOTONIC | very powerful and toxic. They make the heart beat stronger and slower. |
| CARDIOTONIC | used to increase the efficiency of the contraction of the heart muscle. Oldest & most effective drugs used to treat CHF. Improves the contraction of heart w/c leads to improved blood flow to all tissues of body |
| glycoside | substance derived from plants that on hydrolysis, yields sugar and one or more additional products. |
| cardiotonic drugs | all have the same basic action, differences are in the onset and duration of each drug |
| positive inotropic effect | increase force of contraction of the myocardium |
| cardiotonic drugs | they affect transmission of electrical impulses along the pathway of conduction by depressing the SA node slowing conduction |
| cardiotonic uses | CHF, AF, Atrial flutter, atrial tachycardia |
| cardiotonic - adverse reaction | narrow margin between safety and toxicity ; long term usage can toxicity eg DIGITALIS TOXICITY |
| cardiotonic - signs and symptoms | GI problems, muscle weakness, CNS, apathy, drowsy, blurred vision, HALO around, PVCs |
| digitalis toxicity | when a patient taking digoxin begins showing toxic or harmful reactions from too much medication |
| cardiotonic - treatment | Digoxin, Digitoxin, Digitalis |
| Digoxin | cardiotonic drug that has a rapid onset. Serum levels are checked regularly. (0.5-2 nanogram/ml) |
| Digitoxin | cardiotonic drug has a SLOWER onset but longer duration |
| Digitalis | cardiotonic drug has a SLOW onset but longer duration |
| atropine | drug given when a patient taking "Dig" and have a slow heart rate (below 60) |
| 1st dose | loading dose |
| beginning Digoxin therapy | Digitalization |
| Deslanoside (parental only) | same as Parental Digoxin though slightly longer |
| Administration of Cardiotonic drugs | it is imperative to check apical pulse for 60 seconds. If HR is below normal, digitalis preparations should not be given. Inform dr asap unless there is a standing order |
| Administration of Cardiotonic drugs | for any toxicity, inform the physician. If given by IV, give it slowly. If given through IM, rotate the sites. Document where you put it. |
| cardiotonic - antidote | vitamin k, potassium chloride, atropine |
| cardiotonic - main goal | decrease hr and increase force of contraction |
| ANTIARRHYTHMICS - goal | restore normal cardiac rhythm |
| ANTIARRHYTHMICS | used to treat irregular heart beat. Also called dysrhythmia. Occurs due to stress, hypoxia, electrolyte imbalance, noticed by pulse, palpitations, EKG |
| types of arrhythmias | bradycardia, atrial flutter, afibrilation, PVC's (heart skipping beat) |
| ANTIARRHYTHMICS - action | acts as nervous and muscular contracting properties of the myocardium |
| ANTIARRHYTHMICS - classification | classified accdg to effects on myocardium and presume mechanism action |
| ANTIARRHYTHMICS - classification | I - moricizine; IA - procanamide, quinadine, Norpace; IB - Lidocaine; IC - Flecanide; II - Beta adrenergic blocking agents; III - Bretylium; IV - calcium channel blocker |
| moricizine (ANTIARRHYTHMICS) I | anesthetic effect on cells of myocardium |
| procanamide & quinadine (ANTIARRHYTHMICS) IA | some depress excitability of myocardium. some prolong or lengthen resting period |
| Norpace (ANTIARRHYTHMICS) IA | decrease rate of depolarization of muscle fibers during diastole |
| Lidocaine (ANTIARRHYTHMICS) IB | raises threshold of ventricular myocardium; emergency for ventricular arrhythmias/cardiac monitoring/observe for respiratory depression/arrest, convulsions and hypotension |
| Flecanide ((ANTIARRHYTHMICS) IC | direct stabilizing action on myocardium reducing response to electrical stimulation |
| Beta adrenergic blocing agent (ANTIARRHYTHMICS) II | decreases myocardial response to epinephrine and norepinephrine because of ability to block stimulation of beta receptors of the heart |
| Bretylium (ANTIARRHYTHMICS) III | inhibits release of norepinephrine by depressing adrenergic blocking effect; used for life threatening ventricular arrhythmias/emergency treatment |
| calcium channel blocker (ANTIARRHYTHMICS) IV [VERAPAMIL] | inhibits Ca+ through channels across myocardium, therefore slowing rate and increasing refractory period; can cause GI upset |
| ANTIARRHYTHMICS - adverse affect | dizziness, lightheadedness, blurred vision, hypotension, constipation, arrhythmiac HA |
| ANTIARRHYTHMICS - nursing management | v/s, check condition, check color of skin and LOC for orientation |
| ANTICOAGULANTS | used to prevent formation of clot; often called "blood thinner" |
| oral Warfarin (Coumadin) | has no direct effect on existing thrombus (clot); it does not dissolve clots but it prevents additional clots from forming |
| parental Heparin | dissolves clots that already formed; reopens blood vessels. Through IV (heparin drip) |
| Warfarin | interferes with the manufacturing of Vitamin K. it depletes prothrombin (blood clotting protein) |
| ANTICOAGULANTS - uses | prevention of clots; use for AFIB, pts with PLE (pulmonary lung embolysm |
| ANTICOAGULANTS - adverse reactions | bleeding, nausea, vomitting, diarrhea, itching |
| prothrombin time | time it takes for the clot to occur after thromboplastin and Ca+ are added to plasma. Internation ratio is 2 - 3 |
| ANTICOAGULANTS - administration | check for evidence of bleeding; check PT results before giving; inspect stools, emesis, skin venipuncture, IM and sq sites for signs of bleeding |
| warfarin (Coumadin)- antidote | vitamin k |
| dosis of this anticoagulant med are ordered on the basis of measurement of the patient's PT/INR | warfarin (Coumadin) |
| INR (International Normalized Ratio) | the higher it is, it's longer it takes for blood to clot |
| Heparin | parental only (SC or IV); onset - immediate to 4 hr peak. IV infusion - loading does, PTT checks maintenance does |
| ANTICOAGULANTS - nursing intervention | V/S, observation for hemorrhage, plasma, check for allergic reaction |
| Heparin antidote | AMICAR - to control serious bleeing associated with hemorrhage caused by thrombolytics |
| ANTIANGINAL DRUGS (vasodilators) | relax smooth muscle resulting in vasodilation; increase size of blood vessels therefore more blood flow to affected area. May result in complete or partial relief of symptoms |
| NITRATES (Nitroglycerin) | Isosorbide; Isordil - each directly relax the smooth muscle layer of the blood vessels, therefore increasing the opening lumen of the vessels, which increases the blood flow through the structures allowing more O2 |
| NITRATES - uses | angina pectoris, longterm treatment of angina, SL NTG - acute angina |
| NITRATES - adverse reactions | headache, hypertension, dizziness, vertigo, weakness associated with HA, flushing |
| NITRATES - administration | when chest pain is not relieved by SL, the does should be repeated in 3-5 mins |
| NITRATES - administration | always check the apical pulse and BP before administering. |
| calcium channel blocker | Ca+ necessary for transmission of nerve impulses. Procardia, Diltazem (cardizem) inhibit movement of Ca+ ions across the cell member |
| calcium channel blocker - uses | prevention of anginal pain associated with certain forms of angina; not used to stop anginal pain once it has occurred |
| calcium channel blocker - uses | used when pts cannot tolerate beta blockers or nitrate |
| calcium channel blocker - adverse reaction | peripheral edema, dizziness, lightheadedness, nausea, dermatitis, skin rash, fever, chills |
| Beta adrenergic blocking agent (ANTIARRHYTHMICS) II | stimulation beta receptors of the heart results in increase of HR. if the stimulation is interrupted or blocked, heart rate decreases. |
| Beta adrenergic blocking agent - uses | primarily for HTN and certain arrhythmias |
| Beta adrenergic blocking agent - adverse reactions | bradycardia, dizziness, vertigo, hyperglycemia, N/V, diarrhea, HA, depression |
| Beta adrenergic blocking agent - nursing interventions | sublingual, translingual, transmucosal, topical, transdermal, oral |
| ANTIHYPERTENSIVES | include beta blockers, diuretics, calcium channel blockers, alpha blockers, anti-adrenergics, vasodilators |
| ANTIHYPERTENSIVES - actions | lowers BP by increasing size of blood vessels, increases space to allow blood flow therefore reduces BP |
| ANTIHYPERTENSIVES - actions | diuretics act in lowering BP by reducing Na+ content |
| ANTIHYPERTENSIVES - adverse reactions | dry mouth, drowsiness, dizziness |
| ANTIHYPERTENSIVES - nursing interventions | perodic BP checks, same arm same position; periodi weights, check skin for patches |
| ANTIHYPERTENSIVES - nursing interventions | pts receiving antihypertensive drugs should be cautioned about sudden changes in body position, especially from supine standing bec postural hypotension may occur |
Created by:
jekjes
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