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Fall > 311 Exam 2 > Flashcards

311 Exam 2 Flashcards

1
Q

What class of antidysrhythmic drugs are prescribed for atrial flutter and fibrillation?

A

Class 2 beta-adrenergic antagonists

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2
Q

What class of antidysrhythmic drugs are prescribed for severe atrial and ventricular dysrhythmias?

A

Class 3 potassium channel blockers

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3
Q

What class of antidysrhythmic drugs are prescribed for paroxysmal supraventricular tachycardia?

A

Class 4 calcium channel blockers

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4
Q

What antidysrhythmic drugs are prescribed for severe ventricular dysthymias?

A

Lidocaine and flecainide

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5
Q

Using a calcium channel blocker at the same time as digoxin may cause what?

A

A partial or complete heart block , heart failure, or dysrhythmias

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6
Q

The antidysrhythmic drug Amiidarone (Pacerone) carries what black box warning

A

It can cause pneumonia like syndrome in lungs which can be fatal and requires a baseline and periodic lung function assessment
This is a potassium channel blocker

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7
Q

What is Dofetilde (Tikosyn) used to treat

A

It terminates atrial flutter and fibrillation

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8
Q

What waveform would indicate ischemia of the myocardium?

A

Flat T wave

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9
Q

A prolonged PR interval may indicate what?

A

Heart block

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10
Q

What is a dysrhythmia that originates in the atria referred to as?

A

Supraventricular

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11
Q

A rapid rate of >140 and a narrow QRS indicates..

A

Supraventricular tachycardia (SVT)

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12
Q

Amiodarone (Pacerone)
-what class drug?

A

Potassium channel blocker

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13
Q

St. John wort decreases the effectiveness of what potassium channel blocker?

A

Amiodarone (Pacerone)

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14
Q

Grapefruit juice may increase toxicity of what antidysrhythmic drug?

A

Amiodarone (Pacerone). Potassium channel blocker

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15
Q

What are side effects of Amiodarone?

A

Pulmonary toxicity
Hypotension

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16
Q

When a patient is taking Amiodarone (Pacerone) what lab test should be monitored if they are also taking Coumadin

A

TSH. Pacerone block’s warfarin metabolism

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17
Q

What class of drug is Diltiazem (Cardizem) and what are the side effects?

A

calcium channel blocker
HA, Dizziness, Hypotension

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18
Q

what does the drug Adenosine (Adenocard) do? (Miscellaneous antidysrhythmic)

A

Terminates serious atrial tachycardia
Rapid IV administration

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19
Q

Primary factors affecting BP

A

Blood volume
Peripheral resistance/diameter of vessels
Cardiac output (CO)
Stroke volume (SV)
Heart rate

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20
Q

BP of 130-139/80-89 is what

A

HTN stage 1

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21
Q

normal BP

A

less than 120/ less than 80

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22
Q

Potassium sparing diuretics
Most commonly used: and the
Side effects.

A

spironolactone:
hyperkalemia, dehydration

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23
Q

Loop diuretics
Most commonly used: and the
Side effects.

A

furosemide :
hypokalemia, dehydration

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24
Q

Chlorthalidone is what type of drug and has what side effects?

A

Thiazide diuretics

Side effects: hypokalemia, dehydration, hypotension, hyponatremia

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25
Q

what is the primary homeostatic mechanisms controlling blood pressure and fluid balance in the body

A

Renin-angiotensin-aldosterone system (RAAS).
Renin converts angiotensin to angiotensin I (start of increasing BP)

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26
Q

ACE and ARBs mechanism of action

A

act on the RAAS to decrease blood pressure

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27
Q

ARB- LoSARtan, good way to remember arb meds is they have SAR in their name. SAR sounds like ARB

A
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28
Q

ACE- Enalapril, good way to remember ACE meds is they have PRIL in their name. ACE-pril

A
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29
Q

Losartan (Cozaar):
is what drug with what side effects?

A

Side effects (Common with ARBs)
Angioedema
Hyperkalemia
Renal failure
If overdose, administer Normal saline

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30
Q

Enalapril (Vasotec):
is what drug with what side effects?

A

Ace inhibitor
Side effects (Common with ACE inhibitors)

Fetal toxicity
Elevated kalemia (hyperkalemia)
Angioedema
Renal failure

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31
Q

Sodium channel blockers treat what kind of dysrhythmia

A

A-fib. Premature atrial contraction. PVCs. Vent Tachy

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32
Q

All potassium channel blockers can produce what fatal condition

A

Torsades de pointes.

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33
Q

Which antidysrhythmic drug can result in malignant hypothermia as an adverse effect

A

Lidocaine

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34
Q

Which antidysrhythmic drug may induce lupus like symptoms as an adverse effect

A

Procainamide. (Sodium channel blocker)

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35
Q

What patient condition’s are contraindicated for receiving Procainamide

A

Complete AV block
severe HF
Blood dycrasias
Myasthenia gravis

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36
Q

What medication slows down heart rate and decreases conduction velocity through av node

A

Beta adrenergic antagonists.

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37
Q

Beta blockers can affect lungs potentially causing bronchospasms. T/f

A

T

38
Q

Which antidysrhythmic drug is considered both a beta blocker and a potassium channel blocker.

A

Sotalol

39
Q

Which antidysrhythmic drug is approved to treat a-fib or flutter but is contraindicated for serious HF

A

Dronedarone.

40
Q

Which antidysrhythmic drug blocks warfarin, requiring lower doses of the anticoagulant

A

Amiodarone

41
Q

What antidysrhythmic drugs primary indication is a specific dysrhythmia know. As Paroxysmal supraventricular tachycardia (psvt)

A

Adenosine

42
Q

Calcium channel blockers are used for what conditions

A

Angina pectoris
HTN (not usually monotherapy)
Dysrhythmias

43
Q

Selective and non selective calcium channel blocker differences

A

Selective act on vessels only
Non selective act on vessels and heart.

44
Q

What kind of medication is Verapamil. (Calan SR)

A

CCB
Effects both HR and BP
Some herbals interact

45
Q

What kind of drug is Diltiazem (Cardizem) and it’s main side effect

A

CCB

HA

46
Q

What kind of drug is Nifedipine (procardia XL) and it’s side effects

A

CCB
Hypotension
HA
Dizzy
Peripheral edema (common with CCB)
*Grapefruit juice might enhance absorption

47
Q

What kind of drug is clevidipine (cleviprex)
And what is it Used for?
How is it used

A

CCB
To tx serious, life threatening HTN
Has a short half life
Iv route only. Continuous BP monitoring

48
Q

Propranolol had hypoglycemic effects and can mask symptoms of hypoglycemia

A

T

49
Q

(Make this card backwards somehow)
What do alpha adrenergic antagonists do and give an example

A

Block sympathetic receptors in arterioles causing vessels to dilate
Doxazosin (cardura).

50
Q

What are the side effects of doxazosin (cardura)

A

Hypotension, Dyspnea, SOB
(It dilates arteries and veins)

51
Q

T or f
Women have a higher mortality rate than men when it comes to HF

A

T

52
Q

2 most important factors for cardiac output

A

Preload :ventricles filling
After load: pressure aorta needs to overcome for blood to be ejected

53
Q

What is cardiac remodeling

A

Over time the changes in size and shape and structure of myocardial cells occurs with hypertrophy (thickening and hardening of left ventricle working harder)

54
Q

What do adrenergic blockers do to treat HF

A

Decrease cardiac workload by decreasing HR and BP
(Carvdilol)
Used in stages b and c

55
Q

What do vasodilators do to treat HF.

A

Dilate vessels reducing preload
(Hydralazine)
Used in stage c

56
Q

What do phosphodiesterase inhibitors do to treat HF

A

Increase CO by increasing myocardial contraction
(milrinone)
Used in stage d

57
Q

What do aces and arbs do to treat HF

A

Increase CO by lowering BP and decrease blood volume.
Used in stage b, c

58
Q

What do cardiac glycosides do to treat HF

A

Increase CO by increasing myocardial contraction

59
Q

What do diuretics do to tx HF

A

Increase CO by decreasing fluid volume and BP

60
Q

What type of drug is digoxin and how is it used

A

Cardiac glycoside
Increases Cardiac contractility.
Suppresses SA mode and slows conduction through AV node.
Used in HF for rhythm and rate control.

61
Q

Digoxin side effects and warnings

A

Nausea and vomiting and anorexia
Do not stop abruptly
Do not take ginseng

62
Q

What type of drug is Milrinone (Primacor) how is it used and side effects

A

Phosphodiesterase inhibitor
Iv only
Side effects: ventricular arrhythmia: continuous ECG monitoring needed.

63
Q

CAD is a fatty plaque build up in arteries that starts early in life and leads to what

A

MI (heart attack)

64
Q

What is angina pectoris

A

Acute chest pain caused by insufficient oxygen supply
If improves with rest it is -stable
If does not improve with rest - unstable

65
Q

What occur when a coronary artery become completely occluded

A

Myocardial infarction

66
Q

How long does it take for cardiac tissue to die if blood flow is not restored

A

20 minutes

67
Q

How do organic nitrates work

A

Relax arterial and smooth muscle and dilate veins to reduce preload.

68
Q

You should cover the nitrate IV bottle to reduce the degradation of nitrates with light exposure. T/F

A

T

69
Q

Max dose of nitroglycerin is what and how often

A

3 tab max
1 tab every 3-5 minutes

70
Q

Sublingual nitroglycerin dose should terminate chest pain how fast

A

2-4 minutes. If not resolved after 5 minutes call EMS it could indicate MI

71
Q

What drugs are used for angina when beta blockers have been unsuccessful

A

CCBs

72
Q

Shock occurs when tissues are not receiving adequate blood flow and can lead to what

A

Tissue death and organ failure. It is a
Medical emergency

73
Q

Nursing interventions for shock.

A

Chest compressions, airway, breathing
Immediately connect to cardiac monitor, pulse ox and oxygen
Restore fluid volume/composition and maintain adequate BP.

74
Q

What is carcinogenic shock

A

Failure of heart to pump sufficient blood to tissues

75
Q

What is hypovolemic shock

A

Loss of blood volume

76
Q

What is neurogenic shock

A

Vasodilation due to overstimulation of the parasympathetic nervous system or under stimulation of the sympathetic nervous system.

77
Q

What is septic shock

A

Multiple organ dysfunction as a result of pathogenic organisms in the blood. Often a precursor to acute respiratory distress syndrome and DIC

78
Q

What drugs are used for shock

A

Fluid replacement

Albumin- protein to increase BP

Dopamine-given via continuous IV; monitor for dysrhythmia. Monitoring urine output assesses renal and cardiac fx

Norepinephrine- do not abruptly discontinue; continuously monitor BP

79
Q

What is important to monitor for patients with shock being treated with dopamine

A

Monitor for Dysrhythmias
Monitor urinate output

80
Q

Patient presents with low blood pressure, rapid HR, weak threads pulse. They have rapid shallow breathing, are pale cool and clammy and are saying they are thirsty.
What is the most likely condition they are experiencing

A

Shock

81
Q

2 pharmacotherapeutic goal for shock

A

Maintain adequate blood pressure and restore normal fluid volume.

82
Q

Depletion of more than how much blood volume would indicate a need for while blood treatment

A

More than 30%

83
Q

Colloids are proteins or large molecules that stay suspended in the blood.
What blood product colloids are used for shock

A

Human serum albumin and plasma protein fraction.

84
Q

IV Vasoconstrictors are only used when

A

When IV fluid therapy has failed to raise blood pressure.
These are critical care meds.

85
Q

Dopamine is considered both a…(type of drug)

A

Vasoconstrictor and an inotropic drug.

86
Q

If a patient is in acute shock and is also experiencing hypotension due to blood volume deficits- why would you or wouldn’t you administer norepinephrine?

A

It can cause additional vasoconstriction. So do not administer

87
Q

Use of maois along with norepinephrine can cause what

A

Can lead to acute hypertensive crisi.

88
Q

What are inotropic drugs

A

Reverse cardiac symptoms of shock by increasing myocardial contraction
Ex: digoxin, dobutamine, dopamine.

89
Q

A client is experiencing a hypertensive emergency. Which type of medication should the nurse anticipate administering concurrently with a direct vasodilator to help prevent reflex tachycardia?

A

Beta adrenergic blocker

90
Q

What medication dilates the coronary arteries resulting in better blood supply to the myocardium and reducing ischemia?

A

Calcium channel blockers

91
Q

Ace inhibitors prevent the breakdown of bradykinins. What adverse effect should the nurse recognize is due to this build up.

A

Angioedema. (Swelling of mouth, lips, and tongue.) a cough is also a symptom.

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