Angina And Heart Failure

Question 0

Unstable angina

Answer 0

Pain increases

Early stages of progressive CAD

Question 1

Chronic or stable angina

Answer 1

Exacerbated by nicotine, alcohol, caffeine

Subsides within 15 minutes of rest or drug

Question 2

Nitrates

Answer 2

Helps chest pain because it vasodilates

Question 3

Mechanism of action of nitrates

Answer 3

Dilates blood vessels

Dilates everything close to heart not just coronary arteries

Question 4

Indications of nitrates

Answer 4

Acute episode of angina

Question 5

Contraindications of nitrates

Answer 5

Hypotension (systolic is less than 90)
Glaucoma
Severe head injury
Erectile dysfunction

Question 6

Why is severe head injury a contraindication to nitrates

Answer 6

It will vasodilate head and let too much blood in the brain

Question 7

Side effects of nitrates

Answer 7

Hypotension

Headache

Question 8

Considerations with nitrates

Answer 8

Angina pt gets 3 doses of nitrate 5 minutes apart

Have an IV in, in case patient gets dehydrated

Check BP

Assess and reassess bp before giving other doses

Question 9

Nitroglycerin

Answer 9

Nitrate agent
Fast acting
Sublingual, iv, topical, spray

Question 10

Isordil

Answer 10

Nitrate agent

Long acting

Question 11

What to know when applying topical nitrates

Answer 11

Wear gloves
Take off old patch and wipe it off
Place new patch elsewhere

Question 12

When does nitroglycerin lose potency

Answer 12

Within 6 months

Question 13

Beta blockers with angina

Answer 13

Not approved fortis use but has some anti-anginal

Question 14

Benefits of beta blockers with angina

Answer 14

Decreases heart rate

Decreases myocardial contractility

Question 15

Contraindications of beta blockers in angina patients

Answer 15

Bronchial asthma

Question 16

Metoprolol

Answer 16

Beta blocker

Used in angina

Question 17

Propanolol

Answer 17

Beta blocker with angina

Question 18

Calcium channel blockers in angina patients

Answer 18

Slowing down calcium= slowing down contractions

Question 19

Mechanism of action with calcium channel blockers in angina patients

Answer 19

Reduced myocardial contractility

Arterial dilation

Question 20

Cardizem

Answer 20

Calcium channel blocker for angina patients

Question 21

Procardia

Answer 21

Calcium channel blocker for angina patients

Question 22

Ionotropes

Answer 22

Strengths the beat
Slows heart rate

Used for heart failure

Question 23

Cardiac glycosides

Answer 23

Oldest and most effective group of drugs for heart failure

Question 24

Two primary functions of cardiac glycosides

Answer 24

Beneficial effects in the failing heart | Controls the ventricular response to A.fib

Question 25

Indications of cardiac glycosides

Answer 25

Heart failure | Dysrhythmias

Question 26

Mechanism of action of cardiac glycosides

Answer 26

Increase in myocardial contractility (muscles work good and strong with each other)

Question 27

Why does each beat count when using cardiac glycosides

Answer 27

They slow the heart rate down and every beat has to be very strong (increased myocardial contractility)

Question 28

Positive effects of cardiac glycosides

Answer 28

Increase in force of myocardial contraction Reduces heart rate Increase stroke volume

Question 29

Contraindications of cardiac glycosides

Answer 29

2nd or 3rd degree heart block

Question 30

Side effects of cardiac glycosides

Answer 30

Narrow therapeutic index | Bradycardia

Question 31

Digoxin (cardiac glycosides)

Answer 31

PO used once a day | Lots of drug interactions

Question 32

Nursing implications for cardiac glycosides

Answer 32

Monitor apical pulse 1 minute before administering and take blood pressure

Question 33

Digibind

Answer 33

Antidote for digoxin

Question 34

Why use diuretics for heart failure

Answer 34

Decreases preload