antianginals, HF, antiarrhythmics Flashcards
A client is started on a non-selective beta blocker (sotalol/betapace) for conversion of atrial fibrillation. Which finding requires immediate nursing action.
A) Complains of sudden onset of SOB
B) Complains of irregular heart-beat
C) Complains of HA
D) Increased blood glucose levels
A
Complains of sudden onset of SOB
A client is on CCB for HTN and is now prescribed a BB for a fast ventricular rate. What should the nurse include in instructions regarding medications
A) Eat a high-fiber, low carb diet
B) Do not take medication with grapefruit juice
C) Maintain a daily exercise program
D) Report irregular heart rate or SOB to HCP
**D **
Report irregular heart rate or SOB to HCP
Left-sided HF is characterized by?
pulmonary edema
Right-sided HF is characterized by?
peripheral edema
Systolic HF is characterized by?
-Decreased contractility.
-Decreased ejection fraction.
Diastolic failure is charactered by?
-Decreased ventricular filing.
-Normal ejection fraction.
What should the nurse consider when assessing a patient with heart failure?
-ensure pt monitors for dependant bilateral lower extremity (BLE) edema.
-Worsening SOB or new SOB.
-Evaluate # of pillows needed to sleep at night, or if pt sleeps in recliner.
-Weigh themselves every day.
(same time, scale and clothes)
<2lb wt gain in one day>
Cardiac glycosides are used in treating HF before?
ACE inhibitors
Cardiac glycosides a).. contractility
A).. increase (:
Cardiac glycosides improve symptoms but….
do not improve mortality
Cardiac glycosides stabilize a).., so they nurse should b)..
a).. Cardiac conduction abnormalities
b).. watch closely with other antiarrhythmics
what is digitalization
dose is gradually increased until tissues become saturated with medication and symptoms of HF diminish.
Digoxin adverse effects?
-general malaise.
-dizziness.
-headache.
-N/V
-anorexia
-visual disturbances (blurred or yellow vision)
Digoxin serious adverse effects
-ventricular dysrhythmias
-AV block
-atrial dysrhythmias
-sinus bradycardia
Organic nitrates mechanism of action
Relax venous muscle =
reduces preload
(less work for the heart)
Organic nitrates mechanism of action
relax arterial muscle =
increases blood flow to myocardium
Organic Nitrates Adverse Effects
-Hypotension
-Headache
-Tolerance
nitric oxide is a).. and b)..
a) cell-signaling molecule
b) potent vasodilator
Short-acting Organic Nitrates
:
To stop angina attacks
similar to salbutamol for asthma
Long-acting Organic Nitrates
:
prevent angina attacks
similar to salmeterol for asthma
Nitroglycerin mechanism of action
-At vascular smooth muscle, forms nitric oxide, which triggers a cascade resulting in release of calcium ions.
-Releaxes Both arterial and venous smooth muscle = less cardiac return
(less preload)
-Dilates coronary arteries = increases O2 to the myocardium (cardiac muscles)
What drugs are used for management of myocardial infarction?
- Beta-adrenergic blockers
- ACE inhibitors
- Aspirin
- Thrombolitics
Beta-adrenergic blockers do what to myocardial demand?
-reduce myocardial demand
<decrease HR = chronotropic.
<decrease contractility= inotropic.
<decrease BP
(counters effects of sympathetic stimulation)
-reduce conduction.
(prevents dysrhythmias)
Patients can usually quit beta-adrenergic blockers after therapy for MI
True or False
false, Beta-adrenergic blockers therapy usually continued for rest of patient’s life
