Antiarrhythmia (abnormal heart rhythms) Flashcards
cardiac and renal
What is heart failure?
A chronic condition in which the heart muscle weakens and enlarges, losing its ability to pump blood through the heart and body.
What is the most common cause of heart failure?
Chronic hypertension
List three causes of heart failure.
- Myocardial infarction (MI)
- Coronary artery disease (CAD)
- Valve conditions
Name two congenital conditions that can lead to heart failure.
- Congenital heart conditions
- Cardiac infections
What occurs if the left side of the heart fails to pump?
Blood backs up in the left side; lungs become congested.
What happens if the right side of the heart fails to pump?
Blood backs up into the vascular system causing edema.
Left sided heart failure signs and symptoms
decrease urinary output, cyanosis, cough, crackles, paroxysmal nocturnal dyspnea, restlessness, confusion, weak peripheral pulses, cool extremities.
Right sided heart failure signs and symptoms
Fatigue, increased peripheral venous pressure, enlarged liver and spleen, distended jugular veins, anorexia and GI complaints, swelling in hands and fingers, peripheral edema, weight gain, increased blood pressure.
Mechanism of Action (MOA) of Cardiac Glycosides
Work on muscle fibers in heart, increase contractility and cardiac output, decrease heart rate.
Side effects of Cardiac Glycosides
Bradycardia, fatigue, anorexia, nausea, vomiting.
Adverse effects of Digoxin toxicity
Headache, confusion, yellow halos, nausea, vomiting, arrhythmias.
Nursing considerations for Cardiac Glycosides
Check apical heart rate for 1 full minute; hold if <60 BPM; narrow therapeutic range: 0.8ng/mL to 2ng/mL.
Administering Digoxin - Check before
Apical pulse for full minute; hold the dose if pulse is below 60 in adults
Administering Digoxin - Check after
Heart rhythm for changes; monitor for signs and symptoms of toxicity; potassium levels (especially if also taking diuretics).
Patient teaching for Digoxin
Give oral digoxin with food or after meals; take pulse daily before taking digoxin; report signs and symptoms of toxicity; heart rate monitoring.
Contraindications for Digoxin
Severe myocarditis, ventricular tachycardias or ventricular fibrillation; use cautiously in clients with acute myocardial infarction, heart block, electrolyte imbalances, and renal impairment.
Mechanism of Action (MOA) of Positive Inotropes
Work on receptors to cause more forceful contraction; Beta 1 and Alpha receptors; increase contractility and cardiac output; vasodilation.
Side effects of Positive Inotropes
Hyper/hypotension, tachycardia, arrhythmias, headache.
Adverse effects of Positive Inotropes
Ventricular arrhythmias.
Nursing considerations for Positive Inotropes
frequent monitoring of vital signs; patient IV (consider central line).
Examples of Positive Inotropes
Dobutamine, dopamine.
Drugs for Heart Failure - Adjuncts
Potassium & Magnesium for electrolyte replacement to prevent arrhythmias; NEVER give IV push; anticoagulants; antiarrhythmics.
What is normal sinus rhythm (NSR)?
Normal sinus rhythm (NSR) is defined as a heart rate of 60-100 BPM.
What is bradycardia?
Bradycardia is a slow heart rate of less than 60 BPM.
