ATI Section 3: Cardio meds Flashcards
Antihypertensives
Nursing interventions
- Assess weight, vital signs, hydration status
- BP in supine, sitting, and standing position
- Assess labs: renal function, coagulation
- Teach clients to take meds at the same time everyday
- Avoid hot tubs and saunas
- Dont abruptly discontinue
- Prevent orthostatic hypotension
Angiotensin-Converting Enzyme ACE inhibitor
- suffix -pril
Angiotensin II Receptor Blocker (ARBs)
-
-suffix- sartan
ACE & ARBs
- Therapeutic use: hypertension, heart failure, MI, diabetic nephropathy
- Suffix: ACE inhibitor -pril, ARBs -sartan
Side/Adverse effects: persistent non-productive cough with ACE inhibitors -Angioedema -hypotension -do not use during pregnancy
Nursing interventions and client education
Caporal should be taken 1 hr before meals
-monitor BP
-monitor for angioedema
Calcium Channel CCB
- Suffix: -dipine, verapamil, diltiazem
Therapeutic use:
- angina
- hypertension
Precautions/interactions:
use cautiously in clients taking digoxin and BBs
Contraindicated:
-clients who have heart failure, heart block, bradycardia
-NO GRAPEFRUIT JUICE!
- Side/Adverse effects:
- reflex tachycardia
- peripheral edema
Nursing Interventions/Client education:
- do not crush or chew
- administer IV injection over 2-3 min
- slowly taper if discontinuing
- monitor HR and BP
Alpha Adrenergic Blockers (Sympatholytics)
- Suffix: -azosin
Therapeutic use:
-primary hypertension
Precautions/Interactions:
-Increased risk of hypotension and syncope if given with other antihypertensives, BBs, or diuretics
Side/Adverse effects:
- dizziness
- fainting
Nursing Interventions and client education:
- monitor HR and BP
- take at bedtime to minimize effects of hypotension
Centrally acting Alpha2 agonist
-Meds: clonidine, guanfacine, methyldopa
Therapeutic use:
- primary hypertension
- hypertensive crisis
- severe cancer pain
Precautions/Interactions:
- anticoagulant therapy
- MAOIs
- do not administer methyldopa through and IV line with barbiturates or sulfa
side effects/adverse effects:
- dry mouth
- drowsiness/sedation
- rebound hypertension
- black or sore tongue
Nursing interventions and client education:
- monitor for CNS effects, HR, CBC, BP
- assess for weight gain or edema, monitor for rebound hypertension
- never skip a dose, take at bedtime
Beta Adrenergic Blockers (sympatholytics)
-Suffix: -olol
Therapeutic use:
- primary hypertension
- angina
- tachydysrhythmias
- heart failure and MI
Precautions/Interactions:
- propranolol may mask the effects of hypoglycemia in clients with DM
- do not administer labetalol in same IV with furosemide
Side/Adverse effects:
- bradycardia
- nasal stuffiness
- AV block
- rebound myocardium excitation if stopped abruptly
- bronchospasm
Nursing interventions and client education:
- do not crush or chew
- hold med and notify provider if systolic BP is less than 100 mm Hg or pulse less than 60/min
Vasodilators
- nitroglycerin
Therapeutic use:
-hypertensive emergency
Precautions/Interactions:
- hepatic or renal disease older adults
- electrolyte imbalances
Side/Adverse effects:
- profound hypotension
- cyanide toxicity
- thiocynate poisoning
Nursing interventions and client education:
- nitroprusside cannot be mixed with any med
- continuous ECG and BP monitoring
Cardiac Glycosides
-Digoxin
Therapeutic use:
- heart failure
- atrial fibrillation
Precations/Interactions:
- thiazide or loop diuretics increase risk of hypokalemia and precipitate digoxin toxicity -ACE and ARBs increase the risk of hyperkalemia
- verapamil increases risk of toxicity
-Side/Adverse effects:
-GI (anorexia) and CNS (fatigue, weakness
blurred vision and halos around objects)
- Nursing interventions and client education:
- assess apical pulse 1 min prior to admin
- notify provider if HR less than 60 (adult), 70 (child), 90 (infant)
Management of Digoxin toxicity
- Discontinue digoxin and potassium-wasting meds
- treat dysrhymias with phenytoin (Dilantin) or lidocaine
- Treat bradycardia with atropine
- For excess overdose, admin Digibind to prevent absorption
Antianginal Medications
to tx pain related to imbalances between myocardial oxygen supply and demand
organic nitrates
-Nitro
Therapeutic use:
-acute angina attack
Precautions/interactions:
-head injury and ED meds
- Side/Adverse Effects:
- reflex tachycardia
- Nursing Interventions and client education:
- admin sublingual, repeat in 5 min if no relief call 911 up to 3 doses
Antidysrhythmic medications
adenosine
Therapeutic use:
-convert SVT to sinus rhythm
Side/Adverse effects:
- flushing
- nausea
- bronchospasm
- prolonged asystole
Nursing Interventions:
-Rapid IV (1-2 seconds) push, flush immediately with normal saline
Antidysrhythmic medications
Amiodarone
Therapeutic use:
- ventricular fibrillation
- unstable ventricular tachycardia
Side/Adverse effects:
- Bradycardia
- cariogenic shock
- pulmonary disorders
Nursing interventions:
-Incompatible with heparin, monitor for respiratory complications