BNPH700 Cardiac Flashcards
MOA and ADR’s for cardiac glycocides (Digoxin)
MOA - inhibits the Na/K pump which increases intracellular Na+ and therefore Ca2+ resulting in reduced cardiac workload with increased cardiac output
ADRs - Anorexia and GI upset. Visual disturbances, confusion, drowsiness, dysrhythmias
Nursing care for digoxin
Check apical pulse for rate and rhythm prior to admin.
Monitor K+ levels as hypokalaemia can cause digoxin toxicity
What are risk factors, signs and symptoms and antidote for digoxin toxicity
Risk factors - dehydration, hypokalaemia, renal failure.
S&S - Dysrhythmias, nausea and vomiting, confusion and visual disturbances.
Antidote - digibind
MOA for Nitrates (GTN)
MOA - Binds to nitrate receptors in vascular smooth muscle resulting in vasodilation and venodilation which increases coronary perfusion and increases O2 delivery to heart.
ADR’s for GTN
Postural hypotension
Dizziness
Fainting
Headache
Nausea/vomiting
Agitation
Dry mouth
Blurred vision
Facial flushing
What is the angina action plan?
If experiencing angina symptoms stop and rest, tell someone and take 1 puff of GTN
If after 5 more minutes symptoms are still present take 1 more puff.
If after 5 more minutes symptoms are still present call an ambulance.
ACE inhibitors (-pril) MOA
Block the ACE enzyme responsible for converting angiotensin 1 to angiotensin 2 which decreases vascular tone and results in less secretion of aldosterone thereby increasing Na+ and H2O excretion which decreases blood volume and BP.
Indications for use of ACE inhibitors
Hypertension, heart failure, left ventricular dysfunction following MI
ADR’s of ACE inhibitors
Hypotension, headaches, dizziness, fatigue, nausea, hyperkalaemia, renal impairment.
Cough
Nursing considerations for ACE inhibitors
Avoid when pregnant
Do not take with NSAIDS or diuretics
Monitor K+ levels
Monitor BP
Monitor renal function
Indications for use of diuretics
Heart failure, hypertension
Three classes of diuretics?
Loop
Potassium sparing
Thiazides
MOA of diuretics
Decrease Na+ reabsorption at different nephron sites thereby increasing urinary loss of Na+ and H20 which decreases fluid retention.
Common ADR’s of diuretics
Dehydration & electrolyte imbalance, dizziness, postural hypotension
How are potassium sparing diuretics different?
Loop and thiazide diuretics also result in K+ loss and can lead to hypokalemia. Potassium sparing diuretics result in less K+ being lost so can have the opposite effect