Calcium Channel Blockers, Arrythmias, Chest Tubes, & Congenital Heart Defects Flashcards
Calcium channel blockers indications
Tachycardia, tachyarrythmias, post-myocardial infarction to rest heart
Calcium channel blockers are given to _____ the heart
Relax
What conditions do calcium channel blockers treat?
Hypertension, angina, atrial arrythmias (aflutter, afib, premature atrial contractions, supraventricular tachycardia)
Calcium channel blockers side effects
Headache (d/t dilated vessels in brain), hypotension (d/t relaxation of heart and blood vessels)
MEMORY TRICK: think H&H
Calcium channel blockers end in
-dipine (think “Dipin in the calcium channel)
Calcium channel blockers that do not end in -dipine
Verapamil, Cardizem (given continuous IV drip)
Calcium channel blocker nursing considerations
Measure BP before administration, hold if systolic BP is <100, monitor BP continuously if on cardizem drip (if SBP is below 100, slow down and titrate drip to keep SBP over 100)
What four cardiac arrythmias should you be able to interpret?
Normal sinus rhythm, ventricular fibrillation, ventricular tachycardia, asystole
Lethal arrythmias that have no cardiac output
Asystole and Vfib
Arrythmia that has cardiac output, but can be potentially life threatening
V-Tach (can be w/ pulse or pulseless)
Pharmacological treatment for PVCs and Vtach
Lidocaine, Amiodarone
Pharmacological treatment for supraventricular (atrial) arrythmias
Adenosine (IVP less than 8 seconds w/ 20 mL of IV fluid flush after; pt may go into asystole for about 30 sec but they will come out of it), beta blockers, calcium channel blockers, digoxin
Vfib treatment
Defibrillation
Treatment for asystole
Epinephrine and atropine
What is the purpose of a chest tube?
To reestablish negative pressure in the pleural space so that the lungs expand when the chest wall moves
What should be reported in clients with chest tubes?
Chest tube is not bubbling, chest tube drained 800 mL in first 10 hours, the chest tube is not draining, the chest tube is intermittently bubbling
Apical chest tubes remove _____, and basilar chest tubes remove _____.
Air; blood
MEMORY TRICK: A for A, and B for B
What do you do if you knock over chest tube drainage water seal apparatus?
Set it back up and have the pt take deep breaths — NOT a medical emergency
What do you do if the water seal breaks?
Clamp it, cut it away from broken device, stick end of tube in sterile water to reestablish water seal, unclamp it
Intermittent bubbling in the water seal is _________
Good/normal/expected
Continuous bubbling in the water seal is _____
BAD! Find leak and put tape over it until it stops leaking
Intermittent bubbling in the suction-control chamber is _____
BAD! Suction in not high enough… turn up dial on wall so that bubbling becomes continuous
Continuous bubbling in the suction-control chamber is _________
Good/Normal/Expected
Rules for clamping tubes
Never clamp tube for longer than 15 sec w/o Dr. order, use rubber tipped double clamps so tube does not get punctured
TRouBLe congenital heart defects characteristics
Shunts blood R to L, cyanotic, requires surgery, delayed growth and development, decreased life span, exercise intolerance, apnea monitoring,
NO trouble congenital heart defects characteristics
Shunts blood L to R, no cyanosis, no big deal!
All congenital heart defects that start with the letter ___ are trouble
T (Tetrology of fallot, truncus arteriosis, transposition of the great vessels, tricuspid atresia)
Examples of NO trouble CHDs
Ventricular septal defect, patent ductus arteriosus, patent foramen ovale, atrial septal defect, pulmonic stenosis
All congenital heart defect, whether trouble or not, will have
A murmur (d/t shunt of blood) and an echocardiogram done to find out why
4 defects of Tetrology of Fallot mnemonic
“Valentines Day Pick Someone Out A Red Heart”: Ventricular Defect, Pulmonary Stenosis, Overriding Aorta, Right Hypertrophy
What are the four transmission-based precautions?
Standard/universal, contact, droplet, airborne
Examples of diseases requiring contact precautions
C.Diff, Hep A, Cholera, Staph infections, RSV, herpes zoster (shingles)
Contact isolation precautions
Private room, cohort is acceptable, gown, gloves, handwashing, disposable supplies and dedicated equipment (stethoscope, BP cuff)
Examples of infectious diseases that require droplets precautions
Meningitis, Influenza
Droplet isolation precautions
Private room preferred, mask, gloves, handwashing, pt wears mask when leaving room, disposable supplies and dedicated equipment
Examples of infectious diseases that require airborne precautions
Measles, mumps, rubella, TB, varicella (chicken pox)
Airborne isolation precautions
Private rooms required w/ negative airflow, mask, gloves, handwashing, N-95 for TB, pt wears mask when leaving room
Order for TAKING OFF PPE
Gloves, goggles, gown, mask
MEMORY TRICK: take off in alphabetical order!
Order for DONNING PPE
Gown, mask, goggles, gloves
MEMORY TRICK: reverse alphabetical for G’s, but mask comes second
Dosage calculation equation
Desired/Have x Available
IV drip rate equation
Volume x DF / time in minutes
(REMEMBER: mini/micro drips = 60 gtt/mL; macro drips = 10 gtt/mL)
