Cardiac Flashcards
ACE -pril class/use
Class - ACE inhibitor
Used for HTN, HF, diabetic neuropathy, LV dysfunction following MI
ACE -pril SE
hypotension (following first dose), dry nonproductive cough, metallic taste/distorts taste, rash, angioedema, hyperkalemia, neutropenia (low WBC so increase risk for infection)
ACE - pril Interventions
start low and work your way up, monitor BP, report cough, stop if angioedema occurs, monitor potassium levels, monitor WBC
ACE -pril Administration
must be taken 2-3x daily for HTN, 3x for HF give one hour before meals
ACE -pril teaching
dont use potassium supplements or anything with potassium in it, report palipations/twitching/weakness, dont take if pregnant or breast feeding
ACE -pril contraindications
angioedema, hypotension, liver disease with elevated liver enzymes
Sprinolactone class/use
Class- potassium sparing diuretic
Used for hypertension, symptoms of HF
Sprinolactone SE
hyperkalemia
spironolactone interventions
monitor for hyperkalemia, monitor BUN, creatine, make sure they arent taking another potassium sparing med
what is another potassium sparing diuretic (not spironolactone) and how long does it take to work
eplerenon - 4 weeks
Spironolactone teaching
no potassium, report palpitations/twitching/weakness
Spironolactone contraindications
high potassium, type 2 diabetes with microaluminuria, abnormal creatine, lactation,
Carvedilol class/use
Class: betablocker mixed
Used for HTN, HF, prolonges survival following MI
Caredilol SE
dizzy, hypotension, bradycardia, exacerbation of asthma
carvedilol interventions
monitor BP, report hypotension, monitor HR below 60
Carvedilol admin
give with food to mimimize orthostatic hypotension
carvedilol teaching
report dizziness, move slowly changing positions, dont drive until effects are known, check pulse daily report below 60bpm
carvedilol contraindications
unstable HF, asthma, severe bradycardia, cardiogenic shock, lactation, pregnancy
ARBs -sartan class/use
class- ARBs
used for hypertension, prevent stroke (losartan)
-Sartans SE
andioedema, headache, dizziness, hypotension, insomnia
-sartans interventions
stop if angioedema, report CNS effects, monitor BP
-Sartans teaching
report frequent headaches, report fainting/dizziness, dont take if pregnant or breast feeding,
-sartans contraindications
pregnancy, children younger then 6, low creatine
metoprolol, bisoprolol, esmolol class/use
Class - cardioselective betablocker
used for HTN, treat angina, decrease mortality from MI,
metoprolol, bisoprolol, esmolol SE
bradycardia, HF, rebound excitation (causing angina or MI with sudden withdrawl of bb)
metoprolol, bisoprolol, esmolol interventions
monitor HR (report below 60), report signs of HF, do not stop abruptly, taper over 1-2 weeks
metoprolol, bisoprolol, esmolol admin
start IV first then oral, take at same time with food,
metoprolol, bisoprolol, esmolol contraindications
bradycardia, moderate-severe HF, cardiogenic shock,
digoxin class/use
Class - inotropic
used for HF, cardiac dysrhythmias (afib, aflutter, a tachy)
digoxin SE
dysrhythmias, GI symptoms (can be early sign of toxicity), CNS symptoms (fatigue, visual disturbances - halo_
digoxin interventions
vomiting could mean hypokalemia, monitor GI symptoms, monitor digoxin levels, monitor potassium, monitor cardiac rhythm,
digoxin teaching
report vomiting, headache, visual disturbances, take at same time do not double dose
digoxin contraindications
uncontrolled ventricular dysrhythmias, AV block, severe heart disease
clonidine class/use
class - adrenergic inhibiting agent
used for hypertension, pain relief, ADHD
clonidine SE
CNS effects (drowsiness), dry mouth, rebound hypertensive crisis is discontinued abruptly
clonidine admin
oral given at bedtime, start slowly and work your way up, taper off, patch placed once every 7 days, take at night,
clonidine contraindications
Anticoagulant therapy
lidocaine class/use
class - antiarrhythmics
used for ventricular dysrhythmias caused by MI, cardiac surgery
lidocaine SE
CNS effects (confusion, drowsiness, restlessness), respiratory arrest, tremors, hypotension, bradycardia,
lidocaine teaching
IM only for emergency, report numbness of lips, continue cardiac monitoring,
lidocaine contraindications
supreventricular dysrhythmias, untreated bradycardia, heart block
propanolol class/use
class - noncardio selective betablocker
used for cardiac tachydysrhythmias, HTN,
propanolol SE
bradycardia, HF, rebound excitation causing angina or MI with sudden withdrawl, CNS effects (confusion, fatigue, drowsiness)
propanolol interventions
monitor HR report below 60, monitor signs of HF, do not stop abruptly, taper of 1-2 weeks, monitor color/pulse/temp of extremities, monitor CNS effects
propanolol contraindications
bradycardia, pulmonary edema, mitral or aortic valve disease, cardiogenic shock, asthma, severe COPD
amiodarone class/use
class- antiarrhythmics
used for ventricular tachycardia or fib, may treat a fib
amiodarone SE
GI symptoms, pulmonary toxicity (fever cough SOB), dizziness, fatigue, bradycardia, hypotension, blue-grey discoloration of the skin
amiodarone interventions
monitor GI symptoms, test baseline chest xray and pulmonary function test before, listen to lungs, monitor pulse, monitor BP, monitor weight changes, give at same time of the day, can take with milk, wear sunglasses outside, avoid driving
amiodarone contraindications
shock, bradycardia, heart block, server hepatic disease
verapamil class/use
class - calcium channel blocker
used for -convert SVT to normal sinus, slow afib, angina, hypertensive
what are some other calcium channel blockers besides verapamil
Diltiazem, Amlodipine, Nicardipine
verapamil SE
Hypotension, Bradycardia, Heart failure, peripheral edema of feet and legs, Lightheadedness, dizziness
verapamil interventions
monitor cardia rhythm, monitor BP (hold for systolic below 90), monitor HR (below 60 hold), monitor I/O, report edema,
verapamil teaching
do not increase dose, check pulse, dont drive
verapamil contraindications
systolic less then 90, cardiogenic shock, second/third degree AV block
hydralazine class/use
class- direct acting vasodilators
used for Moderate to severe hypotension, Hypertensive crisis
hydralazine SE
Headache, dizziness, weakness and fatigue, Reflex Tachycardia, Fluid retention, edema, Abrupt withdrawal can cause hypertensive crisis and heart failure
hydralazine interventions
monitor pulse, report tachycardia, report facial rash, joint pain, monitor for edema, crackles in the lungs, taper off, take with food
hydralazine teaching
start low, dont stop abruptly, avoid strenous activity,
statins class/use
class - Cholesterol Lowering Agents
used for reduce LDL and triglycerides, increase HDL
statins SE
myopathy (muscle pain), hepatotoxic
statins interventions
report myopathy, monitor liver function
statins admin
tkae at night
statins contraindications
liver disease, elevated ALT/AST, children younger then 8
milirone class/use
class - Inotropic/Phosphodiesterase Inhibitors
used for Short-term treatment of low cardiac output in heart failure
milirone SE
hypokalemia, cardiac dysrhythmias, hypotension, angina
milirone interventions
Monitor potassium levels, Monitor vital signs and ECG rhythm continuously, Monitor for chest pain during infusion
milirone admin
Give a loading dose over 10 minutes and then administer a dose based
on client’s weight by continuous infusion
milirone contraindications
Aortic or pulmonary valve disorder, Acute MI
Furosemide class/use
class- loop diuretic
used for Treats pulmonary edema in heart failure, edema caused by renal, hepatic or cardiac failure not affected by
other diuretics, hypertension not controlled by other diuretics
furosemide SE
Electrolyte imbalance: hyponatremia, hypochloremia, severe fluid loss
(dehydration), and hypokalemia, hypotension, ototoxicity, hyperglycemia, increased uric acid
furosemide admin
give oral with food, IV undiluted, protect all forms from light
furosemide teaching
Eat foods rich in potassium, Report signs of electrolyte imbalance, Avoid hazardous activities, Report new onset of hearing loss, ringing in ears, or vertigo, monitor DM for hyperglycemia,
furosemide contraindications
hepatic coma, electrolyte imbalance, anuria
Nitroglycerin class/use
class - direct vasodilators
used for severe unstable angina attacks and to control blood pressure perioperatively and to treat heart failure after acute MI
nitroglycerin SE
headache, orthostatic hypotension, tachycardia, can build tolerance
Nitroglycerin interventions
monitor baseline HR and BP, monitor for drug tolerance, give in the smallest form needed,
Nitroglycerin admin
Nitroglycerin available as sublingual tablets, sustained-release capsules or tablets, a translingual spray or transmucosal tablets, transdermal ointment or patch, and IV form, sublingual max 3 every 5 min if not call 911,
Nitroglycerin contraindications
pregnancy, lactation, anemia, taminade, pericarditis, uncontrolled hypovolemia
Hydrochlorothiazide class/use
class- thiazide diuretic
used for HTN, cirrhosis of liver and renal failure
Hydrochlorothiazide SE
electrolyte imbalance (low sodium/potassium), hyperglycemia, increased uric acid
Hydrochlorothiazide interventions
monitor electrolytes, monitor glucose (more frequently for DM), monitor uric acid
Hydrochlorothiazide admin
give with food to decrease GI effects, last dose latest by 3pm to minimize nocturia
Hydrochlorothiazide teaching
eat potassium, report signs of elctrolyte imbalances
Hydrochlorothiazide contraindications
anuria, electrolyte imbalances
Fibrates class/use
class- cholesterol lower agents
used for lower triglycerides and increase HDL
Fibrates SE
GI symtoms (nausea, abdominal pain, diarrhea), gallstones, myopathy, liver toxicity
fibrates interventions
report GI symptoms, gall bladder disease, and myopathy, monitor CPK for muscle pain and monitor liver function
fibrates admin
2x per day 30 min before breakfest and dinner,
fibrates contraindications
gall bladder disease, liver dysfunction, severe renal impairment
atropine class/use
class - anticholinergic
used to increase HR
atropine SE
anticholinergic effects (constipation, urinary retention, dry mouth)
