Cardiac Dysrythmias

Question 0

What does amiodarone act on?

Answer 0

All cardiac tissue and smooth muscle

Question 1

What class is amiodarone in?

Answer 1

General antidysrythmics

Question 2

What is amiodarone used for?

Answer 2

All dysrythmias,

Vtach, SVT, V fib, atrial fib

Question 3

How does amiodarone work?

Answer 3

Slows sinus rate,
Increases the PR interval( prolongs)
Increases the QT intervals ( prolongs)
Decreases PVR

Question 4

What are the side effects of amiodarone?

Answer 4

Blurred vision- halos
Bradycardia, decreased BP
Hepatotoxicity
Pulmonary toxicity- cough, dyspnea, chest pain, fever
Dizziness, N/V/D, constipation

Question 5

What are the nursing implications for amiodarone?

Answer 5

If given IV = high alert drug! put on tele
Measure PR QRS, and QT intervals
- continuous BP
Check respiratory status
Labs- thyroid, amiodarone therapeutic level = 1-2.5… Toxicity = > 2.5

Question 6

What are the teaching instructions for amiodarone?

Answer 6

How to take a pulse..check for bradycardia

• no grapefruit, will cause toxicity
• where sunscreen
• increase the effects of anticoagulants
• report any side effects to Dr

Question 7

What is the classification of adenosine ( adenocard)?

Answer 7

Anti arrhythmic, chemical converter

Question 8

What is the mechanism of action of adenosine (adenocard)?

Answer 8

Slows conduction through the AV node,

Inter ups recently pathways through the AV node

Question 9

When is adenosine (adenocard) used?

Answer 9

SVT or V tach with pulses

Question 10

What are the side effects of adenosine ( adenocard)?

Answer 10

Chest pain, chest tightness, 
Facial flushing
Light headed, dizzy, blurred vision,
Dyspnea, palpitations, sweating
Arm tingling, metallic taste

Question 11

What are the nursing implications for adenosine (adenocard)?

Answer 11

Has a 6 sec. Half life.
Give directly into IV…not up in line..only a mid level or higher
Continuous monitor of cardiopulmonary..EKG, BP, RR, rhythm.
EKG intervals
- warm to room temp to dissolve crystals
-monitor resp status, crackles
Monitor I and O ratio and Lytes

Question 12

What are the contraindications of adenosine (adenocard)?

Answer 12

2nd or 3 rd degree AV block,

• atrial flutter
• atrial fib
• V tach with out pulse

Question 13

How do you treat for adenosine (adenocard) overdose?

Answer 13

Defibrillation

Vasopressor for hypotension

Question 14

What do you teach patients how are on adenosine?

Answer 14

Report facial flushing
Dizziness, sweating, heart palpitations,
Chest pain
- rise slowly

Question 15

What is the classification if lidocaine?

Answer 15

Antiarrythmic

Question 16

What is the mechanism of action and the use of lidocaine for?

Answer 16

Decreases the automaticity ( ability to carry an electrical charge)in the ventricles.
Use for ventricle problems, PVC’s

Question 17

What are the side effects and nursing implications for lidocaine?

Answer 17

CNS signs, dizziness, HA,hypotension, bradycardia
Nursing implications- put on tele, check VS and LOC
Use with V-Tach and Ventricular dysrhythmias
Contraindicated in SVT

Question 18

What classification is Atropine?

Answer 18

Antidysrhythmic, anticholinergic,parasympatholytic, anti muscarinic

Question 19

What is the mechanism of action and use of atropine?1

Answer 19

Blocks acetylcholine at parasympathetic sites, increases cardiac output and heart rate by blocking vagostimulation in the heart, dries secretions by blocking vagus
Use- bradycardia(40-50 BPM)

Question 20

What are the side effects of atropine?

Answer 20

HA, dizziness, hyper/hypotension, paradoxical bradycardia, photophobia, blurred vision, dry mouth, pupil dilation

Question 21

What are the nursing implications for Atropine?

Answer 21

Check I and O’s, urinary retention, tele, check bowel sounds for constipation
Take 1/2 hr before meals with water
Teach- report urinary retention,blurred vision, constipation, chest pain.
No strenuous activity in heat..cause heat stroke
No skipping or double dose

Question 22

Is Madelyn awesome

Answer 22

YES

Question 23

What is the classification of diltiazem (Cardizem)

Answer 23

CCB, negative iontropic, anti hypertensive

Question 24

What is the mechanism of action of diltiazem?

Answer 24

Inhibits calcium ion influx across the cell membrane during cardiac depolarization.
Relaxes coronary vascular smooth muscle, dilates coronary arteries,
Slows SA /AV node conduction times,
Dilates peripheral arteries

Question 25

What are the uses of diltiazem for?

Answer 25

Angina due to coronary artery spasm, hypertension, atrial problems, when you want to decrease HR.
Atrial fibrillation, atria flutter
Paroxysmal supra ventricular tachycardia

Question 26

What are the side effects of diltiazem?

Answer 26

HA, fatigue, drowsiness, edema, dizziness,nausea, constipation

Question 27

What are the nursing implications for diltiazem?

Answer 27

Assess cardiac status, HR, BP, pulse,tele
Teach- daily at same time
Take a B/P and pulse before taking med, record on a chart
Avoid hazardous activities until stabilized on med, dizziness is no longer a problem
Limit caffeine, avoid grapefruit juice
Report dizziness, SOB, palpitations
Do not discontinue abruptly