Cardiac Dysrythmias Flashcards
What does amiodarone act on?
All cardiac tissue and smooth muscle
What class is amiodarone in?
General antidysrythmics
What is amiodarone used for?
All dysrythmias,
Vtach, SVT, V fib, atrial fib
How does amiodarone work?
Slows sinus rate,
Increases the PR interval( prolongs)
Increases the QT intervals ( prolongs)
Decreases PVR
What are the side effects of amiodarone?
Blurred vision- halos Bradycardia, decreased BP Hepatotoxicity Pulmonary toxicity- cough, dyspnea, chest pain, fever Dizziness, N/V/D, constipation
What are the nursing implications for amiodarone?
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
What are the teaching instructions for amiodarone?
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
What is the classification of adenosine ( adenocard)?
Anti arrhythmic, chemical converter
What is the mechanism of action of adenosine (adenocard)?
Slows conduction through the AV node,
Inter ups recently pathways through the AV node
When is adenosine (adenocard) used?
SVT or V tach with pulses
What are the side effects of adenosine ( adenocard)?
Chest pain, chest tightness, Facial flushing Light headed, dizzy, blurred vision, Dyspnea, palpitations, sweating Arm tingling, metallic taste
What are the nursing implications for adenosine (adenocard)?
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
What are the contraindications of adenosine (adenocard)?
2nd or 3 rd degree AV block,
- atrial flutter
- atrial fib
- V tach with out pulse
How do you treat for adenosine (adenocard) overdose?
Defibrillation
Vasopressor for hypotension
What do you teach patients how are on adenosine?
Report facial flushing
Dizziness, sweating, heart palpitations,
Chest pain
- rise slowly
What is the classification if lidocaine?
Antiarrythmic
What is the mechanism of action and the use of lidocaine for?
Decreases the automaticity ( ability to carry an electrical charge)in the ventricles.
Use for ventricle problems, PVC’s
What are the side effects and nursing implications for lidocaine?
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
What classification is Atropine?
Antidysrhythmic, anticholinergic,parasympatholytic, anti muscarinic
What is the mechanism of action and use of atropine?1
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)
What are the side effects of atropine?
HA, dizziness, hyper/hypotension, paradoxical bradycardia, photophobia, blurred vision, dry mouth, pupil dilation
What are the nursing implications for Atropine?
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
Is Madelyn awesome
YES
What is the classification of diltiazem (Cardizem)
CCB, negative iontropic, anti hypertensive
What is the mechanism of action of diltiazem?
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
What are the uses of diltiazem for?
Angina due to coronary artery spasm, hypertension, atrial problems, when you want to decrease HR.
Atrial fibrillation, atria flutter
Paroxysmal supra ventricular tachycardia
What are the side effects of diltiazem?
HA, fatigue, drowsiness, edema, dizziness,nausea, constipation
What are the nursing implications for diltiazem?
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
