Cardiac Glycosides Flashcards

1
Q

Medication

A

-Digoxin

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2
Q

Action

A

-Increases force of myocardial contraction, cardiac output and renal perfusion and output decreases blood volume to slow HR and conduction velocity through the AV node

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3
Q

Indications

A

-Treatment of HF and atrial fibrillation

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4
Q

Adverse effects

A
  • Headache, weakness, drowsiness, and vision changes
  • GI upset and anorexia
  • Arrhythmia development
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5
Q

Contraindications

A
  • Allergy
  • Ventricular tachycardia or fibrillation, heart block, or sick sinus syndrome
  • Idiopathic hypertrophic subaortic stenosis
  • Acute MI, renal insufficiency, and electrolyte abnormalities
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6
Q

Caution

A
  • Pregnancy/lactation

- Pediatric and geriatric patients

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7
Q

Drug-Drug interactions

A
  • Verapamil, amiodarone, quinidine, quinine, erythromycin, tetracycline, or cyclosporine
  • Potassium losing diuretics
  • Cholestyramine, charcoal, colestipol, bleomycin, cyclophosphamide, or methotrexate
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8
Q

Assessment

A
  • History: check for any contraindications or cautions

- Physical: VS, weight, electrolytes, mucus membranes, urinary output

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9
Q

Nursing diagnoses

A
  • Risk for imbalanced fluid volume r/t increased renal perfusion
  • Decreased cardiac output r/t ineffective cardiac muscle fx
  • Ineffective tissue perfusion r/t change in CO
  • Impaired gas exchange r/t changes in CO
  • Deficient knowledge r/t prescribed drug therapy
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10
Q

Implementation

A
  • Monitor apical pulse for on minute before admin of drug
  • Monitor pulse for change in quality or rhythm
  • Administer IV doses slowly over at least 5 minutes
  • Avoid IM admin
  • Maintain emergency equipment on standby: potassium salts, lidocaine, phenytoin, atropine, and a cardiac monitor
  • Obtain digoxin level as ordered: monitor for therapeutic level 0.5-2 ng/ml
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11
Q

Evaluation

A
  • Evaluate response to drug
  • Evaluate effectiveness of teaching plan
  • Evaluate effectiveness of comfort and safety measures
  • Evaluate compliance with the regimen
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