Cardiac Glycosides Flashcards
1
Q
Medication
A
-Digoxin
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
3
Q
Indications
A
-Treatment of HF and atrial fibrillation
4
Q
Adverse effects
A
- Headache, weakness, drowsiness, and vision changes
- GI upset and anorexia
- Arrhythmia development
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
6
Q
Caution
A
- Pregnancy/lactation
- Pediatric and geriatric patients
7
Q
Drug-Drug interactions
A
- Verapamil, amiodarone, quinidine, quinine, erythromycin, tetracycline, or cyclosporine
- Potassium losing diuretics
- Cholestyramine, charcoal, colestipol, bleomycin, cyclophosphamide, or methotrexate
8
Q
Assessment
A
- History: check for any contraindications or cautions
- Physical: VS, weight, electrolytes, mucus membranes, urinary output
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
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
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
