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3. Nursing Pharmacology > Cardiac meds > Flashcards

Cardiac meds Flashcards

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1
Q

right side HF symptom

A

peripheral edema

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2
Q

left side HF symptoms

A

SOB , dyspnea

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3
Q

cardiac glycosides examples

A
  • Rapid acting Digitalis- Digoxin (Lanoxin)

- Phosphodiesterase inhibitors= milrinone lactate

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4
Q

digoxin antidote

A

immune fab (Digibind)

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5
Q

cardiac glycosides use and ind

A
  • cause cardiac muscle to contract

- Used to treat HF, atrial fibrillation, and atrial flutter

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6
Q

dig toxicity SS

A
  • anorexia
  • blurred vision, or other vision changes
  • diarrhea- cardiac dysrhythmias, HA
  • N&V
  • Bradycardia P≤60BPM- auscultate HR apical for full minute
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7
Q

Cardiac glycosides CA

A

-HR≤ 60 hold med

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8
Q

therapeutic digoxin levels

A
  • Therapeutic dig blood

0. 2 - 2.0 ng/ml

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9
Q

dig + diuretics=

A

risk for hypokalemia

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10
Q

antianginals

A
  1. nitrates
  2. beta blockers
  3. calcium channel
    blockers
    -treat chest pain
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11
Q

nitrate action

A

generalized vasodilation- emergency

-short & long acting

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12
Q

nitrate SEs

A
  • HA-expected

- AD: HoTN, bradycardia

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13
Q

short acting SL

A

-0.4 mg tablet dissolved under tong

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14
Q

nitrate transdermal patch

A
  • lasts 24 hours but takes 30 -60 min for effects

- Nitro-Bid-only effective for 6-8 hours -needs to be applied 3-4 times a day-rotate topical sites

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15
Q

nitrate PT

A
  • do not stop abruptly -taper dose over weeks to avoid rebound angina and reflex tachycardia- may also make HF worse
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16
Q

beta blocker antianginal effect

A

effects of the SNS by blocking catecholamine(s)= HR and BP

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17
Q

antianginal nursing process

A
  • obtain baseline VS-apical pulse
  • watch for bradycardia pulse < 60
  • watch for HoTN < 100/60
  • position PT lying down or sitting when taking nitrate med for 1st time
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18
Q

Antidysrhythmics

NI

A

-Baseline BP -Pulse and EKG results- always know BP and P before giving any cardiac medication

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19
Q

Antidysrhythmics PT

A

-advise PT to avoid alcohol (HoTN), caffeine ( decrease catecholamine levels), and tobacco (promotes vasoconstriction)

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20
Q

Antidysrhythmics sodium channel blockers action

A

-controls PVC and treats ventricular dysrhythmias

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21
Q

Antidysrhythmics beta blockers

A
  • decrease contraction velocity, automatically, and recovery time of heart contraction.
    Indications: treat angina & HTN, treat ventricular issues
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22
Q

diuretics nursing process

A
  • obtain drug, herbal, medical history

- assess VS, serum electrolytes, weight, and UO for baseline levels

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23
Q

thiazide ex.

A
  • Chlorothiazide (Diuril)

- Hydrochloro-thiazide (HCTZ)-may be combined with other CV meds

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24
Q

thiazide contraind.

A

PT with renal failure risk of oliguria

25
Q

oliguria

A

abnormally low amounts of urine

26
Q

Loop (High ceiling Diuretics)

A

-furosemide (Lasix)
-bumetanide (Bumex)
(never combine other loop diruretics)

27
Q

Loop action/Ind

A
  • Na and H2O are lost with potassium, Mg, Ca.

- effective on HF

28
Q

Loop NI

A
  • very potent and quick acting- risk of SE

- K+-wasting medications- foods on K+

29
Q

Loop SE

A
  • hypokalemia
  • OH
  • hypovolemia
  • ototoxicity in higher doses
  • dig+loop= dig toxicity can result
30
Q

osmotic diuretics ex and use

A

Mannitol- potent osmotic K+-wasting Dtc

- used in ICP and IOP emergency situation - acute

31
Q

osmotic diuretics ind

A

-used to prevent acute kidney failure (oliguria), decrease intra-cranial pressure (ICP), and decrease intraocular pressure (IOP) in glaucoma

32
Q

carbonic anhydrase caution and ind

A
  • Prolonged use may result in metabolic acidosis

- Indication: used to treat open-angle (chronic) glaucoma only

33
Q

potassium sparing diuretics

A
  • spironolactone (Aldactone)- HR more regular/ help with chronic HF
  • triameterine (Dyrenium)-useful in the treatment of HF, edema, or cirrhosis
  • amiloride (Midamor)- antihypertensive
34
Q

potassium sparing diuretics action

A

promote Na and H2O excretion with K+ retention

35
Q

normal urinary output

A

Normal UO should be 30 ml per hour (30mlX24)= 720 ml per day

36
Q

potassium sparing diuretics SE

A
  • Hyperkalemia- be careful when giving to PTs with poor renal function as kidney excretes 80-90% of K+
37
Q

diuretic action as antihypertensives

A
  • thiazide - treat mild HTN

- loop diuretic- used in PT with renal insufficiency because they do not prevent blood flow

38
Q

CA and PT for all antihypertensives

A

Critical Assessments: BP ≤ 100/60 and pulse ≤ 60

-impotence is expected- counsel male clients to talk to their physician

39
Q

antihypertensives beta blockers

A

Used in BP-Continuous use results in decreased vascular resistance and decreased blood pressure as blood vessels do not have to work as hard. decreased HR, contractibility, and renin release

40
Q

beta blockers caution

A
  • do not stop abruptly- may cause rebound hypertension, reflex tachycardia, angina
41
Q

report these symptoms to doc

A
  • Weight gain of more than 2 pounds in 1 day or 5 lbs within 1 week
  • Edema of the feet or ankles
  • SOB
  • Excessive fatigue or weakness
    Syncope or dizziness
42
Q

alpha adrenergics ex.

A
  • Doxazosin (Cardura)- Used for HTN & BPH
  • Prazosin (Minipress)- used for HTN & PTSD
    Terazosin (Hytrin) -used for HTN & BPH
43
Q

alpha adrenergics use

A
  • blockage of alpha receptors result in vasodilation and decrease BP
  • help maintain the renal blood flow
  • useful in PT with HTN and abnormality
44
Q

alpha adrenergics SE

A
  • OH, dizziness, syncope which may occur with first dose

- nasal congestion

45
Q

Angiotensin-Converting Enzyme (ACE) inhibitors action

A

decrease systemic vascular resistance (afterload), vasodilation-> decrease BP

46
Q

Angiotensin-Converting Enzyme (ACE) inhibitors SE

A
  • dry, nonproductive cough, which reverses when therapy is stopped
  • when given first-dose hypotensive and hyperkalemia may occur
47
Q

Angiotensin II receptor Blockers use

A

-do not cause the chronic dry cough that is present with ACE inhibitors

48
Q

anticoagulant SE AD

A
  • risk of bleeding with dosage- localized or systemic

- can also platelets causing thrombocytopenia

49
Q

anticoagulant PT

A

-importance of regular lab testing long term- 4-6 wks
measures to prevent bruising, bleeding, or tissue injury
avoid foods high on Vit K (tomatoes, dark leafy green vegetables)

50
Q

heparin action

A

turn off coagulation pathway and prevent clot formation

51
Q

heparin toxicity antidote

A

Effects reversed by protamine sulfate - binds to medication

52
Q

heparin CA

A

aPTT, platelets

53
Q

heparin NI

A

-ensure that SC doses are given SC, not IM- 45 degree angle

54
Q

Warfarin action

A

inhibits vit K synthesis by bacteria in intestinal tract-> inhibits clotting factors

55
Q

warfarin route

A

oral only

56
Q

warfarin therapeutic levels

A

Warf Therapeutic levels 2-3.5

57
Q

antidote for warfarin

A

Vitamin K

58
Q

warfarin NI

A
  • may be started while the PT is taking heparin until PT-INR levels indicate adequate anticoagulation
  • full therapeutic effect take several days
  • monitor PT-INR regularly

3. Nursing Pharmacology (22 decks)

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