Cardiac Mod 2 Flashcards
Treatment for coronary artery disease
BP control with meds
surgery
anticoagulants
anticolesterol meds
nitrates
beta blockers
ccbs
Is the deficit of oxygen to The myocardium usually caused by atherosclerotic plaque that narrows/blocks coronary arterial blood flow
Angina
Chest pain is unrelieved by rest and nitroglycerin last longer than 30 minutes short as a breath nausea vomiting diaphoresis all indicate what
Myocardial infarction
Treatment and management of MI
Oxygen
Aspirin
Nitroglycerin
Morphine
What drugs decrease myocardial oxygen demand
Nitrates
beta blockers
calcium channel blockers
Adverse effects with-PRILS
Hyperkalemia
angioedema
neutropenia
increases risk for infection
over 100.5 fever
COUGH
-SARTAN can cause
Hyperkalemia
angioedema
What is the Moa of nitroglycerin
Decreases resistance to blood flow in arterial system
decreases preload and afterload helps the heart receive more O2 and pump easier
Nitrates is used to
Relieve acute angina
prevent angina
used after patient has a heart attack or heart failure
Side effects for nitrates
HEADACHE
minor decrease in BP
Patient taking Verapamil - Diltiazem would like to know the signs and symptoms of this medication
Orthostatic hypertension
peripheral edema
headache
constipation
Steven Johnson syndrome
What are the sodium channel blockers (class I) for ventricular dysrhythmias and svts
•Lidocaine
•Quinadine
•Procainamide
A patient that has ventricular dysrhythmias is getting a new medication provided by the healthcare provider what medication could this be?
Lidocaine
A patient showing signs of SVT was put on procainamide what teachings should the nurse tell the patient
To monitor
•heart rate
•blood pressure
•ECG
•GI signs and symptoms
•This can cause urinary retention increase fall risk due to confusion
Side effects for sodium channel blockers (lidocaine, procainamide, quinidine)
•Hypotension
•Dysrhythmias
•Lupus
•Leukopenia
•Thrombocytopenia
Potassium channel blockers
AMIDARONE
What is Amidarone used for?
Reduces heart rate ♡
used for dysrhythmias including
•V-fib
•V-tac
What are some serious issues potassium channel blockers (Amidarone) can cause
Pulmonary issues/toxicity
dizziness
hypotension
photosensitivity
bradycardia
thyroid dysfunction
liver toxicity
Spironolactone is a
Potassium sparing diuretic
Which action by the nurse is most important when caring for a patient with chronic kidney disease who has an order for Furosemide
1. Assess your output in renal laboratory values for signs of nephro toxicity
2. Check the specific gravity of the urine daily
3. Eliminate potassium rich foods from diet
4. Encourage the patient to void every 4 hours
Assess urine output in Reno laboratory values for signs of nephrotoxicity
The patient admitted for heart failure has been receiving hydrochlorothiazide. Which laboratory levels should the nurse carefully monitor (select all that apply
1. Platelet cout
2. WBC
3. Potassium
4. Sodium
5. Uric Acid
Potassium
sodium
uric acid
The nurse is providing teaching to a patient who has been prescribed Furosemide. Which of the following should the nurse teach the patient?
1. Avoid consuming large amounts of kale, cauliflower, or cabbage
2. Rise solely from a lying or sitting position to standing
3. Count the pulse for 1 minute before taking this medication
4. Restrict fluid intake to no more than 1 L per 24-hour period
- Rice slowly from a lying or sitting position to standing
A patient with a history of heart failure will be started on spironolactone. Which drug group should not be used, or used with Extreme Caution in patients taking potassium sparing diuretics
1. Non-steroidal anti-inflammatory drugs
2. Corticosteroids
3. Loop diuretics
4. ACE inhibitors or ARBs
4.
What can increase the risk for digoxin toxicity
Hypocalemia or hyperkalemia
The nifedipine has been ordered for a patient with hypertension. In the care plan the nurse includes the need to monitor for which adverse effect
1. Rash and chills
2. Reflex tachycardia
3. Increase urinary output
4. Weight loss
- Reflex tachycardia
The nurse is caring for a patient with chronic hypertension. The patient is receiving losartan daily. Which patient manifestations would the nurse conclude is an adverse effect of this medication (Select all that apply)
1. Tremors
2. Dizziness
3. Drowsiness
4. Hypoglycemia
5. Angioedema
Dizziness
hypoglycemia
angioedema
A patient taking to dachshund has other medications on his list what medications should not be taken due to the possibility of hyperkalemia
1. ACE inhibitors
2. Warfarin
3. Aspirin
4. Spironolactone
5. Potassium supplements
- ACE inhibitors
- Spironolactone
- Potassium supplements
Treatment of digoxin overdose
Ivy infusion of digoxin immune Fab
Ace inhibitor drugs
-PRILS
A nurse is assessing a patient that is taking Lisinopril what actions by the nurse should be taken with this drug
Assess BP prior to Administration
Older adults, especially those with chronic kidney disease should receive lower doses to prevent toxicity
A patient that has had a previous angioedema has been prescribed Lisinopril what action by the nurse should be taken?
To call the provider
A patient on Lisinopril is showing signs of angioedema what actions by the nurse should be taken next? (Select all that apply)
1. Continue monitoring patient every 2 hours
2. Check for Airway and breathing
3. Discontinue medication and call provider
4. Monitor glucose
- Check for Airway and breathing
- Call provider and discontinue Med
What are the nursing implications for dysrhythmias
Monitor cause of dysrhythmias
need to determine and treat electrolyte imbalance
hypoxia
pain
anxiety
caffeine - no cake
tobacco
observe for signs and symptoms of dysrhythmias
decreased BP
irregular pulse
shortness of breath
dyspnea
chest pain
edema
What drug is used to treat sinus bradycardia
Atropine
Which drug is used for hypercholesterolemia and prevention of coronary artery disease
Statins
Statins are the current wonder drug of the cardiac world now are you required medication for
MI & stroke
What is the Moa of statin drugs?
Decreases production of l
LDL increases HDL
Side effects for statin drugs
Headache
abdominal pain
muscle pain
sore throat
heartburn
Adverse effects of statin drugs
Liver failure
rhabdomyelosis
GI upset
myopathy
elevated LFTs
peripheral neuropathy
Affecting heart rate positive chronotropic medications increase heart rate negative chronotropic medications decrease heart rate
TorF
True
Raas DDI’s
•Lithium
•digoxin
•NSAIDs
•potassium sparing diuretics
•anything that affects the kidneys •avoid any of the meds for angioedema
A client with hypertension is prescribed a beta-blocker. The nurse should educate the client about which potential side effects of this medication?
1. Increase heart rate
2. hypertension
3. hypoglycemia
4. bronchoconstriction
- bronchoconstriction
A client with atrial fibrillation is prescribed warfarin. The nurse understands that the therapeutic effect of Warfarin is primarily due to
- inhibition of platelet aggregation 2. inhibition of vitamin k- dependent clotting factors
- direct inhibition of thrombin……….. 4. promotion of fibrilysis
- Inhibition of vitamin K - dependent clotting factors
A client with hypertension is prescribed an angiotension to receptor blocker. The nurse should instruct the client about the potential benefit of this medication in preventing
1. Hyperlipidemia
2. myocardial infarction
3. cerebral vascular accident
4. renal dysfunction
- Reno dysfunction
Are IV solutions that contain electrolytes and other substances in concentrations that closely resemble the body’s ECF
Crystalloids
Beta blockers
-LOLs
Alpha 2 agonist
Clonidine
Alpha 1 blockers
-Zosin
Adverse effects for sartans
Fetal injury
angioedema
imbalance electrolytes
- decreased glucose
- increase potassium
- decrease sodium
low blood pressure
Treatment for hyperkalemia
Ivy insulin with dextrose
Kayexalate
Renin Antagonist
Aliskiren
Monitor for hyperkalemia
DDI’s for
ARB’s
ACE’S
Renin Antagonist
Lithium
digoxin
NSAID’s
K+ sparing diuretics
Negative chronotropic
Lower rate
Negative inotropic
Less Force
Negative dromotropic
Less Beats
Alpha 1 blocker
-zosin
Vasodilation
Alpha 2 blocker
Clonidine
CNS depression
Sedation
Which medication is safer propranolol or metroprolol
Metoprolol because it is a cardio selective beta one
Beta 1 affects the heart and
Decreases contractility
decreases heart rate
Decreases blood pressure
How does beta 1 blockers affect the liver and lungs
Decreases glucose in the liver
bronchospasms in the lungs
Nitrates drug names
Isosorbide
Nitroglycerin
What is the antidote for Cyanide toxicity?
Thiosulfate
Hydralazine large risk for
Rebound tachycardia on admission due to the vasodilation and drop in blood pressure
Generalized / peripheral edema
Lidocaine quinine procainamide
●Slow down the heart rate
●causes urinary retension
•assess I&O
Amiodarone decreases
The heart rate
Amiodarone can lead to pulmonary complications and you should avoid in
COPD asthma and sleep apnea patients
Photosensitivity
Adenosine helps with
Atrial arrhythmias
Atropine
•Anticholinergic
•use for symptomatic bradycardia can
•lead to tachycardia
•anticholinergic complications
Cholesterol medications General
•Give at night
•Assess liver function
¤Avoid alcohol
•Rhabdomyolosis
¤Muscle pain / breakdown •Myopathy
¤Muscle weakness
•Combining cholesterol medication increases these complications
•Avoid in pregnancy and lactating patients
Statins
○The drug of choice for hyperlipidemia
○Heartburn
○Peripheral neuropathy
Bile acid resins
Chloe-
Chloe - binds to cholesterol to the bile acid and cause it to be
Excreted rectally
Chloe Dash avoid giving other medications give one hour before bile acid resin or
4 to 6 hours after bile acid resins
Chloe- chloestasis,
Chloecystitis
Anemia / leukopenia
Nicotinic acid
•Vitamin B3
•causes flushing
•vasodilation
•rebound tachycardia
•avoid with Benadryl
