Cardio Flashcards by Amanda D

What are the cardiac disorders?

Hypertension

Cardiac dysrhythmia

Coronary artery disease

Heart failure

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What is hypertension

When SBP > 130

When DBP > 80

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What are consequences of HTN

Cardiac disease

Stroke

Renal disease

Peripheral artery disease

Blindness

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What is coronary artery disease (CAD)

CAD is caused by plaque buildup in the wall of the arteries

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What are symptoms of CAD

angina/chest pain

Shortness of breath

GI symptoms

Myocardial infarction

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What are cardiac dysrhythmias/arrhythmias?

Abnormal heart rate and/or rhythm

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What are signs and symptoms of cardiac dysrhythmias/arrhythmias

Low CO

heart failure

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What is heart failure?

Heart failure occurs when the heart can no longer pump effectively and cannot supply adequate blood to the body

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What are the signs and symptoms of left sided heart failure?

Low blood delivered to periphery

Low renal function

Low GI function

Chest pain

Fatigue

Lung congestion

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What are the signs and symptoms of right sided heart failure?

Hypoxia

Peripheral edema

Jugular venous distention (JVD)

Hepatic congestion

Hepatomegaly

Ascites

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What are the HTN drugs?

ACE inhibitors

A2RBs

Calcium blockers

Alpha 1 and 2 blockers

Beta blockers

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MOA for ace inhibitors

Blocks the enzyme (ACE) that converts angiotensin 1 to angiotensin 2. This action promotes vasodilation and excretion of sodium and water from the kidneys

From graph:
Produces vasodilation.. decreases blood pressure.. Lowers hearts workload.. increased blood flow.. increases O2 supply

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What is angiotensin 2

A potent vasoconstrictor and also stimulates the release of aldosterone from the adrenal cortex and antidiuretic hormone (ADH).

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What is aldosterone

It’s a hormone that causes retention of sodium by the kidneys and ADH acts on the hypothalamus to stimulate thirst and on the kidneys to retain water. These actions attempt to increase blood volume and BP

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How do ace inhibitors increase UO?

It blocks aldosterone. The kidneys will no longer hold sodium and retain water, therefore decreasing blood volume which will decrease BP

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Prototype for ACEI

Lisinopril

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Adverse effects of ACEI

Hypotension- dizziness, light headedness, syncope

Arrhythmias, angina, HF

sexual dysfunction

Hyperkalemia

Angioedema

Persistent dry cough

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What is the MOA of angiotensin 2 receptor blockers?

Blocks angiotensin 2 to produce vasodilation

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Adverse effects for A2RBs

Hypotension- dizziness, light headedness, syncope

Arrhythmias, angina, HF

sexual dysfunction

Hyperkalemia

Angioedema

Cough (less)

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What are teachings for ACE and ARBs?

Monitor electrolytes especially K

Monitor renal function: BUN, creatine, EGFR

Avoid salt substitutes and foods with high potassium

What are specific teachings for all HTN drugs?

Same time and stagger if > 1

Don’t abruptly stop

No hot weather

No excess alcohol

MOA for calcium channel blockers

Blocks Ca+ channels in vascular smooth muscle walls which increases vasodilation

Generic names for calcium blockers

Nifedipine

Diltiazem

Verapamil

Amlodipine

Adverse effects for calcium blockers

Bradycardia or reflex tachycardia

Orthostatic hypotension

Constipation (with Verapamil)

Edema

Teachings for calcium channel blockers

Monitor bowel function and add fiber to diet Check BP, HR Check cardiac enzymes: troponin, CK, LDH, myoglobin

Routes for ACEIs

PO; but IV for rapid action

What do ACEIs treat?

Hypertension by lowering BP Heart failure by lowering afterload and preload

Nursing considerations for ACEIs?

Assess BP and pulse routinely— watch for hypotension Monitor— Potassium levels, make sure they are not experiencing hyperkalemia Monitor renal function— BUN and creatine and UOP Angioedema which is swelling of dermis and Sub Q tissue.. so it’s really deep swelling Watch for dry cough

Prototype for A2RBs

Losartan Valsartan

Route for A2RB

PO; IV for rapid action

What do ARBs treat?

It treats hypertension Heart failure: lowering preload and afterload

What do calcium channel blockers treat

Hypertension Angina Arrhythmia

Prototypes for alpha blockers

Prazosin Doxazosin

Adverse effects of alpha blockers

1st dose hypotension

What do alpha blockers treat?

Hypertension

Prototype for nitrates

Nitroglycerin

Specific teaching for short acting nitroglycerin

Have the patient stop activity 1 tablet sublingual every 5 mins x 3 for chest pain.. PRN For patches and ointments: Apply to clean, dry, hairless area, rotate sites, avoid distal portions 12 hours on- 12 hours off

Prototype for angiotensin receptor neprilysin inhibitors

Valsartan/sacubitril

Therapeutic effect for ARNIs

Decrease signs of heart failure Improved ejection fraction

Prototype for k+ channel blockers

Amiodarone

What does amiodarone treat?

Dysthymia HR returns to baseline (60-100 beats per min) Rhythm will return to regular No signs of HF

Adverse effects of amiodarone

Pulmonary toxicity Visual disturbances Liver/thyroid dysfunction GI and CNS symptoms

Teachings for anti dysthymics?

How to take pulse for 1 full min Have BP monitored regularly Use OTC cold remedies, appetite suppressants, and anti sleep with caution Timing of medications especially if taking more than one Safety about reposition changes Follow up labs- electrolytes Report any worsening SOB, palpitations, chest pain

What does digoxin treat?

Dysthymia

Therapeutic effects for digoxin

HR returned to baseline Rhythm becomes regular Narrow therapeutic range Serum blood levels: 0.5-2 ng/ml

Adverse effects for digoxin

Bradycardia Hypotension S/SX of decreased cardio output or HF Anorexia is common early sign of digoxin toxicity Visual changes- yellow halos around objects, blurring

Nursing considerations for digoxin

It has a long half life due to high protein binding so give once a day and loading dose is required Antidote: digoxin immune fab (Digibind)

What kind of electrolyte imbalance is associated with digoxin

Hypokalemia Hypomagnesemia Hypercalcemia