Cardiovascular or peripheral vascular disorder

Question 1

Action
Used to control rapid ventricular rate in atrial fibrillation and to convert paroxysmal supraventricular tachycardia to normal sinus rhythm.
Increases cardiac force and efficiency slows heart rate, increases cardiac output.

Nursing
Monitor apical pulse to ensure rate is above 60bpm (call health care provider if med is withheld)
Monitor for digitalis toxicity (nausea, vomiting, anorexia, dysrhythmias, bradycardia, tachycardia, headache, fatigue, visual disturance)

Answer 1

digoxin (Lanoxin)

Cardiac Glycoside

Question 2

Action
IV solutions given for severe ventricular dysrhythmias
Depresses excitability of cardiac muscle to electrical stimulation and slows conduction in atrium, bundle of His, and ventricle, thus increasing refractory period

Nursing Interventions
Observe for new dysrhythmias, dry mouth, blurred vision, bradycardia, hypotension, nausea, anorexia, dizziness, visual disturbances

Answer 2

procainamide

Antidysrhythmic Agents

Question 3

Action
Suppresses the impulse that triggers dysrhythmias

Nursing Interventions
Monitor heart rate and BP closely

Answer 3

lidocaie (IV)

Antidysrhythmic Agents

Question 4

Action
Provides long-term treatment of premature ventricular contractions, ventricular tachycardia and atrial fibrillation

Nursing
Monitor BP and apical pulse

Answer 4

disopyramide (Norpace CR)

Antidysrhymic Agents

Question 5

Action
Slows conduction through AV node, can interrupt reentry pathways through AV node, and can restore normal sinus rhythm in patients wit paroysmal supraventricular tachycardia (PSVT)

Nursing Intervention
Monitor BP, pulse rate, and respirations.
Assess patient for headache, dizziness, gastrointestinal complaints, new dysrhythmias.
Do not give caffeine within 4-6 h of meds because caffeine inhibits the effect of the drug

Answer 5

Adenosine (Adenocard)

(Antidysrhythmic Agent0

Question 6

Action
Prolongs duration of action potential and effective refractory period; provides noncompetitive alpha- and beta- adrenergic inhibition; increase P-R and Q-T intervals; decreases sinus rate; decreases peripheral vascular tachycardia, supraventricular tachycardia, atrial fibrillation, ventricular fibrillation not controlled by first-line agents, cardiac arrest

Nursing interventions
Observe for headache, dizziness, hypotension, bradycardia, sinus arrest, heart failure, dysrhythmia
Assess BP continuously for hypotension or hypertension
Report dysrhythmia or bradycardia
Monitor for dyspnea, chest pain.

Answer 6

amiodarone (Pacerone)

Antidysrhythmic Agents

Question 7

Action
Decrease excitability of cardiac muscle

Nursing intervention
Monitor pulse, BP
Monitor for diarrhea, visual disturbances, respiratory distress

Answer 7

mexiletine propaenone (Rythmol)

Antidysrhythmic Agents

Question 8

Action
Suppresses automaticity of conduction tissue

Nursing interventions
Notify health care provider if cough, wheezing, or shortness of breath occurs

Answer 8

tocainide

Antidyrhythmic Agent

Question 9

Action
Used to treat suparaventricular and ventricular dysrhythmias, persistent sinus tachycardia.
Decrease myocardial oxygen demand, decrease workload of the heart, decrease heart rate.

Nursing interventions
Monitor HR and BP carefully. Use caution with patient with bronchospastic disease.
Monitor for bradycardia, hypotension, new dysrhythmias, dizziness, headache, nausea, diarrhea, sleep disturbances

Answer 9

propranolol (Inderal)
sotalol (Betapace)
acebutolol (Sectral)
metoprolol (Lopressor)
carvedilol (Coreg)

(Beta-Adrenergic Blockers)

Question 10

Action
Treat supraventricular tachycardia and control rapid rates in atrial tachycardia.
Produce relaxation of coronary vascular smooth muscle, dilate coronary arteries.

Nursing Intervention
Use caution in patients with CHF.
Monitor apical pulse and BP
Watch for fatique, headache, dizziness, peripheral edema, nausea, tachycardia.
Verapamil and diltiazem increase the toxicity of digoxin.

Answer 10

verapamil (Calan)
Ditiazem (Cadizem)

(Calcium Channel Blockers)

Question 11

Action
Used in severe CHF with pulmonary edema
Increase myocardial contractility.
Increase cardiac output, increase BP, and improve renal blood flow.

Nursing interventions
Monitor BP, heart rate, and urinary output continuously during the administration.
Palpate peripheral pulses; notify health care provider if extremities become cold or mottled.

Answer 11

dobutamine (IV)
dopamine (IV)

(Inotropic Agent)

Question 12

Action
Used in treatment of atrial fibrillation with embolization to prevent complication o stroke

Nursing intervention
Assess patient for signs of bleeding and hemorrhage.
Monitor prothromin time and international normalized ratio (PT/INR) frequently during therapy.
Review foods high in Vitamin K. Patient should have consistently limited intake of these foods because these foods will cause levels to fluctuate.

Answer 12

warfarin (Coumadin)