Ch 44 Agents for Treating Heart Failure

Question 1

What is CHF?

Answer 1

condition in which the heart fails to effectively pump blood throughout the body

Question 2

What is the goal in treating a patient with CHF?

Answer 2

the heart muscle contracts more efficiently bringing the system back into balance

Question 3

what causes CHF?

Answer 3

CAD, cardiomyopathy, hypertension, valvular heart disease

Question 4

What are the underlying medical conditions in a client with CHF?

Answer 4

muscle damage: atherosclerosis, cardiomyopathy
increase workload: hypertension, valvular disease
structural abnormality: congenital heart defects

Question 5

How does the body compensate with CHF?

Answer 5

decreased cardiac output: sympathetic stimulation, release of renin
cellular changes: ineffective contractility, Ca ion cascade decreases

Question 6

what are some common signs and symptoms of CHF?

Answer 6

SOB, difficulty focusing, fatigue, confusion, lowered ability to exercise, heart palpitations, dry/hacking cough, edema

Question 7

What are the classifications of medications that treat CHF?

Answer 7

cardiac glycosides, phosphodiesterase inhibitors, HCN blocker

Question 8

What medication is a cardiac glycoside?

Answer 8

Digoxin (Lanoxin)

Question 9

What does a cardiac glycoside treat?

Answer 9

CHF, Atrial Fibrillation

Question 10

How does a cardiac glycoside work?

Answer 10

increase Ca during depolarization

Question 11

What does a cardiac glycoside increase?

Answer 11

force of contraction, cardiac output, renal perfusion

Question 12

What does a cardiac glycoside decrease?

Answer 12

heart rate, AV node of contraction, workload of heart

Question 13

What are the adverse affects of cardiac glycosides?

Answer 13

yellow hallow, headache, weakness, drowsiness, GI upset, anorexia, arrhythmias

Question 14

What is the normal level of digoxin in the body?

Answer 14

0.5 to 2.0

Question 15

What level of digoxin in the body signifies toxicity?

Answer 15

> 2.5 ng/ml

Question 16

What are signs of digoxin toxicity?

Answer 16

yellow halo, irregular heart rhythm, nausea, vomiting, depression, anorexia, malaise

Question 17

what is the antidote for digoxin?

Answer 17

Digoxin Immune Fab

Question 18

What should a nurse consider when caring for a patient taking a cardiac glycoside?

Answer 18

apical heart rate, kidney and liver function, electrolyte abnormalities, orientation, cardiac status, urinary output, history and physical

Question 19

When are cardiac glycosides contraindicated?

Answer 19

ventricular tachycardia or fibrillation, heart block, sick sinus syndrome

Question 20

What are some drug interactions with cardiac glycosides?

Answer 20

Potassium losing diuretics, verapamil, charcoal, cholestyramine

Question 21

What is the medication ending for Phosphodiesterase Inhibitors?

Answer 21

RINONE

Question 22

What is a medication name for a phosphodiesterase inhibitor?

Answer 22

milrinone (Primacor)

Question 23

What does a phosphodiesterase inhibitor treat?

Answer 23

CHF; usually on Digoxin at the same time or not responding to Digoxin

Question 24

How does a phosphodiesterase inhibitor work?

Answer 24

blocks phosphodiesterase

Question 25

what does a phosphodiesterase inhibitor increase?

Answer 25

myocardial cell cyclic adenosine
calcium
stronger contraction
relaxes smooth muscle in the heart

Question 26

What are the side effects of a phosphodiesterase inhibitor?

Answer 26

arrhythmias, hypotension, pericarditis, chest pain, N/V, fever, pleuritis, thrombocytopenia, burning at injection site

Question 27

What is a drug interaction with a phosphodiesterase inhibitor? What is the interaction?

Answer 27

Furosemide (Lasix) ; creates an IV interaction