Heart Failure

Question 1

What to do when giving Adenosine?
What happens when giving it?

Answer 1

push very fast IV + flush right after
converting PSVT to normal sinus rythm
aystole up to 6 seconds
very uncomfortable for the Pt
- SOB, going to die feeling

Question 2

Digoxin adverse effects?

Answer 2

narrow therapeutic window
headache confusion fatigue
colored vision + halo lights
bradycardia
EKG changes (ventricular arrythmia)

Question 3

Who to not give digoxin to?

Answer 3

people with
-hypokalemia ( or with meds that lower K)
-renal insufficiency
-arrythmias
-2nd and 3rd degree HB
- SSS
-pregnancy

Question 4

What is the tolerance of nitrates?

Answer 4

need larger doses to achieve effect
transdermal form: remove patch at night and reapply in the morning to have the “patch free interval”

Question 5

What are the types of nitrates?

Answer 5

Nitroglycerin
Isosorbide dinitrate

Question 6

How is nitroglycerin used?

Answer 6

PO,SL,topical,IV, metered dose aerosol

Question 7

How many times a day do you take Isosorbide dinitrate?

Answer 7

QD

Question 8

How to take the sublingual nitroglycerin?

Answer 8

do not chew or swallow
spray the tongue not inhale
burning sensation should be felt
fresh sublingual med (3 months)

Question 9

How to take care of the nitroglycerin?

Answer 9

airtight, dark glass bottle with metal cap and no cotton

Question 10

How to take the topical and transdermal nitroglycerin?

Answer 10

site rotation
remove old medication
remove @ bedtime and reapply in morning
nurses wear gloves

Question 11

How to take ALL nitroglycerin and what to do if pain occurs?

Answer 11

take as needed and do not wait
before activities that precipitate pain
stop lie down and take tab
3 does 5 min interval
do not drive to hosptal