Heart Failure

Question 1

Heart Failure

Answer 1

-results from inability of heart muscles to pump enough blood to supply whole body

Question 2

Medications used to control symptoms of HF

Answer 2

1) diuretics
2) Ace inhibitors
3) ARBs
4) Beta adrenergic blockers
5) cardiac glycosides

Question 3

Cardiac glycosides: medications

Answer 3

-prototype = digoxin (Lanoxin, Lanoxicaps, Digitek)

Question 4

Cardiac glycosides: expect action and therapeutic uses

Answer 4

1) increased force of myocardial contraction
2) decreases heart rate
AND
1) HF
2) dysrhythmias

Question 5

Cardiac glycosides: adverse effects

Answer 5

1) dysrhythmias-medication interferes w/ electrical conduction of myocardium
2) cardiotoxicity leading to bradycardia
3) GI effects–anorexia, nausea, vomiting, abdominal pain
4) CNS effects–fatigue, weakness, vision change (diplopia, blurred vision, yellow-green or white halos)

Question 6

Digoxin (Lanoxin):

nursing interventions

Answer 6

1) dysrhythmias:
- monitor for hypokalemia
- monitor digoxin level (dosage based on serum levels
2) GI/CNS effects
- teach to monitor for symptoms and notify provider

Question 7

Digoxin (Lanoxin):

client education

Answer 7

1) report to provider:
- nausea
- vomiting
- weakness
2) teach to consume high-potassium foods
3) teach client to monitor pulse rate, recognize differences and report
4) report
- anorexia
- nausea
- vomiting
- abdominal pain
- fatigue
- weakness
- vision change: diplopia, blurred vision, yellow-green or white halos

Question 8

Digoxin (Lanoxin): medication/food interactions and interventions

Answer 8

1) thiazide/loop diuretics can lead to hypokalemia (result dysrhythmias)
2) ACE inhibitors and ARBs increase risk of hyperkalemia
3) Quinidine increases risk of digoxin toxicity
4) varapamil (Calan) increases plasma level of digoxin
INTERVENTION
1) monitor serum levels and maintain 3.5-5 mEq/L
2) treat with potassium supplements or potassium-sparing diuretic
3) use medications cautiously
4) avoid concurrent use
5) if used together, increase digoxin dose

Question 9

Digoxin: nursing administration

Answer 9

1) take medication as prescribed
2) if dose is missed, next dose should not be doubled
3) check pulse and rhythm before administering
4) notify provider if HR:
- less than 60/min in adults
- less than 70/min in children
- less than 90/min in infants
5) administer at same time daily
6) avoid OTC medications