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Mod 7 - Cardiac Meds Flashcards

1
Q

what does vasoconstriction do to the blood pressure?

A

increase BP

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2
Q

what does vasodilation do to the blood pressure?

A

decrease BP

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3
Q

What is the most important implementation when giving meds?

A

Determine is it safe to give this medication to this patient at this time

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4
Q

What are we worried about when giving meds that get rid of fluid?

A

BP dropping

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5
Q

what meds get rid of fluid

A

diuretics (furosemide), ACE inhibitors (lisinopril), ARBs (losartan)

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6
Q

When are we worried about BP

A

if the medication is changing vessel size or fluid levels

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7
Q

When would you hold a med?

A

antihypertensives BP <100/60
HR <60
warfarin - if PT is too high or low range depends normal 0.8-1.2, on warfarin 2.0-3.0, with mechanical valve 2.5-3.5
heparin in PTT is too high or low

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8
Q

Why could someone have a low HR

A

just woke up, other meds, athlete, normal

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9
Q

what happens during vasodilation of veins

A

venous return slows so decreases the work of the heart

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10
Q

what happens during vasodilation of arteries (ateriodilation)

A

decrease in BP

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11
Q

What is the first line of defence for HTN

A

Furosemide (Diuretics)

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12
Q

Brief description of the RAAS System

A

low BP and low volume causes release of renin from kidneys. that stimulates conversion of angio 1 to angio 2 in the lungs with angioconverting enzyme. angio 2 causes vasoconstriction increases BP, and the release of aldosterone which retains Na+ and water and excretes K+ which increases blood volume (neg feedback loop).

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13
Q

Where do ACE inhibitors interrupt the RAAS system

A

blocks the converting enzyme for angio 1 to angio 2

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14
Q

where do ARBs interrupt the RAAS system?

A

ARBs block angio 2 receptors and do not allow them to do their job

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15
Q

what is the normal range for PT?

A

0.8-1.2 secs

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16
Q

what is the therapeutic range for someone on warfarin

A

2.0-3.0 secs

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17
Q

what is the therapeutic range if the pt has a mechanical valve

A

2.5-3.5 seconds

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18
Q

What classifications of medications do you check just BP for?

A

Diuretics (Furosemide), ACE Inhibitors (Lisinopril), ARBs (Losartan), Nitrates (Nitroglycerin),

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19
Q

What classifications of medications do you check just HR for?

A

Cardiac Glycosides (digoxin)

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20
Q

What classifications of medications do you check BP and HR for?

A

Calcium Channel Blockers (diltiazem), Beta Blockers (metoprolol)

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21
Q

Which will affect aPPT hep subq or hep IV

A

Hep IV

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22
Q

what can subq hep lead to?

A

Heparin‐induced thrombocytopenia (HIT). a potentially devastating immune mediated adverse drug reaction caused by the emergence of antibodies that activate platelets in the presence of heparin.

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23
Q

what is the antidote for Heparin

A

Protamine sulfate

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24
Q

What is the antidote for Warfarin

A

Vitamin K

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25
What medications does grapefruit juice interact with?
Calcium channel blockers, warfarin, some statins
26
how does digoxin work?
It inhibits the Na+/K+ pump resulting in an increase of intracellular Na+ and an influx of Ca2+ into cardiac cells. causes the cardiac muscle fibres to contract more efficiently and increase CO (slower, stronger beat)
27
what is the O/E of digoxin
bradycardia, fatigue, digoxin toxicity (nausea, vomiting, halos)
28
what is digoxin used for?
HF and atrial fib
29
what are some considerations for digoxin?
check HR stop and think if <60 therapeutic level of digoxin 0.8-2.0 monitor serum K+ levels because hypokalemia of digoxin tox. (normal 3.5-5) Digibind treats digoxin toxicity
30
how does Diltiazem work?
inhibits ca2+ during depolarization to decrease workload of the heart and increase O2 supply to myocardium, relax SM and decrease BP and HR
31
what are the uses of diltiazem?
angina, HTN, tachycardia
32
what is the O/E of diltiazem?
hypotension, bradycardia, fatigue, arrhythmia
33
what are some nursing considerations for diltiazem
take BP and HR, change position slowly, avoid grapefruit juice
34
how does furosemide work?
inhibit absorption of Na+ in loop of henle causing fluid loss, and loss of Na+ and other electrolytes
35
what are the uses of furosemide
treat HTN and edema
36
what are the O/E of furosemide
hypotension, dehydration, electrolyte imbalances (hyponautremia, hypokalemia - can cause arrhythmias)
37
what are some considerations of furosemide?
may take a K+ supplement assess BP change position slowly dehydration so drink fluids take in morning to not interfere sleep with need to urinate if BID take last dose at 4pm no later toxicity includes renal toxicity and ototoxicity
38
how does metoprolol work?
blocks beta-1 receptors in the heart causing decrease HR and decrease in BP by blocking epi high doses can block beta-2 receptors in the lungs causing bronchoconstriction
39
what are the uses of metoprolol
HTN, fast HR, chest pain due to poor bf to the heart, early intervention for MI
40
what are the O/E of metoprolol
hypotension, bradycardia, fatigue, SOB
41
what are the nursing considerations of metoprolol
check HR and BP everytime, slow change of position
42
how does lisinopril work
blocks conversion of angio1-angio2, leads to vasodilation and water and salt excretion which decreases bv and bf, decreases BP. it retains K+
43
what are the uses of lisinopril
HTN, HF
44
what are the O/E of lisinopril
hypotension, cough, hyperkalemia
45
what are the nursing considerations of lisinopril
monitor BP, switch to ARB if cough is persistent, hyperkalemia- dont increase diet of K+
46
how does losartan work
blocks angio 2 receptors to produce vasodilation and not allow it to stimulate the release of aldosterone which in turn will cause more water and electrolytes to be excreted.
47
what is the use of losartan
HTN
48
what is the O/E of losartan
hypotension
49
what are the nursing considerations of losartan
check BP everytime, change position slowly
50
how does nitroglycerin work
relaxes SM to produce vasodilation, slow blood return = dec. work of heart, arteriodilation = decrease BP
51
what are the uses of nitroglycerin
angina
52
what are the O/E of nitroglycerin
hypotension, severe headache
53
what are some nursing considerations for nitroglycerin
3 sprays q5min check BP each time, have pt sit bc of hypotension, teach signs of hypotension, goal 0/10 pain, OPQRSTTU, symptoms vary between gender, prophylactic use
54
how does artovastatin work?
inhibits HMG-CoA reductase and cholesterol synthesis, which reduces LDL
55
what are the uses of artovastatin
hyperlipidemia and prevention of CVD
56
what are the O/E of artovarstatin
myalgia, muscle cramps/aches (usually deal breaker)
57
what are the nursing considerations for artovastatin
routine liver assessments, take same time every day, report jaundice or muscle weakness
58
how does warfarin work
inhibit synthesis of vit. K dependant clotting factors and anticoagulant proteins
59
what are the uses of warfarin
DVT, Pul. emboli
60
what are the O/E of warfarin
bleeding, hemorrhage
61
what are some nursing considerations for warfarin
vit k is reversal agent, monitor PT = 2.0-3.5, avoid alc, grapefruit juice, sharp objects, floss gentle, teach signs of bleeding, dont increase vit. K intake (leafy greens)
62
how does heparin work
inhibits the activated coagulation factors involved in the clotting sequence (Xa, IIa). Prevents the formation of a stable fibrin clot by inhibiting activation of the stabilizing factor. Does not breakdown existing clots.
63
what are the uses of heparin
DVT, pulmonary emboli, acute MI
64
what are the O/E of heparin
Hemorrhage
65
what are some nursing considerations for heparin
protamine sulfate slow infusion = antidote | bruising, bleeding gums, no PO form
66
how does aspirin work
inhibit platelet activation and aggregation
67
what are the uses of aspirin
PAD, MI, stroke, history of MI
68
what are the O/E of aspirin
bleeding
69
what are some nursing considerations for aspirin
effects last lifetime of a platelet (7days) avoid NSAIDS, alcohol report tinnitus, bleeding educate S&S of bleeding

Pharm (9 decks)

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