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Nursing > Pharm Week 8 > Flashcards

Pharm Week 8 Flashcards

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1
Q

There is no cure for Heart Failure (True of False)

A

True

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2
Q

Diseases that cause or accelerate HF

A

mitral stenosis, myocardial infarction (MI), chronic hypertension (HTN), coronary artery disease (CAD), diabetes mellitus

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3
Q

What causes cough and shortness of breath in HF

A

Blood backs up into the lungs

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4
Q

Cause of left sided HF

A

excess blood accumulates in the left ventricle, causing it to thicken and enlarge (hypertrophy) in order to compensate for the increased workload

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5
Q

Cause of right sided HF

A

excess blood backs up into veins, resulting in peripheral edema and engorgement of organs, such as the liver

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6
Q

What should a nurse monitor in HF and diuretic therapy

A

electrolyte levels, weakness, hypotension, confusion, vital signs, intake and output, blood glucose , blood-urea nitrogen (BUN)

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7
Q

What is the max amount of sodium a heart failure pt should intake

A

4000mg daily

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8
Q

ACE inhibitors

A

lisinopril, captopril, zestril

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9
Q

ACE inhibitor side effects

A

cough, headache, dizziness, orthostatic hypotension, first-dose phenomenon, hyperkalemia; Serious adverse effect-angioedema*

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10
Q

contra-indications of ACE inhibitors

A

hyperkalemia

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11
Q

Labs to monitor while on ACE inhibitors

A

BUN, creatinine, K+

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12
Q

Mechanism of action in ACE inhibitors

A

inhibits conversion of angiotensin I to angiotensin II and decreases aldosterone secretion; BP is decreased and CO is increased

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13
Q

What blocks the action of ACE inhibitors

A

NSAIDS

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14
Q

Cardiac glycosides

A

digoxin and lanoxin

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15
Q

MOA of cardiac glycosides

A

increases contractility of heart and slows conduction which improves cardiac output

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16
Q

Adverse effects of cardiac glycosides (digoxin and lanoxin)

A

n/v dysrythmia, visual disturbances(halos,yellow-green tinge, blurring)
Serious adverse effect: dysrhythmias especially in the presence of hypokalemia**

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17
Q

Metoprolol side effects

A

bradycardia, orthostatic hypotension, abnormal sexual function, drowsiness, fatigue

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18
Q

Contra-indications of metoprolol

A

asthma, COPD

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19
Q

which drug enhances effects of hypoglycemics

A

metoprolol

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20
Q

Electrical conduction pathway

A

sinoatrial (SA) node, across both atria>atrioventricular (AV) node> atrioventricular bundle (bundle of His)>to the right and left bundle branches>Purkinje fibers

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21
Q

What is the most common type of dysrthymia

A

Atrial fibrillation

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22
Q

Types of Dysrhythmias

A

Premature atrial contraction (PAC)
Premature ventricular contractions (PVC)
Ventricular tachycardia(VT)
Atrial flutter (AF)
Atrial fibrillation (A Fib)
Sinus bradycardia (SB)
Heart block (1st, 2nd, 3rd degree)

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23
Q

When does generation of the action potential

A

begins when sodium-ion channels open and sodium ions rush in

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24
Q

Depolarization (contraction)

A

calcium-ion channels open and calcium ions enter the cell, stimulating cardiac-muscle cells, SA and AV cells depolarize in response to calcium-ion influx

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25
Q

Repolarization (resting)

A

return to a polarized state, sodium pump removes sodium from the cell, potassium-ion channel

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26
Q

Nonpharmacological therapies for dysrhythmias

A

Cardioversion and defibrillation-(ventricular tachycardia, ventricular fibrillation)electrical shock that stops all electrical impulses in the heart and allows the sinoatrial node to regain control
Catheter ablation- identifies and destroys aberrant cardiac cells that cause dysrhythmias
Cardiac pacemaker-paces the heart at a set rate
Implantable cardioverter defibrillators (ICDs)-combination of pacemaker and defibrillator

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27
Q

Sodium-ion-channel blockers (Class IA)

A

procainamide, quinidine

28
Q

Side effects of sodium channel blockers (procainamide, quinidine)

A

hypotension, headache, cardiotoxicity

29
Q

Labs to monitor on Sodium channel blockers

A

CBC-neutropenia, TPC

30
Q

Beta-adrenergic blockers (Class II)

A

propranolol, esmolol

31
Q

Primary use of propanolol, esmolol

A

treatment of tachycardia, hypertension, angina, migraines, prevention of MI

32
Q

Adverse effects of propanolol and esmolol

A

bradycardia, hypotension, fatigue, diminished libido; masks hypoglycaemia for those taking insulin

33
Q

Contra-indication of beta blockers

A

asthma

34
Q

When to hold beta blockers

A

Pulse < 60

35
Q

Mechanism of action of potassium channel blockers

A

decreases contractility & dilates blood vessels

36
Q

Potassium channel blockers

A

amiodarone

37
Q

Side effects of amiodarone

A

blurred vision, rashes, photosensitivity, n/v, fatigue, dizziness, hypotension BBW* pumonary toxicity

38
Q

Calcium channel blockers (Class IV)

A

verapamil, diltiazem

39
Q

Side effects of calcium channel blockers

A

bradycardia, orthostatic hypotension, heart failure, flushed skin, constipation, edema

40
Q

Drug interactions of calcium channel blockers

A

increased effects of digoxin toxicity; no statins- increases muscle pain

41
Q

mechanism of action of calcium channel blockers

A

slows conduction velocity, lowers blood pressure, reduces cardiac workload

42
Q

how long does it take normal clotting to occur

A

6 minutes

43
Q

deficiency of platelets < 100,000

A

Thrombocytopenia

44
Q

bleeding disorders caused by genetic deficiencies in specific clotting factors

A

Hemophilias

45
Q

inhibit specific clotting factors, thereby inhibiting the aggregation of these cells, preventing Clots from forming or growing larger

A

Anticoagulants

46
Q

Parental anticoagulant

A

Heparin

47
Q

MOA of heparin

A

Inhibits thrombin activity,prevents enlargement or formation of clots (does not dissolve clots)

48
Q

Side effects of heparin

A

abnormal bleeding and heparin-induced thrombocytopenia (HIT), results in the opposite effect of excessive bleeding

49
Q

Heparin BBW

A

do not administer to patients with an epidural or will cause hematoma

50
Q

Heparin OD

A

protamine sulfate- reverses in 5 minutes

51
Q

Oral anticoagulant

A

Warfarin (Coumadin)

52
Q

MOA of Warfarin

A

inhibits the action of vitamin K

53
Q

Primary use of warfarin

A

prevent stroke, MI, DVT, and pulmonary embolism

54
Q

side effect of warfarin

A

abnormal bleeding

55
Q

Nursing for warfarin

A

monitor PT/ INR; Avoid vitamin K supplements and protein supplement drinks, and limit intake of garlic

56
Q

Warfarin OD

A

Vitamin K- reverses in 6 hrs

57
Q

Antiplatelet, ADP-receptor blockers

A

clopidrogrel (Plavix)

58
Q

MOA of clopidrogel

A

inhibiting ADP from binding to its receptor

59
Q

primary use of clopidrogel

A

prevent thromboembolic events in patients with a recent history of MI, CVA, or peripheral artery disease

60
Q

side effects of clopidrogel

A

abnormal bleeding, flulike syndrome, headache, dizziness, bruising, and rash or pruritus, tcp

61
Q

Thrombolytic

A

altepase (Activase)

62
Q

MOA of altepase

A

dissolves the clot

63
Q

side effect of altepase

A

abnormal bleeding

64
Q

contra indications of altepase

A

hemorrhage, CVA, recent trauma or surgery, aneurysm

65
Q

Nursing for altepase

A

check vs q 15 minutes, bedrest, hold pressure x 30 minutes, no IM/SQ injections

Nursing (11 decks)

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