Question/Answers Flashcards
Outpatient setting , afib , stable , what med to use
This patient is hemodynamically stable with a complaint of palpitations caused by atrial fibrillation, and thus does not require hospitalization. Beta blockers or calcium channel blockers are first-line treatment for rate control for a patient who is hemodynamically stable. Amiodarone has a relatively slow onset and is most useful as an adjunct when rate control with beta blockers or calcium channel blockers is incomplete or contraindicated or when cardioversion is planned. Procainamide, due to multiple side effects, is rarely used, and dofetilide must be initiated in the hospital due to potential risk of torsades de pointes.
AA with DM and HTN and proteinuria
According to guidelines for the management of hypertension by the Eighth Joint National Committee, patients of all ages who have evidence of kidney disease, with or without diabetes and regardless of race, should be treated with an ACE-inhibitor or ARB, either alone or in combination with antihypertensive medications of other drug classes. For African American patients with proteinuria, the use of an ACEI or ARB is especially important given a higher likelihood of progression of renal disease to end-stage. Hydrochlorothiazide is the recommended initial treatment of clients of all ages and races without kidney dysfunction.
