Unit 3: Ch 52 & 54 Flashcards by Taya Schreiter

What is a dysrhythmia?

abnormality in the rhythm of the heartbeat

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What is a supra ventricular dysrhythmia?

impulse arises above the ventricle
Causes atrial flutter or fibrillation

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What is a ventricular dysrhythmia?

Premature ventricular complexes
causes ventricular fibrillation

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How do you minimize the risks of using antidysrhythmic drug therapy?

start doses low and increase slowly
Relate to good baseline data (Holter)
Monitor drug levels with labs

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What is the Class I antidysrhythmic drugs?

Sodium Channel Blockers

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Which med class is Lidocaine apart of?

Sodium Channel Blockers

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What are the therapeutic effects of Lidocaine?

ventricular dysrhythmias

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What are the adverse effects of Lidocaine?

CNS effects
Paresthesias

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What is the Class II antidysrhythmic drug?

Beta Blockers

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Which med class is Propranolol apart of?

Beta Blockers

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What effects does Propranolol have on the heart?

block cardiac beta 1 receptors
decreased automaticity of SA node
decreased AV conduction velocity
decreased myocardial contractility

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What are the therapeutic uses of Propranolol?

dysrhythmias caused by excessive sympathetic stimulation of heart

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What are the adverse effects of Propranolol?

heart block
HF
AV block
Sinus arrest
Hypotension
Bronchospasm
Increased glucose levels

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What is the class III antidysrhythmic drugs?

Potassium Channel Blockers

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Which med class is Amiodarone apart of?

Potassium Channel Blockers

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What are the therapeutic uses of Amiodarone?

For life-threatening ventricular dysrhythmias
Recurrent ventricular fibrillation

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What are the adverse effects of Amiodarone?

Cardiotoxicity
Toxicity in pregnancy and breast feeding
corneal microdeposits
optic neuropathy

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Are levels of Amiodarone increased or decreased with grapefruit juice?

Increased

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When taking Amiodarone with diuretics, does the risk for dysrhythmias increase or decrease?

Increase

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Does combining amiodarone with a beta blocker, verapamil, or diltiazem lead to excessive bradycardia or tachycardia?

Excessive bradycardia

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What med class is Verapamil and Diltiazem apart of?

Class IV: Calcium Channel Blockers

What is the mechanism of action for Verapamil and Diltiazem?

Reduce SA nodal automaticity
Delay AV nodal conduction
Reduce myocardial contractility

What are the therapeutic effects of Verapamil and Diltiazem?

Slows ventricular rate

What are the adverse effects of Verapamil and Diltiazem?

Bradycardia
Hypotension
AV block
HF
Peripheral edema
Constipation

What kind of dysrhythmias does Digoxin help treat?

Supraventricular dysrhythmias

What is the main adverse effect of Digoxin?

Cardiotoxicity

The nurse is administering intravenous lidocaine [Xylocaine] to a patient with a ventricular dysrhythmia. What is the priority nursing intervention to prevent a potential complication with this drug? A. Monitor the electrocardiogram (ECG). B. Obtain a complete blood count. C. Instruct to report any chest pain. D. Keep naloxone [Narcan] at the bedside.

What is oxygen demand?

HR Myocardial contractility Intramyocardial wall tension (preload/afterload)

What entails oxygen supply?

Myocardial blood flow Myocardial perfusion only in diastole

What is chronic stable angina?

chest pain triggered by activity

What causes chronic stable angina?

Coronary artery disease (CAD)

What is the treatment for chronic stable angina?

increase cardiac oxygen supply decrease oxygen demand

What are the drug therapies of chronic stable angina?

Organic nitrates Beta blockers Calcium Channel Blockers

What causes Prinzmetal's Angina?

coronary artery spasm (pain not related to exercise)

What is the treatment for Prinzmetal's Angina?

Increase oxygen supply

What are the drug therapies of Prinzmetal's Angina?

Calcium channel blockers Organic nitrates

What causes Unstable Angina?

Severe CAD complicated by vasospasm

How can unstable angina be managed?

maintain oxygen supply decrease oxygen demand

Which drugs are apart of anti-ischemic therapy in unstable angina?

nitrates beta blockers oxygen ACE inhibitor

What drugs are apart of anti platelet and anticoagulant therapy in unstable angina?

aspirin anticoagulants

What is the action of Nitroglycerin?

Vasodilator Relaxes or prevents spasm in coronary arteries

Does Nitroglycerin reduce oxygen demand?

What are the adverse effects of Nitroglycerin?

Headache Orthostatic Hypotension Reflex tachycardia

What is the main precaution of Nitroglycerin?

Tolerance develops quickly

What are the drug interactions of Nitroglycerin?

Hypotensive drugs Beta blockers CCBs PDE-5 Inhibitors

What are the instructions for using sublingual nitrate tablets?

Take one tablet sublingually, wait 5 minutes before taking another but assess pain. If pain is still persistent after 2 dose call 911

What is isosorbide dinitrate used for?

Angina

What type of angina are beta blockers used to treat?

stable angina

What type of angina are CCBs used to treat?

stable and variant angina

A patient with angina pectoris is prescribed sublingual nitroglycerin. Which of the statements made by the patient indicates understanding of the medication teaching? A. “I may experience a headache as a side effect.” B. “The chest pain should be relieved within 20 minutes.” C. “I should swallow the tablet.” D. “I should take this medication in the morning before breakfast.”

A patient is prescribed a nitroglycerin transdermal patch. The nurse will teach the patient to: A. apply the patch to the chest over the heart. B. change the patch each week. C. remove the patch at night. D. use the patch to prevent exercise-induced chest pain.

Which medication is the treatment of choice for ST-segment elevation myocardial infarction (STEMI)–associated pain? A. Aspirin B. Lorazepam [Ativan] C. Morphine D. Hydromorphone hydrochloride [Dilaudid]