Term
| Cardiac glycosides: list 3 different mechanisms of action |
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Definition
1) positive inotropic: increase heart contractions
2) negative chronotropic: decrease heart rate
3) negative dromotropic: decrease conduction velocity of electrical impulse
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Term
| Cardiac glycosides: Desired effect |
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Definition
| Increase cardiac output by increasing effectiveness of heart pumping (by either a positive inotropic, negative chronopic or negative dromotropic effect) |
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Term
| 2 (2) Conditions cardiac glycosides treat |
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Definition
1) heart failure
2) arrythmia: atrial flutter or atrial flibiration |
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Term
| Cardiac glycosides: routes |
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Definition
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Term
| Cardiac glycosides: give 2 examples |
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Definition
1) digitalis
2) digoxin (Lanoxin) |
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Term
| Cardiac glycosides: list 3 side effects |
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Definition
| bradycardia, nausea, vomiting, diarrhhea |
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Term
| Cardiac glycosides: 3 nursing interventions |
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Definition
1) check apical pulse before administration. Pulse should be >60 beats/min
2) encourage intake of potassium-rich food (unless otherwise supplemented)
3) Monitor blood level
4) Monitor for signs of hypokalemia (ECG will indicate a depressed T-wave)
5) Instruct to count radial pulse before taking med, should be >60bpm |
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Term
| Antidyrhythmics: List the four classes |
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Definition
I] Sodium Channel Blockers (1A, 1B or 1C)
II] Beta-adreneric blockers
III] drugs prolonging repolarisation
IV] Calcium channel blockers |
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Term
| Antidyrhythmics: 3 major side effect |
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Definition
- hypotension
- blood dyscarius (decreased WBC, RBC and platelet synthesis)
- heart failure
- anticholinergic effects
- dizziness
- nausea and vomiting
- heart block |
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Term
| Antidyrhythmics: 3 nursing interventions |
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Definition
- Administer PO with meals to reduce GI irritation
- Instruct to change positions slowley
- Instruct to increase fiber and fluid intake to prevent constipation
- IV: use cardiac monitoring, ensure there is a follow up ECG, use infusion control device for continous IV administration |
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Term
| When would an ECG be required during the course of antidyrhythmic use? |
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Definition
| As a follow up after IV administration of an antidysryhthmic |
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Term
| Cardiac Stimulants: 3 examples |
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Definition
- atropine (atropine sulfate)
- epiNEPHrine (Adrenalin) |
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Term
| Cardiac stimulants: 3 side effects |
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Definition
-tachycardia
-CNS stimulation
- cardiac dyrhythmias
- atropine: anticholinergic effects
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Term
| Cardiac stimulants: 2 actions |
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Definition
1) increase heart rate
2) indirectly OR directly affects autonomic nervous system |
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Term
| Cardiac stimulants: route (4) |
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Definition
| IM, IV, endotracheal and intracardiac preparations |
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Term
| Cardiac stimulants: 3 nursing interventions |
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Definition
- Ensure follow up ECG
- Asses vital signs during therapy
- Use cardiac monitoring during IV administration |
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Term
| Coronary vasodilators: 2 drug groups |
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Definition
- nitrates
- calcium channel blockers
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Term
| Coronary vasodilators: 5 nursing interventions |
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Definition
NGT:
-Instruct client to obtain a new supply of sublingual nitrogen every 3mths
- Instruct that there will be a slight stinging sensation after spraying under drug
- Wear gloves if spraying
- Instruct to take spray prior to activities before angina-stimulating activities
- Instruct not to exceed more than 3 sprays in 15 minutes, have intervals of 5 mins
- Assess for hypotension before administration, withhold if BP is low |
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Term
| Antihypertensives: describe 3 actions |
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Definition
1) dilaition of peripheral blood vessels to decrease peripheral resistance afterload and BP
2) reduce cardiac contractability
3) Reduce blood volume |
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Term
| Antihypertensives: List 5 drug groups |
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Definition
- ACE inhibitors
- Angiotension II receptor blockers (ARBs)
- Calcium channel blockers
- Diuretics
- Beta blockers
- Alpha1 blockers
- Alpha-beta blockers
- Central alpha2 agonists
- Direct vasodilators |
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Term
| Antihypertensives: 4 side effects |
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Definition
- Orthostatic hypotension
- Sexual disturbances (loss of vascular tone)
- Blood dyscarius
- ACEIs: dry cough
- Dizziness
- Drowziness
- Beta blockers: brochospasm and may mask hypoglycemia
- Calcium channel blockers: may cause leg oedema
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Term
| Antihypertensives: 3 nursing interventions |
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Definition
- Asses vital signs, Systolic should be over 80 mmHg
- Instruct to have a low sodium diet, restrict to 2g/ day
- Eat foods high in B- complex vitamins
- Take meds as prescribe: long-term and hypertension may rebound
- Initial: avoid hazordous activites, chang position slowly, may need to monitor urinary output
- Teach to report significant weight loss: may need to change dose |
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Term
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Definition
1) Thiazides
2) Potassium sparers
3) Loop diuretics
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Term
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Definition
- chlorothiazide (Diuril)
- hydrochlorothiazide (HydroDIURIL)
- metalozone (Zaroxolyn)
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Term
| 2 potassium-sparer examples |
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Definition
- spironolactone (Aldactone)
- triamterene (Dyrenium)
- amiloride (Midamor)
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Term
| 2 examples of loop diuretics |
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Definition
- furosemide (Lasix)
- bumetanide (Bumex)
- torsemide (Demadex) |
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Term
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Definition
- GI irritation
- hyponatraemia
- hyperuricemia (partial blockage for excretion of uric acid)
- dehydration
- hyperglycemia
- all diuretics except potassium sparers: hypokalemmia
-potassium sparers- hyperkalemia
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Term
| Diuretics: 4 nursing interventions |
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Definition
- Administer diuretics and aspirin with caution. May cause aspirin toxicity
- Monitor I&O
- Daily weighs in morning
- Assess for signs of fluid/electroyte imbalances
- Encourage intake of foods high in Ca, Zn, K and Mg
- Monitor electrolyte and glucose levels |
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Term
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Definition
| Oranges, bananas, beef, fish, peas, tomoatoes, beets, mushrooms, avocadoes, strawberries and apricots |
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Term
| Anticoagulants: routes (3) |
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Definition
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Term
| Anticoagulants: 3 examples |
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Definition
- heparin
- warfarin (Coumadin)
- dabigatran (Pradaxa)
- enoxaparin (Lovenox)
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Term
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Definition
- prevent fibrin formation: interfer with various clotting factor production of coagulation process
- Prevent platelet aggregation and clot extension
- Prevent thrombus and emolus formation
- Treat trombus and/or embolus |
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Term
| Anticoagulants: 4 side effects |
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Definition
- brochospasms
- chill
- bruising
- haemorrhage
- diarrhea
- thrombocytopenia and other blood dyscrasias |
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Term
| Anticoagulants: 6 nursing interventions |
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Definition
- heparin and warfarin: montior blood work
- Administer heparin in abdomen: DO NOT aspirate or massage area
- Have antidote
- Assess for signs of bleeding
- Instruct to carry med alert card
- Avoid meds containig aspirin
- Avoid alcohol
- Avoid herbal supplements (green tea, St. John's wart, ginseng, garlic)
- Instruct to report bleeding or injury
- Maintain safety precautions |
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Term
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Definition
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Term
OTHER:
-thrombolytics
- meds to manage hypotension shock
- antienemics
-antilipidemics
- phosphodiesterase |
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Definition
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