Term
| What types of Cardiac Rhythm Disturbances may a patient suffer from (8)? |
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Definition
-Arrhythmias (changes from normal rate or heartbeat)
-Ectopic pacemaker
-Sinus bradycardia, tachycardia
-AV block
-Re-entry
-Atrial flutter and fibrillation
-Ventricular flutter and fibrillation
-Premature ventricular contractions (PVCs) |
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Term
| Common Diseases Associated with Arrythmias (7) |
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Definition
-Hypertension
-Cardiac valve disease
-Coronary artery disease
-Low potassium levels in blood
-Myocardial infarction
-Stroke
-Diabetes mellitus |
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Term
| What are the objectives in treating arrhythmias (4)? |
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Definition
1. Restore cardiac rhythm to normal
2. Prevent arrythmia recurrence
3. Decrease the hemodynamic consequences of arrhythmia
4. Reduce risk of sudden cardiac death |
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Term
| How are arrhythmias treated (3)? |
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Definition
-Drug therapy
-Surgical ablation of point of origin
-Manage underlying disease |
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Term
| What are the 4 classes of antiarrhythmic drugs? |
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Definition
Class 1 (A, B, and C): block fast sodium channels
Class 2: Beta blockers
Class 3: Potassium channel blockers
Class 4: Calcium channel blockers |
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Term
| Name 2 Class 1-A Sodium Channel Blockers |
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Definition
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Term
| Name 1 Class 1-B Sodium Channel Blocker |
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Definition
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Term
| Name 1 Class 1-C Sodium Channel Blocker |
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Definition
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Term
| What is the mechanism of action of the Class 1 Sodium Channel Blockers (5)? |
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Definition
-Block sodium channels
-Prolong AP
-Decrease conduction velocity
-Suppress abnormal automaticity of ectopic pacemakers
-Some also affect potassium channels. |
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Term
| What are the Class 1 Sodium Channel Blockers used for (4)? |
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Definition
-Atrial fibrillation
-Premature ventricular contractions
-Prevention of life-threatening ventricular arrhythmias
-Not for mild arrhythmias |
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Term
| ADRs of Class 1 Sodium Channel Blockers (11) |
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Definition
-May worsen existing arrhythmias
-Cinhonism (toxicity)
-Nausea
-Vomiting
-Diarrhea
-Hypotension
-Dizziness
-Confusion
-Drowsiness
-Rash
-Thrombocytopenia (low platelets) |
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Term
| Contraindications of Class 1 Sodium Channel Blockers |
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Definition
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Term
| What are the nursing considerations when administering Class 1 Sodium Channel Blockers (2)? |
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Definition
-Check apical pulse for 1 minute before administering
-Monitor BP |
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Term
| Name a Class 2 Beta Blocker |
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Definition
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Term
| What is the mechanism of action of the Class 2 Beta Blockers? |
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Definition
| They decrease heart rate which slows conduction in SA node and also ectopic pacemakers. |
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Term
| What is one advantage to using Class 2 Beta Blockers? |
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Definition
| They do not cause arrhythmias. |
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Term
| Name 2 Class 3 Potassium Channel Blockers. |
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Definition
-Amiodarone (blocks potassium and calcium channels)
-Bretylium |
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Term
| What is the mechanism of action of Class 3 Potassium Channel Blockers? |
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Definition
| They prolong action potential usually by blocking potassium channels. |
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Term
| What are Class 3 Potassium Channel Blockers used for? |
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Definition
| The prevention and treatment of ventricular arrhythmias |
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Term
| ADRs of Class 3 Potassium Channel Blockers (4) |
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Definition
-Neurotoxicity
-Sensitivity to UV light (amiodarone)
-Hypotension
-Risk of worsening arrhythmias |
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Term
| Name 2 Class 4 Calcium Channel Blockers. |
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Definition
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Term
| What is the mechanism of action of the Class 4 Calcium Channel Blockers? |
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Definition
| They slow down conduction at SA and AV nodes. |
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Term
| What are 2 Antiarrhythmics that are not included in Classes 1-4 and how do they work? |
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Definition
Adenosine- Adenosine Receptor Agonist that slows conduction in the SA and AV nodes and can interrupt reentry
Digoxin-Cardiac glycoside used to slow conduction through the SA and AV node |
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Term
| What are the nursing implications when administering antiarrhythmic drugs (14) |
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Definition
-Check BP and apical pulse before administration
-Monitor vital signs
-Monitor ECG
-Monitor kidney, liver
-Monitor serum drug levels
-Monitor electrolyte levels
-Teach patient about SEs
-Do not stop treatment abruptly
-Evenly spaced doses
-Avoid caffeine
-Reduce CV risk factors
-Medical ID tag
-Avoid alcohol
-Take with food |
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