Term
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Definition
| condition which the heart fails to effectively pump enough blood to meet the demands of the body |
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Term
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Definition
involves helping the heart muscle to contract more efficiently to bring system back in balance
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Term
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Definition
coronary artery disease, cardiomyopathy, HTN, diabetes, mitral valve stenosis, drugs and alcohol
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Term
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Definition
| Stroke Volume x Heart Rate; volume of blood pumped by heart per minute |
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Term
decreased cardiac output, increases preload, increases afterload, decreases contractility and stroke volume;
chronic, acute, progressive
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Definition
decreased cardiac output, increases preload, increases afterload, decreases contractility and stroke volume;
chronic, acute, progressive
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Term
amount of blood present in left ventricle before contraction
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Definition
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Term
mean arterial pressure which is a component of blood pressure; the pressure that the heart must overcome to eject blood to rest of the body
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Definition
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Term
more force/squeeze the heart will be able to pump more blood/beat therefore increasing the stroke volume which will increase cardiac output
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Definition
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Term
amount of blood ejected from left ventricle (55-65%); with each heart beat 55-60% of blood is pumped out of ventricle; 40-45% remains in heart
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Definition
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Term
dyspnea, tachypnea, orthopnea, increased pulmonary edema, paroxysmal nocturnal dyspnea, rales, hemoptysis, anxiety, GI upset
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Definition
| s/s Left Side Heart Failure |
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Term
elevated jugular veins, peripheral edema, gut edema, lead to liver congestions
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Definition
| s/s Right Side Heart Failure |
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Term
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Definition
| inatropic/cardiotonic vasodilators, ACE inhibitors, ARBS diuretics, beta-adrenergic antagonists |
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Term
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Definition
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Term
Increases intracellular calcium by allowing more calcium to enter the myocardial cell during depolarization. Has a positive inotropic effect on the heart. Increases the heart's contractions (inotropic effect) and will also slow the heart rate (chronotropic effect); negative dromotropic effect (decrease in conduction activity of current); increased renal profusion with diuretic
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Definition
Cardiac Glycoside Actions- Digoxin (Lanoxin)
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Term
lGastrointestinal (GI) disturbances (anorexia, nausea, vomiting, diarrhea)
lVisual disturbances - blue green halo
lBradycardia
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Definition
| Side effects, toxic effects of Cardiac Glycosides |
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Term
lMonitor for toxicity; digoxin level above 2 ng/mL
lMonitor potassium level for hypokalemia
lMonitor apical pulse; if less than 60/min, hold medication, notify physician
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Definition
| Interventions for Cardiac Glycosides |
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Term
Cardiac Glycoside: Pharmokinetics
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Definition
| rapidly absorbing and widely distributed throughout the body |
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Term
Cardiac Glycoside: Contraindications
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Definition
| AV block, hypersensitivity, uncontrolled ventricular arrythmias |
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Term
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Definition
| heart failure, Atrial Fibrillation, Atrial Flutter, Atrial Tachycardia, superventricular dysrhythmias, cardiogenic shock |
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Term
Positive inotrope: increased systolic emptying, strong chronotropic effect, depresses SA node, slows AV node conduction, used to control/Tx Afib/flutter, CHF, and PAT
*VERY SMALL MARGIN OF SAFETY*
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Definition
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Term
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Definition
IV: 0.6-1 mg, 50%, 4-8 hrs
PO: 0.75-1.25 mg, 50%, 4-8 hrs
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Term
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Definition
| headache, weakness, drowsiness, confusion, visual disturbances, dysrhythmias, anorexia, N/V/D, hypotension |
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Term
headache, weakness, drowsiness, confusion, visual disturbances, dysrhythmias, anorexia, N/V/D, hypotension
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Definition
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Term
-increased digoxin levels: propantheline, quinidine, verapamil, anticholinergics
-increased bradycardia: B-adrenergic blockers, antidysrhythmics
-increased cardiac dythrythmic risk: sympathomimetics
-increased digoxin action: aloe, licorice, purple foxglove, rhubarb
-increased hypokalemia: coffee, cocoa, cola, licorice
-decreased digoxin absorption: antacids, kaolin/pectin, psyllium
-decreased digoxin levels: thyroid agents, cholestyramine, colestipol
-decreased digoxin effect: St. John's Wort
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Definition
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Term
Therapeutic digoxin levels 0.5-2ng/mL
s/s: anorexia, N/V, malais, depression, irregular heart rhythms
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Definition
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Term
Therapeutic digoxin levels 0.5-2ng/mL
s/s: anorexia, N/V, malais, depression, irregular heart rhythms
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Definition
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Term
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Definition
-apical pulse for 1 minute: hold for <60 in adults, <90 in infants
-note apical rate, rhythm, character
-monitor cardiac, ECG, lab work, I&O, skin turgor, edema
-assess lung sounds
-obtain digoxin levels
-have RN check calculations protect from light |
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Term
-admin close same time each day
-auscultate for 1 full minute
-assess perfusion of lung sounds
-monitor ECG
-observe for side effects
-obtain daily weight, intake, and output
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Definition
| Implications for Pt Receiving Cardiotonic Meds |
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Term
Phosphodiesterase Inhibitors: Classification
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Definition
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Term
Phosphodiesterase Inhibitors: Classification
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Definition
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Term
-Inamrinone (Inocor): approved only for use in patients with HF that has not responded to digoxin, diuretics, or vasodilators
-Milrinone (Primacor): short term management of HF in patients recieving digoxin and diuretics
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Definition
| Phosphodiesterase Inhibitors: Types |
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Term
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Definition
-increase urine flow
-reduce blood volume and cardiac workload
-reduce edema and pulmonary congestion
-perscribed in combination with other drugs
-used in symptomatic patients to reduce fluid retention
-instruct patients to monitor weight
-monitor K and magnesium levels; oral supplements may be required
-keep patients free of volume overload |
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Term
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Definition
Has a Narrow Theraputic Index 0.5-0.2ng/mL
-Digitalization- build up of digoxin in he body, takes 7 days
-Hold the dose if heart rate is below 60bpm
-You would administer digibind for Digoxin toxicity |
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