Term
|
Definition
| amount of blood ejected from left ventricle with each contraction |
|
|
Term
|
Definition
| volume of blood pumped from left ventricle in 1 minute. |
|
|
Term
|
Definition
| amount of stretch exerted on left ventricle |
|
|
Term
|
Definition
| the amount of pressure the left ventricle must pump against to eject blood into system circulation |
|
|
Term
| Perpherical vascular resistance |
|
Definition
| diameter of systemic vessels and the pressure within them |
|
|
Term
|
Definition
weakens, enlarges, and loses the ability to pump
peripheral tissues and lungs are congested
myocardial hypertrophy; cardiomegaly |
|
|
Term
|
Definition
chronic hypertension
myocardial infarction
coronary artery disease
valvular heart disease
congenital heart disease
aging |
|
|
Term
| Pharmalogical treatment goals for heart failure |
|
Definition
increases contractility
decreases preload and afterload
decreases edema
decreases sluggish movement of blood
decrease sympathetic response |
|
|
Term
| Pharmacologic meds used for heart failure |
|
Definition
| digoxin, inotropic agents, diuretics, beta blockers, ace inhibitors, angiotensin receptor blockers, calcium channel blockers, and vasodilators |
|
|
Term
Postive inotropic Agents
what does it do?
examples? |
|
Definition
increase the force of contractions
Phosphodiesterase Inhibitors (Inocor,Primacor) |
|
|
Term
|
Definition
decrease peripheral vascular resistance by relaxing vessel walls
causes arterial vasodilaion - some may cause venous dilation |
|
|
Term
|
Definition
Nitrates (Isosorbide; nitroglycerine)
Isosorbide is taken orally
Nitroglycerine can be taken sublingual or can be in patch form |
|
|
Term
| Nursing Consideration for Vasodilators |
|
Definition
- watch for headache dizziness, syncope
- go from lying to standing position slowly
- keep meds in dry dark container to prevent deterioration
- remove old paste and patches before applying new ones
nitroglycerin- sublingually
isosorbide- oral |
|
|
Term
| Alpha Adrenergics Blockers |
|
Definition
- blocks alpha 1 adrenergic receptors which results in vasodilation
- decreases bad cholesterol and increase good (HDL)
|
|
|
Term
| Examples of Alpha Adrenergics Blockers |
|
Definition
| Cardura, minipress, hytrin |
|
|
Term
| Nursing consideration of Alpha Adrenergics Blockers |
|
Definition
- watch for headache, dizziness, and syncope
- give at bedtime
- tachycardia may occur due to sudden drop in b/p
- sodium and water retention may occur- give diuretics
- Watch out for decrease myocardial contractility- indicates heart failure
- nasal congestion and gi disturbances may also occur
|
|
|
Term
|
Definition
block beta 1 adrenergic receptors: result vasodilation
reduce renin release from the kidneys
some also block beta 2 receptors; non-therapeutic |
|
|
Term
| S/S of Beta Adrenergic Blockers |
|
Definition
headache, dizziness, syncope
bradycardia
fatigue- usually 1st complaint; will go away
some- may cause bronchoconstriction with wheezing |
|
|
Term
| Actions of Beta Adrenergic Blockers |
|
Definition
vasodilation
reduces renin release from kidneys |
|
|
Term
| Examples of Beta adrenergic blockers |
|
Definition
Selective Beta 1 blockers
atenolol(Tenormin)
metoprolol(Lopressor, Toprol)
Nonselective Beta 1 & Beta 2 blockers
Nadolol(Corgard)
propranolol Hcl(Inderal) |
|
|
Term
| Alpha 1 and Beta 1 Adrenergic Blockers |
|
Definition
| block the sympathetic effect on alpha 1 and beta 1 receptors |
|
|
Term
| Nursing considerations for Alpha 1 & Beta 1 Adrenergic Blockers |
|
Definition
orthostatic hypotension
fatigue |
|
|
Term
|
Definition
- inhibit influx of calcium ions
- decrease free calcium
- decrease perpherial vascular resistance: vasodilation
- decrease myocardial contractility
- Ca partially responsible for MI
- works better in African americans
|
|
|
Term
| side effects of CCBlockers |
|
Definition
orthostatic hypotension:headaches dizziness and syncope
bradycardia |
|
|
Term
| Nursing consideration for CCBlockers |
|
Definition
avoid grapefruit and grapefruit juice (toxic)
watch for signs of heart failure: decrease myocardial contractility |
|
|
Term
Renin Angiotensin System Drugs (PRIL)
Ace inhibitors |
|
Definition
block conversion of angiotensin 1 to angiotensin 2
decrease release of aldosterone
excrete sodium and water
retains potassium
should be used with diuretics |
|
|
Term
| side effects of RAS Ace inhibitors |
|
Definition
postural hypotension
renal insufficiency
nonproductive cough
hyperkalemia |
|
|
Term
| Renin Angiotension system drugs (ARBS) |
|
Definition
block the binding of angiotensin 2 receptors in vascular smooth muscle and adrenal glands
block vasoconstricting effect of angiotensin 2
decrease release of aldosterone
promotes sodium and water excretion
retain potassium |
|
|
Term
| Side effects/Nursing considerations of RAS (ARBS) |
|
Definition
watch for headaches dizziness syncope
angioedema
tickling sensation in throat or dry cough
elevated k+, BUN, CR
pt will need diuretic
avoid K+ supplements and food |
|
|
Term
| Central Acting Adrenergic Blockers |
|
Definition
cause vasodilation+++
suppress sympathetic activity in medulla of the brain
Alpha 2 agonist
less norepinephrine is released |
|
|
Term
| Nursing considerations and side effects of Central acting adrenergic blockers |
|
Definition
drowsiness, mental depression
bradycardia
impotence
urinary retention
edema
dry mouth |
|
|
Term
| Direct Acting Vasodilators |
|
Definition
decrease b/p
relax smooth muscles of arteries; vasodilation
very potent++++ |
|
|
Term
| Nursing consideration and side effects for direct-acting vasodilators |
|
Definition
used in emergency situations
sodium and water retained+++
tachycardia
nasal congestion |
|
|
Term
|
Definition
- considered to be safe
- stops synthesis of lipids in the liver
- helps lowers cholesterols
- stop absorption of cholesterol in small intestine
- stops release of fatty acids from adipose tissue
- increase metab. of triglycerides
- binds with acids in small intestine
- cholesterol gets excreted in feces
- stimulates the breakdown of liproproteins
|
|
|
Term
|
Definition
| animals fats, shellfish, oils, egg yolks |
|
|
Term
|
Definition
| animal fats, oils, simple sugars |
|
|
Term
| How can you increase HDL's naturally |
|
Definition
|
|
Term
total cholesterol
ldl
hdl
triglycerides |
|
Definition
less than 200mg/dl
100-129
50mg
less than 150mg/dl |
|
|
Term
| Nursing consideration for antilipemics |
|
Definition
hepatoxic- have liver check 3 months
Rhabdomylosis- report pain or weakness (body fails rapidly, muscle wasting)
pregnancy category x
should be taking in evening because cholesterol is made at night |
|
|
Term
|
Definition
induces diuresis
increases urine output
decrease circulating fluid volume
increases intraocular pressure
treats HTN, peripheral edema, cerebral edema, ascites, renal insufficiency |
|
|
Term
| What can occur with Diuretics? |
|
Definition
| Fluid, acid-base, electrolyte disturbances can occur |
|
|
Term
|
Definition
| act on the tubule of kidney inhibit sodium and chloride, water reabsorption treats mild HTN, peripheral edema with renal function. water, sodium, chloride, potassium, magnesium, and bicarb excreted |
|
|
Term
| What are THiazide/ THiazide-like diretics derived from? |
|
Definition
|
|
Term
| WHat can be elevated with THiazide/Thiazide Diuretics? |
|
Definition
| calcium, uric acid, glucose, & serum lipids |
|
|
Term
|
Definition
- can be used with renal dysfuction.
- has a different chemical makeup
- same therapeutic activity
|
|
|
Term
| Nursing considerations for THiazide/Thiazide-like |
|
Definition
give in am
monitor urine output, b/p
monitor weight
monitor serum sodium, chloride, potassium, mg, ca, uric acid, glucose and lipids
urine alkaline- increase chance of uti
teach pt to eat foods high in potassium and magnesium.
++notify dr if the pt gain more than two pounds
++wear same amount of clothing, same time, same scale |
|
|
Term
| Carbonic Anhydrase Inhibitors |
|
Definition
blocks enzyme carbonic anhydrase
useful in treatment of glaucoma
mild diuretic
excretes hydrogen
blocks water, sodium, bicarb excretion |
|
|
Term
| Nursing considerations for CAI's |
|
Definition
monitor urine output
monitor sodium, potassium, bicarb,
calcium, glucose, uric acid-may increase
watch out for crystalluria- renal stones |
|
|
Term
|
Definition
prevents thromboembolism
inactivates factor XA and thrombin in clotting cycle
lower risk of bleeding than heparin
used for immobility
+++hold pressure for a while
++frequently lab monitoring is not necessary
assess for bleeding
ex: Lovenox |
|
|
Term
|
Definition
prevents stroke and MI in pts with atrial fibrillation
not used in valvular disease
direct thrombin inhibitor |
|
|
Term
| Nursing consideration for Pradaxa |
|
Definition
assess for bleeding, bruising, dizziness, weakness
OTC medications, other medications
gastric ulcers, indigestions, stomach upset/burning, pain
unexpected swelling, pain or joint pain
lab work monitoring unnecessary
Pregnancy X
Take with food or without food |
|
|
Term
|
Definition
used for nonvalvular atrial fibrillation, treatment of and reduction of DVT & PE.
prophylaxis for DVT in knee and hip replacement surgery
Inhibits Factor XA |
|
|
Term
| Nursing considerations for Xarelto |
|
Definition
assess for bleeding, bruising, headaches, dizziness, weakness
otc medications
pain, swelling, new wound drainage
pregnancy X
take in evening with meals or without |
|
|
Term
| First line of treatment for a pt blood pressure? |
|
Definition
|
|
Term
| If a pt is taking a statin drug, you should watch for which adverse reaction? |
|
Definition
|
|
Term
| Why are beta blockers effective as antianginals |
|
Definition
| because they decrease heart rate and decrease myocardial contractility |
|
|
