Antiarrhythmic Agents - General

Question 1

Phase 0

Answer 1

• Sodium ions move into cells

- Depolarization

Question 2

Phase 1

Answer 2

• Potassium ions move out of the cells

- Plummet

Question 3

Phase 2

Answer 3

• Calcium ions move into the cells

- Contraction

Question 4

Phase 3

Answer 4

• Potassium ions move out of the cells

- Repolarization

Question 5

Phase 4

Answer 5

-Back at rest and ready to start over again

Question 6

Causes of cardiac arrhythmias

Answer 6

• Electrolyte disturbances that alter the action potential
• Decreases in oxygen delivered to the cells
• Structural damage changing the construction pathway through the heart
• Acidosis or accumulation of waste products altering the action potential
• Drugs that alter the action potential

Question 7

Types of cardiac arrhythmias

Answer 7

• Tachycardia
• Bradycardia
• Premature atrial contractions (PACs) and premature ventricular contractions (PVCs)
• Atrial flutter
• Atrial fibrillation or ventricular fibrillation
• Alterations in conductions through the muscle

Question 8

Considerations for children

Answer 8

• Monitor closely- more likely to experience ADE
• Digoxin is approved in children
• Dosages should be based on age and weight

Question 9

Considerations for adults

Answer 9

• Used frequently during emergencies
• Monitor frequently
• Avoid use in pregnancy and lactation

Question 10

Considerations in older adults

Answer 10

• Frequently prescribed
• More likely to experience ADE
• Start at a lower dose

Question 11

Other drugs used to treat arrhythmias

Answer 11

• Adenosine
• Digoxin
• Dronedarone

Question 12

Adenosine

Answer 12

-Used to convert supraventricular tachycardia to sinus rhythm when vagal maneuvers have been ineffective

Question 13

Digoxin

Answer 13

-Slows calcium from leaving the cell, prolonging the action potential and slowing conduction and HR

Question 14

Dronedarone

Answer 14

-Used to reduce risk of hospitalization in patients with paroxysmal or persistent AF or flutter who have risk factors for CVD and are in sinus rhythm or scheduled to be converted to sinus rhythm

Question 15

Assessment

Answer 15

• History: check for any contraindications or cautions

- Physical: neurological and cardiac status, respirations, baseline ECG, and appropriate lab values

Question 16

Nursing diagnoses

Answer 16

• Decreased CO r/t cardiac effects
• Disturbed sensory perception r/t CNS effects
• Risk for injury r/t adverse drug effects
• Deficient knowledge regarding drug therapy

Question 17

Implementation

Answer 17

• Titrate the dose to the smallest amount needed to achieve control of the arrhythmia
• Continually monitor cardiac rhythm
• Ensure emergency life-support equipment is readily available
• Consult with provider to reduce dose in patients with renal or hepatic dysfunction
• Establish safety precautions
• Provide pt teaching

Question 18

Evaluation

Answer 18

• Evaluation patient response to the drug (alleviation of signs and symptoms of heart failure)
• Monitor for adverse effects
• Evaluate the compliance with the regimen
• Evaluate the effectiveness of the teaching plan