1
Q
Dysrhythmias
A
- also known as arrhythmias are abnormal heart rhythms that can affect the heart’s ability to pump blood effectively
2
Q
Types of Dysrhythmias
A
- Atrial fibrillation, ventricular tachycardia, bradycardia
3
Q
Class 1 Dysrhythmias
A
Sodium channel blockers (ex: quinidine, lidocaine)
4
Q
Class 2 Dysrhythmias
A
Beta-Blockers (ex: propranolol, metoprolol)
5
Q
Class 3: Dysrhythmias
A
Potassium channel blockers (e.g., amiodarone, sotalol)
6
Q
Class 4(IV): Dysrhythmias
A
Calcium channel blockers (e.g., verapamil, diltiazem)
7
Q
Sodium Channel Blockers Mechanism of action
A
Block sodium channels, reducing the
rate of depolarization and
conduction velocity in the heart.
8
Q
Nursing Considerations Sodium Channel Blockers
A
Monitor ECG for changes, assess for signs
of toxicity, and educate patients
about potential side effects
such as dizziness and nausea.
9
Q
Class 2: Beta Blockers Mechanism of Action
A
Block beta-adrenergic receptors,
reducing heart rate and contractility.
10
Q
Beta Blocker uses:
A
Used to manage hypertension, angina, and certain arrhythmias.
11
Q
Beta Blocker Nursing Considerations
A
Monitor blood pressure and heart rate,
assess for signs of bradycardia, and educate patients about potential side effects such as fatigue and cold extremities.
12
Q
Potassium Channel Blockers Mechanism of Action
A
Block potassium channels, prolonging
repolarization and the refractory
period in the heart.
13
Q
Potassium Channel Blockers Nursing Considerations
A
Monitor ECG for changes, assess for signs
of toxicity, and educate patients
about potential side effects
such as dizziness and nausea.
14
Q
Potassium Channel Blockers uses
A
Used to treat ventricular and atrial arrhythmias.
15
Q
Calcium Channel Blockers mechanism of action
A
Prevent calcium from entering cells of the heart and blood vessel walls, leading to relaxation of blood vessels.
16
Q
Calcium Channel Blockers uses
A
Effective in lowering blood pressure
and treating certain heart conditions.
17
Q
Calcium Channel Blockers Nursing Considerations
A
Monitor blood pressure and heart rate, assess for signs of peripheral edema, and educate patients about potential side effects such as dizziness and constipation
18
Q
Digoxin Mechanism of action
A
Increases the force of myocardial contraction (positive inotropic effect) and
slows the heart rate (negative chronotropic effect)
19
Q
Digoxin Uses
A
Used to treat heart failure and atrial fibrillation.
20
Q
Digoxin Nursing Considerations
A
Monitor serum digoxin levels,
assess for signs of toxicity (nausea, vomiting, visual disturbances), and educate patients about potential
side effects.
21
Q
Adenosine Mechanism of Action
A
Slows conduction through the
AV node, restoring normal sinus rhythm in
supraventricular tachycardia (SVT).
22
Q
Adenosine uses
A
Used to treat paroxysmal supraventricular tachycardia (PSVT)
23
Q
Adenosine Nursing Considerations
A
Monitor ECG during
administration, assess for signs of bradycardia or hypotension, and educate patients about potential side effects such as flushing and chest discomfort
24
Q
Baseline Nursing Assessments for Dysrhythmias
A
-Vital Signs
- Electrocardiogram (ECG)
-Patient History
- Physical Examination
25
Nursing interventions for Dysrhythmias
-Monitoring: Continous ECG
-Medication Administration: Administering antidysrhythmic medication
-Patient Education: teaching pt about their condition
26
Class 1: Sodium Channel Blocker AE
Dizziness, headache, nausea, and
potential for proarrhythmia.
27
Class 2: Beta Blockers AE
Fatigue, bradycardia, hypotension, and
bronchospasm
28
Class 3: Potassium Channel Blockers AE
Thyroid dysfunction, pulmonary
toxicity, liver toxicity, and proarrhythmia
29
Class IV: Calcium Channel Blockers AE
Constipation, dizziness, hypotension,
and bradycardia.
30
Other (Digoxin, Adenosine) AE
Nausea, vomiting, visual disturbances
(digoxin), and transient asystole (adenosine).
31
Six Cardinal Signs of Cardiovascular Disease
*Chest Pain
* Dyspnea (Shortness of Breath)
* Fatigue
* Palpitations
* Syncope (Fainting)
* Edema (Swelling
32
Angina Pectoris
Angina pectoris is chest pain or discomfort caused by reduced blood
flow to the heart muscle.
33
Causes of Angina Pectoris
Often due to coronary artery disease
(CAD).
34
Assessment Data for evaluating an anginal Attack
-Pain Characteristics: Location,
intensity, duration, and quality of pain.
-Precipitating Factors: Activities or
events that trigger the pain.
-Associated Symptoms: Shortness of
breath, nausea, sweating, dizziness.
-Vital Signs: Blood pressure, heart rate,
respiratory rate.
35
Chronic Stable Angina
Predictable chest pain that occurs with exertion or stress and is relieved by rest or nitroglycerin.
36
Unstable Angina
Unpredictable chest pain that
occurs at rest or with minimal
exertion and is not relieved by
rest or nitroglycerin; may
indicate an impending myocardial infarction.
37
Drug Classifications to Treat Angina
-Nitrates
-Beta-Blockers
-Calcium Channel Blockers
-Antiplatelet Agents
-Statins
38
Nitrates Actions
Dilate blood vessels, reduce preload
and afterload, decrease oxygen demand of the heart.
39
Nitrates AE
Headache, dizziness, hypotension, flushing.
40
Nitrates Nursing Considerations
Monitor blood pressure closely, advise patients to rise slowly to prevent dizziness, educate about the
potential for headaches and how to manage them.
41
Beta-Blocker Actions Angina
Decrease heart rate, reduce
myocardial oxygen demand, improve
exercise tolerance.
42
Calcium Channel Blockers Actions
Dilate coronary arteries, reduce afterload, decrease myocardial oxygen demand
43
Antiplatelet Agents Actions
Inhibit platelet aggregation,
prevent thrombus formation.
44
Antiplatelet Agents AE
Bleeding, gastrointestinal
upset.
45
Antiplatelet Agents Nursing Considerations
Monitor for signs of bleeding, educate patients about the importance of reporting any unusual bruising or bleeding, advise on taking medication with food to reduce gastrointestinal upset.
46
Statins Actions
Lower LDL cholesterol levels, stabilize atherosclerotic plaques.
47
Statins AE
Muscle pain, liver dysfunction.
48
Statins Nursing Considerations
Monitor liver function tests regularly, educate patients about the importance of
reporting any muscle pain or weakness, advise on lifestyle changes to support cholesterol management.
49
Risk Factor Management for Angina Prevention
*Smoking Cessation
* Blood Pressure Control
* Diabetes Management
* Cholesterol Management
50
Healthy Lifestyle changes for Angina prevention
-Diet
-Physical Activity
- Weight Management
-Stress Management
-Alcohol Moderation
51
Peripheral Vascular Disease (PVD)
PVD is a circulation disorder
that affects blood vessels outside of the
heart and brain.
52
Peripheral Vascular Disease (PVD) Causes
Atherosclerosis, blood clots, diabetes,
inflammation of blood vessels
53
Peripheral Vasofilating Agents
Medications that dilate blood vessels to improve blood flow. Ex. Cilostazol,
pentoxifylline
54
Peripheral Vasodilating Agents Effects
-Improved Circulation: Enchance blood flow to the extremities
-Symptom Relief: Reduction in pain, cramping, and discomfort
- Monitoring: Regular monitoring of blood pressue and heart rate to assess response to treatment
55
Cilostazol Mechanism of Action
Inhibits phophodiesterase 3, leading to vasodilation and inhibition on platelet aggregation
56
Cilostazol uses
Used to treat intermittent claudication in patients with PVD
57
Cilostazol AE
- Hypotension: Vasodilation caused by cilostazol can lead to a decrease in BP
-Tachycardia: The decrease in blood pressure can trigger a reflex increase in heart rate (Compensation)
58
Conditiosn that put you at risk for developing Blood Clots
- Prolonged Immobility: bed rest, long flights, or surgery
- Medical conditions: Cancer, Heart disease, stroke
- Pregnancy: Increased risk due to hormonal changes
- Smoking: Damages blood vessels and increases clothing risk
- Obesity: Excess weight increases pressure on veins
59
Nursing interventions to Prevent blood clots
1. Encourage Mobility
2. Compression Devices
3. Hydration
4. Medication Adminstration
60
Action of Platelet Inhibitors
Medications that prevent platelets from clumping together to form clots
Ex: Aspirin, clopidogrel (Plavix)
61
Actions of Anticoagulants
Medications that interfere with the clotting cascade to prevent clot formation
Ex: Warfarin, Heparin
62
Actions of Thrombin Inhibitor
Medications that directly inhibit thrombin, an enzyme involved in blood clotting
Usually used due to heaprin allergies
Ex: Dabigatran, argatroban
63
Actions of Fibrinolytic Agents
- Clot Busters
- Medications that dissolve existings blood clots by breaking down fibrin
-Ex: Altepase (tPA), streptokinase
64
Monitoring procedures for detecting Hemmorrhage
* Vital Signs: Monitor blood pressure,heart rate, and respiratory rate.
* Physical Examination: Check for signs of bleeding such as bruising, petechiae, or hematomas.
* Laboratory Tests: Monitor complete blood count (CBC), prothrombin time (PT), international normalized ratio
(INR), and activated partial
thromboplastin time (aPTT)
65
Laboratory Data for Detecting Hemorrhage
- CBC: Monitor hemoglobin, hemtocrit, and platelet levels
- Prothrombin Time (PT) and INR: Assess the effectiveness of Warfarin therapy
- Activated Partial Thromboplastin Time (aPTT): Assess the effectiveness of heparin therapy
66
Nursing Assessments for Anticoagulant Therapy
1. Monitor Lab values: PT/INR/aPTT levels
2. Assess for signs of bleeding: Check for bruising, bleeding gums, nosebleeds, or blood in urine/stool
3. Evaluate Patient symptoms: Monitor for relief of symptoms such as pain or swelling
67
Nursing Assessments for Anticoagulant Therapy AE
-Monitor for AE: excess bleeding, allergic rxn, or other SE
-Patient Education: Teach patients about the signs of bleeding and hen to seek medical attention
-Regular Follow up: Schedule regular follow up appointments to monitor therapy
68
Heart Failure
Heart failure is a condition in which the heart is unable to pump enough blood to meet the body's needs
69
Causes of Heart Failure
- Coronary Artery Disease
- Hypertension
- Myocardial infarction
-Cardiomyopathy
70
Compensatory Mechnisms in Heart Failure
- Sympathetic Nervous
System Activation:
Increases heart rate and
contractility.
-Renin-Angiotensin-
Aldosterone System (RAAS)
Activation: Increases blood
volume and blood pressure.
-Ventricular Remodeling:
Changes in the size, shape,
and function of the heart.
71
Goals of Treatment for HF
-Improve Symptoms
- Slow Disease Progression
- Improve Quality of Life
-Reduce Hospitalization
- Prolong Survival
72
Digoxin Effects
Improves cardiac output and
reduces symptoms of heart failure.
73
Digoxin Actions
Increases the force of
myocardial contraction (positive
inotropic effect) and slows the heart rate (negative chronotropic effect).
74
Digoxin Nursing Considerations
Monitor for signs of digoxin toxicity (e.g., nausea,
vomiting, visual disturbances), check apical pulse before administration, and educate patients about maintaining
consistent potassium levels.
75
ACE Inhibitors Actions
Inhibit the Conversion of angiotensin I to angiotensin II,
leading to vasodilation and
reduced blood volume.
76
ACE Inhibitors Effects
Decrease blood pressure,
reduce afterload, and prevent
ventricular remodeling.
77
ACE Inhibitors Nursing Considerations
Monitor blood pressure and renal function, assess for signs of angioedema, and educate patients about the potential for a persistent dry cough.
78
ARBs Actions
Block the action of angiotensin II at its receptor, leading to vasodilation and reduced blood
volume.
79
ARBs effects
Decrease blood pressure,
reduce afterload, and prevent
ventricular remodeling.
80
ARBs Nursing Considerations
Monitor blood pressure and renal function, assess for signs of hyperkalemia, and educate patients about the importance of regular follow-up appointments.
81
Entresto Actions
Combination of a neprilysin
inhibitor (sacubitril) with an ARB
(valsartan) that enhances natriuretic peptides and blocks angiotensin II
82
Ernesto Effects
Reduces blood pressure,
decreases afterload, improves
cardiac function, and reduces
hospitalizations.
83
Erntresto Nursing Considerations
Monitor blood pressure and renal function, assess for signs of hyperkalemia, and educate patients about the importance of adherence to medication and lifestyle modifications.
84
Beta Blockers Actions
Block beta-adrenergic
receptors, reducing heart rate and contractility.
85
Beta Blocker Effects
Decrease myocardial oxygen
demand, reduce symptoms, improve survival, and prevent ventricular remodeling.
86
Beta Blocker Nursing Considerations:
Monitor heart rate and blood pressure, assess for signs of worsening heart failure, and
educate patients about the potential for fatigue and how to manage it.
87
Nursing Assessments for Hydration Status
-Vital Signs: Monitor blood pressure,heart rate, and respiratory rate.
-Skin Turgor: Assess skin elasticity by gently pinching the skin.
-Mucous Membranes: Check for
moisture in the mouth and eyes.
-Urine Output: Measure urine output and assess color and
concentration.
88
Nursing Assessments for Renal Function
-Blood Tests: Monitor serum creatinine, BUN, and electrolytes
-Urinalysis: Assess urine for protein, glucose, ketones, and specific gravity
- Glomerular Filtration Rate (GFR): Estimate kidney function based on creatinine levels
89
Actions of Diuretics
Diuretics reduce blood
volume, leading to decreased blood pressure.
90
Diuretics
Diuretics are medications that
increase urine production to remove excess fluid from the body
91
Electrolyte Imbalance Diuretics
Diuretics can cause imbalances in sodium, potassium, calcium, and magnesium levels.
92
Thiazide Diuretics
- Commonly used to treat high BP and edema
-Working by inhibiting sodium
reabsorption in the distal
convoluted tubule of the kidney
-Examples include
hydrochlorothiazide and
chlorthalidone.
93
Loop Diuretics
* Potent diuretics used for
conditions like heart failure
and edema.
* Act on the ascending loop of
Henle in the kidney to inhibit
sodium and chloride
reabsorption.
* Examples include furosemide
(Lasix) and bumetanide.
94
Potassium Sparing Diuretics
-Help prevent potassium loss,
which can be a side effect of
other diuretics.
-Work by interfering with sodium-
potassium exchange in the
distal convoluted tubule.
-Examples include
spironolactone and amiloride
95
Carbonic Anhydrase Inhibitors
-Less commonly used as diuretics but can be effective in treating
glaucoma and altitude sickness.
-Work by inhibiting the enzyme
carbonic anhydrase, reducing
sodium and bicarbonate
reabsorption in the proximal tubule.
-An example is acetazolamide.
96
Osmotic Diuertics
-Used in acute
settings to reduce
intracranial
pressure or treat
acute kidney
failure.
-Work by increasing
the osmolarity of
the blood,
drawing water out
of tissues and into
the urine.
-An example is
mannitol
97
Adminstering Diuretics Cautiously
- Older Adults: Increased risk of dehydration
- Impaited renal function: can effect the excretion of diuretics leading to toxicity
- Cirrhosis of the liver: fluid retention and electrolyte imbalances
- DM: Diuretics can affect blood glucose levels and increase the risk of hyperglycemia
98
Nursing Assessments for Diuretic Therapy
- Monitor labs: Electrolyte levels
- Assess for Dehydration: dry mucous membrane, decrease skin tigor, and low urine output
- Evaluate BP
99
Nursing Assessments for Diuretic Therapy AE
-Monitor for Adverse Effects: Watch for signs of electrolyte imbalances, dehydration, and renal impairment.
-Patient Education: Teach patients about the signs of adverse effects and when to seek medical attention.
-Regular Follow-Up: Schedule regular follow-up appointments to monitor the patient's response to therapy and adjust treatment as needed.
Untitled Class
flashcards
Decks in class (2)
# Cards
