Study your flashcards anywhere!

Download the official Cram app for free >

  • Shuffle
    Toggle On
    Toggle Off
  • Alphabetize
    Toggle On
    Toggle Off
  • Front First
    Toggle On
    Toggle Off
  • Both Sides
    Toggle On
    Toggle Off
  • Read
    Toggle On
    Toggle Off
Reading...
Front

How to study your flashcards.

Right/Left arrow keys: Navigate between flashcards.right arrow keyleft arrow key

Up/Down arrow keys: Flip the card between the front and back.down keyup key

H key: Show hint (3rd side).h key

A key: Read text to speech.a key

image

Play button

image

Play button

image

Progress

1/37

Click to flip

37 Cards in this Set

  • Front
  • Back
What happens when the heart fails as a pump?
Cardiac output eventually falls below the minimum level required to deliver adequate blood flow to the tissues.
While patients in early stages of heart failure may have few symptoms, name two findings
that may be present on examination?
Enlarged heart and increased heart rate.
Eventually, what does the inability of the heart to pump all the blood delivered to it lead to?
Leads to symptoms caused by congestion in the pulmonary and venous blood vessels.
Identify four assessment findings that are typical of patient who have heart failure
Short of breath,rapid resting pulse rate resulting from sympathetic stimulation of the heart, obvious swelling of the hands and feet and sometimes the abdomen, and an enlarged heart.
Although heart failure cannot be cured, how does drug therapy help?
It can prolong the patient's life by slowing the progression of the disease and improve the quality of life by reducing symptoms.
What occurs as a direct result of increased calcium levels produced by digoxin?
Increased calcium level directly increases contractility, which increases cardiac output, improves blood flow to the kidneys and periphery, reduces venous pressure, and allows excess fluid to be excreted as edema clears.
Identify two effects that result from digoxin on the nervous system?
Slows the heart rate and slows conduction through the AV node.
Why is digoxin used to treat systolic heart failure?
Directly improves the strength of the heart muscle, elevating cardiac output.
Give examples of three categories of drugs that when taken with digoxin may lead to more
optimal effects.
Diuretics, vasodilators, or ACE inhibitors.
Besides heart failure, for what other reason would digoxin be prescribed?
Treatment of certain types of arrhythmia.
What is the half-life of digoxin? What is required because of this long half-life? What is this
type of dosing called?
Half-life: 32-48 hours.
Because of their long half-lives, the use of cardiac glycosides often requires loading doses
This type of dosing is known as digitalization.
What does a loading dose accomplish?
Raises the concentration in blood rapidly to the therapeutic range.
Does digoxin have a high or low therapeutic index? Identify the statement in the text that
supports your answer.
Low therapeutic index.
"Therapeutic levels are so close to toxic levels."
Which of the five senses may be adversely affected by digoxin? Describe changes that may be present.
Vision. Dimness of vision, double vision, blind spots, flashing lights, or altered color vision.
What is the most common sign of cardiac glycoside-induced rhythm problems? What other
changes are possible? What should be noted and reported?
Bradycardia.
Other changes in heart rate are possible.
Any change in heart rate and rhythm should be noted and reported.
An excess of what electrolyte may increase the risk of arrhythmias in patients taking cardiac
glycosides? What is the proper term for the excess of this electrolyte?
Potassium.
Hyperkalemia.
What percentage of patients receiving cardiac glycosides experience toxicity?
10%-20%
What diagnostic test is monitored routinely to aid in diagnosing drug toxicity?
Blood levels
What is an antidote for digoxin toxicity?
digoxin-immune Fab (Digibind)
What may be the effect if a patient taking digoxin is started on quinidine, amiodarone, or
propafenone? What are these drugs used to treat?
May double the plasma levels of digoxin.
Quinidine, amiodarone, propafenone are used to treat arrhythmia.
Why might a potassium depleting diuretic predispose the patient taking digoxin to toxicity?
A low intracellular potassium level increases the likelihood of arrhythmia.
An excess of what electrolyte may increase the risk of arrhythmias in patients taking cardiac
glycosides? What is the proper term for the excess of this electrolyte?
Potassium.
Hyperkalemia.
What assessment should be completed before administering each dose of cardiac glycoside?
Apical and radial pulse should be taken for 1 full minute.
What percentage of patients receiving cardiac glycosides experience toxicity?
10%-20%
What action is appropriate for the nurse to take if bradycardia is present?
Drug is ordinarily omitted and the health care provider when the pulse rate (taken before the scheduled dose) is less than 60 beats per minute.
What diagnostic test is monitored routinely to aid in diagnosing drug toxicity?
Blood levels
What pulse ranges would generally warrant holding the drug and notifying the physician?
What may happen if an oral dose of digoxin is given to a patient the same time as a large
amount of fiber?
What is an antidote for digoxin toxicity?
digoxin-immune Fab (Digibind)
How should the daily dose be scheduled? Give two reasons why.
It should be taken at the same time each day.
1.) To maintain more consistent blood levels.
2.) To assist in remembering to take the drug.
What may be the effect if a patient taking digoxin is started on quinidine, amiodarone, or
propafenone? What are these drugs used to treat?
May double the plasma levels of digoxin.
Quinidine, amiodarone, propafenone are used to treat arrhythmia.
What two types of drugs should not be administered within two hours of digoxin?
Antacids or antidiarrheals.
Why might a potassium depleting diuretic predispose the patient taking digoxin to toxicity?
A low intracellular potassium level increases the likelihood of arrhythmia.
What assessment should be completed before administering each dose of cardiac glycoside?
Apical and radial pulse should be taken for 1 full minute.
What action is appropriate for the nurse to take if bradycardia is present?
Drug is ordinarily omitted and the health care provider when the pulse rate (taken before the scheduled dose) is less than 60 beats per minute.
What pulse ranges would generally warrant holding the drug and notifying the physician?
What may happen if an oral dose of digoxin is given to a patient the same time as a large
amount of fiber?
How should the daily dose be scheduled? Give two reasons why.
It should be taken at the same time each day.
1.) To maintain more consistent blood levels.
2.) To assist in remembering to take the drug.
What two types of drugs should not be administered within two hours of digoxin?
Antacids or antidiarrheals.