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85 Cards in this Set
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CARDIOVASCULAR: DYSRHYTHMICS
ATRIAL DYSRHYTHMIAS MEDS CLASS 1A ANTIDYSRHYTHMIC MEDS LIKE DISOPYRAMIDE, PROCAINAMIDE, & QUINIDINE ARE INDICATED FOR WHAT ATRIAL DYSRHYTHMIAS? (2) |
A-FIB
PACs |
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CARDIOVASCULAR: DYSRHYTHMICS (10 QUESTIONS)
ATRIAL DYSRHYTHMIA MEDS CLASS 1C ANTIDYSRHYTHMIC MEDS LIKE FLECAINIDE & PROPAFENONE ARE INDICATED FOR WHAT ATRIAL DYSRHYTHMIAS? (2) |
A-FIB & A-FLUTTER
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CARDIOVASCULAR: DYSRHYTHMICS (10 QUESTIONS)
ATRIAL DYSRHYTHMIAS MEDS AMIODARONE, DOFETILIDE, IBUTILIDE, & SOTALOL ARE CLASS 3 DYSRHYTHMIC MEDS THAT ARE INDICATED FOR WHAT ATRIAL DYSRHYTHMIA? (2) |
A-FIB OR A-FLUTTER
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CARDIOVASCULAR: DYSRHYTHMICS (10 QUESTIONS)
ATRIAL DYSRHYTHMIAS MEDS CALCIUM CHANNEL BLOCKERS LIKE VERAPAMIL & DILTIAZEM (CARDIZEM) ARE CLASS 4 DYSRHYTHMIC MEDS THAT ARE INDICATED FOR WHAT ATRIAL DYSRHYTHMIA? (2) |
RATE CONTROL OF A-FIB & A-FLUTTER
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CARDIOVASCULAR: DYSRHYTHMICS (10 QUESTIONS)
VENTRICULAR DYSRHYTHMIA MEDS CLASS 1A ANTIDYSRHYTHMIC MEDS LIKE DISOPYRAMIDE, PROCAINAMIDE, & QUINIDINE ARE INDICATED FOR WHAT VENTRICULAR DYSRHYTHMIAS? (2) |
PVCs
V-TACHY |
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CARDIOVASCULAR: DYSRHYTHMICS (10 QUESTIONS)
VENTRICULAR DYSRHYTHMIA MEDS PHENYTOIN (DILANTIN) & LIDOCAINE ARE CLASS 1B DYSRHYTHMIC MEDS THAT ARE INDICATED FOR WHAT VENTRICULAR DYSRHYTHMIAS? (4) |
LIDOCAINE-ALL; PVCs, V-TACHY, & V-FIB
PHENYTOIN- V-TACHYDYSRHYTHMIAS R/T DIGITALIS TOXICITY |
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CARDIOVASCULAR: DYSRHYTHMICS (10 QUESTIONS)
VENTRICULAR DYSRHYTHMIA MEDS CLASS 1C ANTIDYSRHYTHMIC MEDS LIKE FLECAINIDE & PROPAFENONE ARE INDICATED FOR WHAT VENTRICULAR DYSRHYTHMIAS? (2) |
SEVERE V-TACHY
SUPRAVENTRICULAR TACHYCARDIA (SVT) |
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CARDIOVASCULAR: DYSRHYTHMICS (10 QUESTIONS)
VENTRICULAR DYSRHYTHMIA MEDS BETA BLOCKERS LIKE PROPANOLOL, METOPROLOL, ATENOLOL, & ESMOLOL ARE CLASS 2 ANTIDYSRHYTHMIC MEDS INDICATED FOR WHAT VENTRICULAR DYSRHYTHMIAS? (2) |
BOTH SUPRAVENTRICULAR & VENTRICULAR DYSRHYTHMIAS
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CARDIOVASCULAR: DYSRHYTHMICS (10 QUESTIONS)
VENTRICULAR DYSRHYTHMIA MEDS CLASS 3 MEDS LIKE AMIODARONE, DOFETILIDE, IBUTILIDE, & SOTALOL ARE ANTIDYSRHYTHMIC MEDS INDICATED FOR WHAT VENTRICULAR DYSRHYTHMIAS? (2) |
LIFE THREATENING V-TACHY OR V-FIB
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CARDIOVASCULAR: DYSRHYTHMICS (10 QUESTIONS)
VENTRICULAR DYSRHYTHMIA MEDS CALCIUM CHANNEL BLOCKERS LIKE VERAPAMIL & DILTIAZEM ARE CLASS 4 ANTIDYSRHYTHMIC MEDS INDICATED FOR WHAT VENTRICULAR DYSRHYTHMIAS? |
PAROXYSMAL SUPRAVENTRICULAR TACHYCARDIA (PSVT)
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NAME CLASS 1 MED(S) FOR DYSRHYTHMIAS
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moricizine (Ethmozine)
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BESIDES BLOCKING NA CHANNELS, WHAT IS THE ACTION OF A CLASS 1 MED?
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Used for symptomatic ventricular and life-threatening dysrhythmias
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NAME CLASS 1A MED(S) FOR DYSRHYTHMIAS (3)
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quinidine, procainamide, disopyramide
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WHAT IS THE ACTION OF A CLASS 1A MED? (3)
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-Block sodium (fast) channels
-Delay repolarization (relaxation) -Increase APD (action potential duration) |
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WHAT IS A CLASS 1A MED USED TO TREAT? (5)
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1. atrial fibrillation (Afib)
2. premature atrial contractions (PAC) 3. premature ventricular contractions (PVC) 4. ventricular tachycardia (VT) 5. *Wolff-Parkinson-White syndrome (WPW) |
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NAME CLASS 1B MED(S) FOR DYSRHYTHMIAS (2)
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phenytoin (Dilantin), lidocaine
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WHAT IS THE ACTION OF CLASS 1B MEDS? (3)
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1. Block sodium channels
2. Accelerate repolarization 3. Decrease APD |
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WHAT IS LIDOCAINE, A CLASS 1B MED USED TO TREAT? (3)
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Ventricular Dysrhythmias Only
1. PVC'S 2. ventricular tachycardia 3. ventricular fibrillation |
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WHAT IS PHENYTOIN (DILANTIN), A CLASS 1B MED USED TO TREAT? (2)
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ATRIAL & VENTRICULAR TACHYDYSRHYTHMIAS CAUSED BY DIGITALIS TOXICITY
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WHEN DO YOU GIVE CLASS 1B MEDS?
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Give after you have defibrillated the pt
Shock them, wait, and give meds to stabilize pt |
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NAME CLASS 1C MED(S) FOR DYSRHYTHMIAS (2)
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flecainide, propafenone
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WHAT IS THE ACTION OF A CLASS 1C MED? (2)
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1. Block sodium channels
(more pronounced effect) 2. Used for severe ventricular dysrhythmias |
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WHAT IS A CLASS 1C MED USED TO TREAT? (3)
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1. a-fib/flutter
2. SVT dysrhythmias *3. Wolff-Parkinson-White syndrome (WPW) |
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WHAT ARE CLASS 2 MEDS?
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beta-blockers
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WHAT IS THE ACTION OF CLASS 2: BETA-BLOCKERS?
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Reduce or block SNS stimulation
(reduces transmission of impulses in the heart’s conduction system) |
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WHAT ARE CLASS 2: BETA-BLOCKERS USED FOR?
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General myocardial depressants for BOTH supraventricular and ventricular dysrhythmias
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NAME CLASS 2: BETA BLOCKER MED(S)
(4) |
atenolol (Tenormin)
esmolol (Brevibloc) metoprolol (Lopressor) propranolol (Inderal) |
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TRUE OR FALSE: CLASS 2 BB ARE GIVEN IN IV FORM FAST
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FALSE; CLASS 2 BB ARE GIVEN IN IV FORM SLOWLY
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WHAT ELSE CAN CLASS 2: BB AND CLASS 4 CCB BE USED TO TREAT? (2)
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Also used as antianginal & antihypertensive drugs
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NAME CLASS 3 MEDS (3)
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amiodarone (Cordarone)
sotalol (Betapace) ibutilide (Covert) |
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WHAT IS THE ACTION OF A CLASS 3 MED? (2)
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Increase APD
Prolong repolarization in phase 3 (FAST) |
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WHAT IS THE CLASS 3 MEDS USED TO TREAT? (3)
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1. Used for dysrhythmias that are difficult to treat
2. Life-threatening v-tachy/fib, a-fib/flutter—resistant to other drugs 3. Sustained v-tachy |
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NAME CLASS 4 MED(S) FOR DYSRHYTHMIAS (2)
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Verapamil (Calan)
diltiazem (Cardizem) |
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WHAT IS THE ACTION OF CLASS 4 MEDS? (3)
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1. Calcium channel blockers-Inhibit slow-channel (calcium-dependent) pathways
2. Depress phase 4 depolarization 3. Reduce AV node conduction |
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WHAT ARE CLASS 4 MEDS USED TO TREAT? (2)
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1. paroxysmal supraventricular tachycardia (PSVT)
2. rate control for atrial fibrillation and flutter |
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WHAT ARE SOME OTHER MEDS THAT CAN BE USED FOR DYSRHYTHMIAS? (2)
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Digoxin & adenosine
Have properties of several classes not placed into one particular class |
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DYSRHYTHMIA DRUGS
WHAT IS ADENOSINE (ADENOCARD) USED FOR? |
Used to convert paroxysmal supraventricular tachycardia (PSVT) back to sinus rhythm
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TRUE OR FALSE: ADENOSINE (ADENOCARD) HAS A SHORT-HALF OF LESS THAN 10 SECONDS
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TRUE; CAN BE PUSHED VERY QUICKLY
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WHAT DOES THE NURSE NEED TO BE ADVISED ABOUT WHEN ADMINISTERING ADENOSINE (ADENOCARD)?
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May cause asystole for a few seconds
(3 - 5 secs) |
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WHAT ARE THE SIDE EFFECTS OF DYSRHYTHMIA DRUGS? (4)
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1. ALL anti-dysrhythmics can cause dysrhythmias!
2. Hypersensitivity reactions 3. N/V/D 4. Dizziness, Blurred vision, Headache |
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WHAT ARE THE CLASSES OF ANGINA MEDS? (3)
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1. Nitrates/nitrites
2. Beta-blockers 3. Calcium channel blockers |
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WHAT ARE THE GOALS FOR TREATMENT FOR ANGINA MEDS? (5)
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1. Increase blood flow to ischemic heart muscle
2. Decrease myocardial oxygen demand-decrease the need by providing blood flow 3. Minimize the frequency of attacks and decrease the duration and intensity of anginal pain 4. Improve the patient’s functional capacity with as few adverse effects as possible 5. Prevent or delay the worst possible outcome: MI |
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ANGINA:
WHAT ARE THE MAIN ROUTES FOR NITRATES? (4) |
Sublingual*
Buccal* IV solutions* Ointments * |
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WHAT ARE THE RAPID ACTING FORMS OF NITRATE USED FOR?
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Used to treat acute anginal attacks
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ANGINA:
WHAT ARE THE LONGER ACTING FORMS OF NITRATE USED FOR? |
Used to PREVENT anginal episodes
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ANGINA:
TRUE OR FALSE: SINCE SOME NITRATES CAN BYPASS THE FIRST BYPASS-EFFECT, RENAL/LIVER PT'S DONT HAVE TO BE WORRIED |
TRUE
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ANGINA
WHAT IS THE MECHANISM OF ACTION FOR NITRATES? (6) |
1. Cause vasodilation because of relaxation of smooth muscles
2. Used for prevention and treatment of angina 3. Vasodilation results in reduced myocardial oxygen demand Result: oxygen to ischemic myocardial tissue 4. Nitrates alleviate coronary artery spasm 5. Nitrates cause dilation of both large and small coronary vessels 6. Potent dilating effect on coronary arteries |
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ANGINA
WHAT IS NITROGLYCERIN USED FOR? |
Used for symptomatic treatment of ischemic heart conditions (angina)
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WHAT IS THE IV FORM OF NITROGLYCERIN USED FOR? (5)
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1. BP control in perioperative hypertension
2. treatment of HF 3. ischemic pain 4. pulmonary edema associated with acute MI 5. hypertensive emergencies |
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AS THE NURSE, WHAT DO YOU TEACH THE PATIENT TO DO WHEN TAKING NITROGLYCERIN? (4)
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1. Instruct patients in proper technique and guidelines for taking sublingual nitroglycerin for anginal pain
2. Instruct patients never to chew or swallow the sublingual form 3. Instruct patients that a burning sensation felt with sublingual forms indicates that the drug is still potent 4. Teach pt’s how to take Nitro-3 nitro: 1 q 5min if pain is not relieved |
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TRUE/FALSE: NITRO TEACHING
To preserve potency, meds should be stored in an airtight, dark glass bottle with a metal cap and no cotton filler |
TRUE
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TRUE/FALSE: NITRO TEACHING
AS THE NURSE YOU SHOULD DISCOURAGE THE PT FROM keeping a fresh supply of sublingual medication on hand; potency is lost in about 3 months after the bottle has been opened |
FALSE; AS THE NURSE,
Instruct patients to keep a fresh supply of sublingual medication on hand; potency is lost in about 3 months after the bottle has been opened |
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NITRO TEACHING
YOU HAVE A PATIENT WHOSE TAKING NITRO IN THE FORM OF AN OINTMENT. WHAT SHOULD YOU TEACH THE PT ABOUT USING THE OINTMENT? |
ROTATE THE SITE
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TRUE/FALSE: NITRO TEACHING
To reduce tolerance, the patient may be instructed to remove topical forms at bedtime and apply new doses in the morning, allowing for a nitrate-free period |
TRUE
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TRUE/FALSE: NITRO TEACHING
THE NURSE SHOULD Monitor vital signs frequently during acute exacerbations of angina and during IV administration |
TRUE
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TRUE/FALSE: ANGINA
AS THE NURSE YOU SHOULD NOT Instruct patients to take prn nitrates at the first hint of anginal pain |
FALSE; Instruct patients to take prn nitrates at the first hint of anginal pain
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ANGINA-NITRO TEACHING
If a pt is experiencing chest pain and taking sublingual nitroglycerin what should they do next? |
They should lie down to prevent or decrease dizziness and fainting that may occur because of hypotension
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NITRO TEACHING
1ST TIME NITRO USERS WHO GET A HEADACHE SHOULD DO WHAT WITH THE NEXT DOSE? |
Put it somewhere away from the heart like the leg.
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WHAT ACTIONS SHOULD A PT TAKE IF ANGINAL PAIN OCCURS? (5)
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1. Stop activity and sit or lie down
2. Take a sublingual tablet, and call 911/Emergency Services immediately! 3. If no relief in 5 minutes, take a second sublingual tablet 4. If no relief in 5 minutes, take a third sublingual tablet 5. *Do not try to drive to the hospital |
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NAME SOME NITRATE MEDICATIONS (2)
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Isosorbide dinitrate
(Isordil, Sorbitrate, Dilatrate SR) Isosorbide mononitrate (Imdur, Monoket, ISMO) |
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ANGINA
WHAT IS ISORDIL OR IMDUR USED FOR? (3) |
Acute relief of angina
Prophylaxis in situations that may provoke angina Long-term prophylaxis of angina |
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ANGINA
WHAT ARE THE BIGGEST ADVERSE EFFECTS OF TAKING NITRATE? (3) |
Headaches
Tachycardia postural hypotension |
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ANGINA
TRUE/FALSE: NITRATE SINCE A TOLERANCE MIGHT DEVELOP, FOR Transdermal forms: remove patch at bedtime for 8 hours, then apply a new patch in the morning |
TRUE
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NAME SOME BETA BLOCKERS THAT ARE USED FOR ANGINA (4)
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atenolol (Tenormin)
metoprolol (Lopressor) propranolol (Inderal) nadolol (Corgard) |
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WHAT IS THE MECHANISM OF ACTION FOR BB USED FOR ANGINA? (3)
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1. Block beta1-receptors on the heart
2. Decrease HR, resulting in decreased myocardial oxygen demand and increased oxygen delivery to the heart 3. Decrease myocardial contractility, helping to conserve energy or decrease demand |
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Angina:
WHAT ARE SOME CLINICAL INDICATIONS FOR BB? (4) |
1. Angina
2. Antihypertensive treatment 3. Cardiac dysrhythmias 4. Cardioprotective effects-especially after MI |
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ANGINA:
WHAT ARE SOME THINGS AS THE NURSE SHOULD YOU TEACH YOUR PT ABOUT BB? (3) |
1. Patients taking beta-blockers should monitor pulse rate daily and report any rate lower than 60 beats per minute
2. Instruct patients to report dizziness or fainting 3. Constipation is a common problem- Instruct patients to take in adequate fluids and eat high-fiber foods |
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ANGINA:
IF A PT STOPS TAKING THE BB ABRUPTLY WHAT CAN HAPPEN? |
REBOUND HYPERTENSIVE CRISIS
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TRUE/FALSE: ANGINA
A PT CAN STOP TAKING BB ONCE THEY HAVE IMMEDIATE RELIEF FROM SYMPTOMS. |
FALSE; Inform patients that these medications are for long-term prevention of angina, not for immediate relief
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ANGINA:
WHAT IS THE MECHANISM OF ACTION FOR CALCIUM CHANNEL BLOCKERS? (3) |
1. Cause coronary artery vasodilation
2. Cause peripheral arterial vasodilation, thus decreasing systemic vascular resistance 3. Reduce the workload of the heart Result: decreased myocardial oxygen demand |
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NAME SOME CCB USED FOR ANGINA (4)
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1. verapamil (Calan, Isoptin)
2. diltiazem (Cardizem) 3. nifedipine (Procardia) 4. amlodipine (Norvasc) |
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ANGINA:
WHAT ARE THE CLINICAL INDICATIONS FOR CCB? (3) |
1. First-line drugs for treatment of angina, HTN, and SVT
2. Coronary artery spasms (Prinzmetal’s angina) 3. Short-term management of a-fib and flutter |
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ANGINA:
WHAT ARE THE ADVERSE EFFECTS OF CCB? (6) |
1. Hypotension
2. Palpitations 3. Tachycardia or Bradycardia 4. Constipation (a common problem)- instruct patients to take in adequate fluids eat high-fiber food 5. Nausea 6. Dyspnea |
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TRUE/FALSE: ANGINA
A NURSE HAS TO TAKE INTO CONSIDERATION PTS WITH ANGINA THAT ARE TAKING CCB & HAD A PAST Hx OF AN ENDOCRINE DISORDER BECAUSE IT CAN CAUSE EXACERBATIONS. |
TRUE
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LABS
WHAT ARE THE NORMAL THERAPEUTIC LEVELS FOR DIGOXIN (LANOXIN)? |
0.5 - 2
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LABS
WHAT IS THE NORMAL RBC COUNT? |
4.2 - 6.2 million cells/mm3
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LABS
WHAT IS THE NORMAL Hct? |
37 - 54%
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LABS
WHAT IS THE NORMAL Hgb LEVEL? |
12 - 18
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LABS
WHAT IS THE NORMAL PLATELET COUNT? |
150,000 - 450,000
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LABS
WHAT IS THE NORMAL WBC COUNT? |
4,500 - 10,000
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LABS
WHAT IS THE NORMAL RANGE FOR SODIUM? |
135 - 145
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LABS
WHAT IS THE NORMAL RANGE FOR CALCIUM? |
8.6 - 10.2
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LABS
WHAT IS THE NORMAL LEVEL FOR CREATININE? |
0.7 - 1.4
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LABS
WHAT IS THE NORMAL LEVEL FOR BUN? |
7 - 18
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LABS
WHAT IS THE NORMAL RANGE FOR POTASSIUM? |
3.5 - 5.0
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