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33 Cards in this Set
- Front
- Back
- 3rd side (hint)
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afterload
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pressure to overcome for the ventricles to eject blood from the heart
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chronotropic effect
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change in the heart rate
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contractility
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strength of contraction of the heart
similar to rubber band |
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dromotropic effect
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change in the speed of electrical conduction through the heart
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dysrhythmia
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abnormal cardiac rhythm
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Frank-Starling Law
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the greater the stretch on myocardial fibers, the greater the force by which they contract
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heart failure (HF)
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heart muscle can't contract with enough force to meet the body's metabolic needs
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inotropic effect
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change in the strength or contractility of the heart
primary characteristic of cardiac glycosides (class of drugs) |
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peripheral edema
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swelling in the limbs due to an accumulation of interstitial fluid
particularly the feet and ankles |
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phosphodiesterase
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enzyme in muscle cells that cleaves phosphodiester bonds
its inhibition increases myocardial contractility |
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preload
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degree to which heart fibers are stretched just prior to contraction
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refractory period
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time during which the myocardial cells rest and are not able to contract
occurs between heart beats |
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The three primary characterisitcs of heart function are . . .
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1. force of contraction
2. heart rate 3. speed of impulse conduction |
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_____ have 1.5 to 2 times the incidence of HF as whites.
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Blacks
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HF is twice as frequent in 1_____ pts and five times as frequent in persons who have experienced a 2_____ 2_____.
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1 hypertensive
2 heart attack |
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What are the treatment goals for HF?
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prevent, treat, or remove underlying causes (whenever possible)
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HF on the left side of the heart can cause:
1. 2. |
1. the wall of left ventricle to hypertrophy
2. blood to "back up" into the lungs (congestive HF) |
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Although 1_____ HF is more common, the 2_____ side can fail as well (both sides simultaneously or one side only). In 3_____ HF, the blood "backs up" into the peripheral veins resulting in peripheral 4 _____ and engorgement of 5_____.
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1 left
2 right 3 right 4 edema 5 organs |
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digoxin
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AKA: Lanoxin
CLASS: cardiac glycoside ACTION: positive inotropic effect - ↑ force & velocity of myocardium - ↑ cardiac output = ↑ urine production - ↓ blood volume - affects impulse conduction in heart A/E: dysrhythmias - effects on digestive system - increased salivation - blurred vision * monitor drug/drug interaction carefully |
cardiac glycoside
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lisinopril
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AKA: Prinivil - Zestril
CLASS: Angiotensin Converting Enzyme (ACE) Inhibitor ACTION: lowers peripheral resistance - reduces blood volume via increasing excretion of sodium & water - dilates veins returning blood to heart - increases cardiac output - decreases preload A/E: high K+ levels - cough - taste disturbances - hypotension |
ACE inhibitor
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isosorbide dinitrate
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AKA: Isordil - Sorbitrate - Dilatrate
CLASS: vasodilator ACTION: acts directly on vascular smooth muscle - reduces cardiac workload - an organic nitrate A/E: headache - hypotension - reflex tachycardia - contraindicated if taking Viagra |
vasodilator
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furosemide
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AKA: Lasix
CLASS: diuretic ACTION: increase urine flow - reduce blood volume & cardiac workload A/E: electrolyte imbalance - hypokalemia - dehydration - hypotension * monitor carefully when used w/digoxin |
diuretic
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milrinone
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AKA: Primacor
CLASS: Phosphodiesterase inhibitor ACTION: block enzyme phosphodiesterase in cardiac & smooth muscle - increases calcium available for myocardial contracction - positive inotropic response - vasodilation A/E: ventricular dysrhythmia (occurs in more than 1:10) |
phosphodiesterase inhibitor
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carvedilol
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AKA: Coreg
CLASS: beta-adrenergic blocker ACTION: reduces heart rate and bp - reduces cardiac afterload - negative inotropic effect |
beta-adrenergic blocker
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The pulse should be checked before giving 1_____. If the rate is 2_____ bpm, it should not be given.
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1 digoxin
2 <60 |
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Blood electrolyte levels are critical to safe digoxin therapy. Which of the following will significantly reduce the effectiveness of digoxin?
a. hypokalemia b. hyperkalemia c. hypocalcemia d. hypercalcemia |
a. hypokalemia
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The primary action of digoxin (Lanoxin) that makes it very effective at treating heart failure is its ability to:
a. dilate the coronary arteries b. increase impulse conduction across the myocardium c. decrease blood pressure d. increase cardiac contractility/output |
d. increase cardiac contractility/output
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Cardiac glycosides help the heart to beat more forcefully and:
a. with a faster heart rate b. with a slower heart rate c. do not affect cardiac output d. with a diminished cardiac output |
b. with a slower heart rate
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A client with heart failure is prescribed digoxin (Lanoxin) 0.3 mg. It is available as digoxin 500 mcg/2 ml. How many ml's will the nurse administer?
a. 1 ml b. 1.1 ml c. 1.2 ml d. 1.3 ml |
c. 1.2 ml
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The physician orders enalapril (Vasotec) 15 mg. It is available as 10 mg/ 5 ml. How many ml's will the nurse administer?
a. 6 ml b. 6.5 ml c. 7.5 ml d. 8 ml |
c. 7.5 ml
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T.N., age 64, receives hydralazine (Apresoline) 50 mg. It is available as hydralazine 25 mg/ tablet. How many tablets are needed to administer this dose?
a. 2 tabs b. 3 tabs c. 4 tabs d. 5 tabs |
a. 2 tabs
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A client takes isosorbide dinitrate (Isordil) 8.75 mg. It is available as isorsobide dinitrate 2.5 mg/tablet. How many tablets woudl the nurse need to administer this dose?
a. 2.5 tabs b. 3 tabs c. 3.5 tabs d. 4 tabs |
c. 3.5 tabs
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The physician orders a client to receieve a stat dose of bemetanide (Bumex) 10 mg and it is mixed in 50 ml of D5W. It is to be administered in 15 minutes. In ml/hr, how does the nurse set the IV pump?
a. 25 ml/hr b. 100 ml/hr c. 150 ml/hr d. 200 ml/hr |
d. 200 ml/hr
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