Cardiac Medications Flashcards
(135 cards)
1
Q
common site for ABG
A
Radial Artery
2
Q
ABG type and size of syringe
A
10mL heparinized syringe
3
Q
why do they use heparinized syringe in ABG analysis?
A
anticoagulant to prevent bleeding
4
Q
What is done to assess collateral circulation of the hand?
A
Allen’s Test
5
Q
Normal return to pinking color during ABG analysis?
A
6 seconds
6
Q
ABG: Where to place specimen?
A
container with ice to prevent hemolysis or breakdown of RBC
7
Q
How to do an ABG analysis?
A
- Occlude radial and ulnar artery
- Close and open hand until blanch
- Release ulnar artery
- Wait for 6s for the return of pinkish color
*Less than 6seconds indicates decrease collateral circulation of the hand
8
Q
Interpret ABG
pH: 7.18
PaO2: 90
co2: 47
HCO3: 22
A
Respiratory Acidosis
8
Q
Interpret ABG
pH: 7.25
PaO2: 94
co2: 38
HCO3: 20
A
Metabolic Acidosis
9
Q
Interpret ABG
pH: 7.47
PaO2: 98
co2: 49
HCO3: 29
A
Partially Compensated Metabolic Alkalosis
10
Q
Interpret ABG
pH: 7.48
PaO2: 93
co2: 21
HCO3: 20
A
Partially Compensated Respiratory Alkalosis
11
Q
Primary Risk Factor of Respiratory Acidosis
A
COPD
12
Q
Clinical Manifestations of Respiratory Acidosis
A
Headache
Hypercapnia
Warm and flush skin
Tachycardia
Blurry Vision
Irritability
Decrease level of consciousness
13
Q
Late sign of respiratory Acidosis
A
Disorientation and Confusion
14
Q
Management for Respiratory Acidosis
A
Maintain patent airway: 2-3 lpm (Venturi mask)
Give medications as prescribed
Administer o2 as ordered
Perform tracheal suctioning, postural drainage, coughing, and deep breathing
*Hyperoxygenate before and after
15
Q
Interval for tracheal suctioning
A
15 minutes Max time
20-30 minutes before re-inserting
16
Q
Chest physiotherapy nursing considerations
A
15 minutes
Upon awakening
Before meals
At bedtime
*After meals causes aspiration
17
Q
most common cause of respiratory alkalosis
A
Panic Attack/ Anxiety
18
Q
Manifestations of respiratory alkalosis
A
Tachypnea
Anxiety
Restleness
Lightheadedness
Paresthesia
Increase deep tendon reflex
(+) Trousseau and Chvostek sign
Convulsion and seizure
19
Q
hyperventilation management
A
breathe into brown paper bag
20
Q
hypoventilation management
A
pursed lip breathing
21
Q
most common causes of metabolic acidosis
A
renal failure and diarrhea
22
Q
metabolic acidosis manifestations
A
breathing is rapid and deep (Kussmaul’s breathing)
SOB or dyspnea
Headache
23
Q
metabolic acidosis ECG reading
A
peaked T wave
Prolonged PR Interval & QRS duration
24
Initial signs of metabolic acidosis
paresthesia, high and fast > diarrhea
25
late sign of metabolic acidosis''
muscle weakness
26
Management for metabolic acidosis
Na HCO3 per IV (alkalinizing solution)- to reduce the effects of the acidosis on cardiac function. Flush it with NSS
27
Management for metabolic acidosis esp. for renal failure
Dialysis
28
Metabolic Alkalosis is caused by
loss of H production due to excessive vomiting
commonly associated with the use of diuretics because of hydrogen ion loss from kidneys
29
manifestations of metabolic alkalosis
electrolyte imbalance
disorientation/ confusion
muscle twitching
paresthesia
headache
nausea/ vomiting
30
metabolic alkalosis late sign
tremor and convulsion
31
management for metabolic alkalosis
Adm. 02 as ordered
Seizure precautions
Maintain patent IV
Adm. diluted K solution w/ am infusion pump
Monitor I and O
32
Metabolic alkalosis drug management use to increase excretion of HC03
Diamox
33
What is the IV solution for the management for metabolic alkalosis. This solution is infused no faster than 1L over 4hrs.
Ammonium Chloride
*Don't adm. to patients with hepatic or renal disease
34
Arterial Disorder
Reynaud's Disease
35
Venous Disorder
Deep Vein Thrombosis
36
Pain; intermittent claudication aggravated by activity and exercise
Reynaud's Disease
37
Reynaud's Disease Manifestations
Thin, shiny skin in the legs
Loss of hair on the affected leg
Skin is cold to touch
Ulcers occur in toes
Gangrene may develop
38
DVT pathognomonic Manifestation
Homan's sign > positive calf pain
39
DVT s/sx
pain is improved by activity and exercise
brown pigments around ankles
Redness of skin with edema
skin is warm to touch
ulcers occur in ankle
gangrene does not develop
*phlebitis
40
what triad is the cause of DVT
Virchow's triad
- vessel wall injury
- venous stasis
- hypercoagulability of the blood
41
antidote for anticoagulant heparin
protamine sulfate
42
thrombolytics examples
streptokinase
urokinase
reteplase
tenecteplase
tissue plasminogen activator
anisolyted plasminogen streptokinase activater complex
43
thrombolytics adverse reactions
hypersensitivity reactions
bleeding
44
antidote for thrombolytic
Amicar/ aminocaproic acid
45
examples of anticoagulant
enoxaprin (lovenox)
heparin
tinzaparin (innohep)
daleparin (fragmin)
certoparin (sancloparin)
nadroparin (flaxiparin)
46
Route for anticoagulant
IV and SQ
*roate injection site
47
Anticoagulant can cause decrease in
platelet count causing pat prone to bleeding: reactal bleeding, gum bleeding, epistaxis, melena
48
Side effects of anticoagulant
hemorrhage
itching
burning
49
determine the effectivity of heparin
partial thromboplastin time
50
normal result for ptt
60-70s
51
more sensitive version of ptt
activated partial thromboplastin time
52
aptt normal normal range
30-40s
53
antidote for anticoagulant warfarin
vit k
54
what is the measurement for anticoagulant warfarin
Prothrombin Time
Internation Normal Ratio
55
measures the time it takes for the blood clotting to occur
Prothrombin Time
56
side effects of Coumadin
internal bleeding- petechiae
anorexia
diarrhea
rashes
n/ v
fever
abdominal cramps
stomatitis
57
nursing management
bed rest for 5-7 days
elevate legs: improves venous return
apply compression support stockings: anti-embolic stockings
avoid prolonged standing
check pulse distal to the site of thrombosis
assess presence edema
monitor calf pain
58
PT normal range
11-16s
59
PT therapeutic range
1.5-2 * N
60
aptt therapeutic range
therapeutic range: 2-2.5 * N
61
INR normal range
0.8-1.2s
62
INR therapeutic range
2-3s
63
furosemide common side effects
orthostaticc hypotension
ototoxicity
rashes
photo sensitivity
64
common electrolyte imbalance in furosemide
hypokalemia
65
furosemide nursing considerations
monitor I and O
assess blood pressure
if given in IV, expect urinalysis output to increase in 15-20minutes
Adm. it slowly to prevent ototoxicity
66
when to take furosemide
in the morning to prevent sleep pattern disturbances
67
furosemide management
arise slowly to prevent orthostatic hypotension
if given per orem, give with four to prevent go upset
68
magnesium normal range
1.5-2.5
69
phosphorus normal range
1.5-4.5
70
potassium normal range
3.5-4.5
71
calcium normal range
8.5-10
72
chloride normal range
98-110
73
sodium normal range
135-145
74
neutrophils normal level
2,500-6000
75
mild neutropenia
1000-1500
76
moderate neutropenia
500-1000
77
severe neutropenia
< 500
77
nephrotoxic drugs
acetaminophen
acyclovir
amino glycoside
amphotericin B
ciprofloxacin
rifampicin
sulfonamide
tetracycline
contrast medium
78
hepatotoxic drugs
acetaminophen
erythromycin
iron overdose
isoniazid
rifampicin
sulfonamide
79
80
drugs causing staining
macrodantin
iron
lug's solution
loop diuretic
81
ototoxic drugs
aminoglycoside
aspirin
chloroquine
loop diuretic
82
teratogenic
fluoriquinolone
aminoglycoside
tetracycline
ACE inhibitors
lithium
orał hypoglycemic agents
83
not taken by 7years old and below
tetracycline
84
not given to pregnant mother
ACE inhibitor
85
anti-hypertensive drugs
ACE
ARBS
CCB
Cardiac glycoside
86
ACE Inhobitors
lisinopril
enalapril
87
ARBS
Losartan
telmisartan
irbesartan
88
CCB
Verapamil
diltiazem
nifedipine
nicardipine
89
side effects of ace
angioedema
dry cough
90
side effects of arbs and ace
avoid in pregnant
elevated K
91
increases heart contraction. thus decreasing BP and HR
CCB
92
what does ccb blocks
L-type calcium channels
93
cardiac myocyte function
Inc. contraction
94
cardiac nodal tissue
Inc. HR
95
Vascular smooth muscle
Narrows blood vessel
Inc BP
96
CCB Is not taken with?
grapefruit
97
most common side effect of ccb
headache
98
makes the stronger heart contractions
positive inotropic
99
increases heart rate
positive chronotropic
100
(+) inotropic
(+) chronotropic
Cardiac glycoside
101
digoxin toxicity
green halos
blurring of vision
n/v
dizziness
102
digoxin normal range
0.5-2ng/ mL
103
digoxin considerations in terms of apical pulse
< 60 (adult)
< 90 (children)
*do not adm.
104
Warfarin route
Oral and IV
104
heparin route
SQ and IV
105
beta 1 acts on the following:
cardiac myocyte
cardiac nodal tissue
kidney
106
beta 2 acts on the following:
GI system
vascular smooth muscle
skeletal muscle
ciliary body of the eye
107
selective beta blockers
metoprolol
atenolol
esmolol
108
nonselective beta blockers
propanolol
sotalol
tinolol
109
non-selective beta-blocker effects
Dec. IOP
Bronchoconstriction
Hypo/ Hyperglycemia
Peripheral Vasoconstriction
Dec. HR
110
Antilipidemics effects
Dec. LDL
HMG-Coa reductase inhibitors
111
Examples of Antilipidemics
atorvastatin
simvastatin
112
effects of atorvastatin
sore muscle
113
bile acid sequestrants
colestipol (Colestid)
cholestyramine (Question)
114
effects of antianginals
Dec. resistance, workload, and cardiac output
115
antianginals 4Bs
Bradycardia
Bad for patients with respiratory problems
Blood sugar masking
Bad for patients with heart failure
116
Nitrates effects
vasodilator BV
dilates
decrease BP
Decrease vascular resistance
117
Nitrate drug examples:
nitroglycerin, nitroprusside, hydralazine, isosurbide, minoxidil, sildenafil
118
Nitrates considerations:
No rinsing
Don't eat/ drink after 5-10 minutes of adm.
119
tranlingual nitrates considerations
direct to oral mucosa via spray
spray 5-8
hold breath 5-10s
avoid inhaling the spray
120
sublingual nitrates considerations
offer sip of water
let med dissolve
under the tongue
don't chew or swallow
121
transdermal patch
hairless area
don't shave
remove patch after 12-14hrs
allow 10-12 hrs patch free
122
topical ointment
instruct patient to remove excess prior applying
rotate site of application
123
transmucosal
between upper lip and gum or in buccal area
between the cheek and gum
124
meds for hypotension and shock
adrenergic agonist
1. dopamine and dobutamine
2. Epinephrine
125
class I
Sodium channel blockers
126
Class II
Beta Blockers
127
Class III
Conduction Delayers
128
Class IV
Calcium Channel Blockers
129
Class I Meds
Quinidine
Procainamide
LIdocaine
Flecainide
130
Class II Meds
Acebutolol
Propranolol
Esmolol
131
Class III Meds
Bretylium
Amiodarone
132
Class IV Meds
Verapamil
Diltiazem
Nifedipine
