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NCLEX > Cardiovascular meds > Flashcards

Cardiovascular meds Flashcards

1
Q

Action of ACEs

A

block conversion of of angiotensin 1 to angiotensin 2

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2
Q

Action of ARBs

A

selectively block the binding of angiotensin 2 to AT1 receptors found in tissues

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3
Q

Therapeutic use of ACE/ARBs (4)

A
  • HTN
  • Heart failure
  • MI
  • Diabetic nephropathy
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4
Q

Side/adverse effects of ACE/ARBs (3)

A
  • Persistent, non-productive cough
  • Angioedema
  • Hypotension
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5
Q

Calcium channel blocker action

A

Slows movement of calcium into smooth muscle cells causing arterial dilation and decreased blood pressure

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6
Q

Therapeutic uses for calcium channel blockers (2)

A
  • Angina
  • HTN
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7
Q

Precautions for ACE/ARBs

A
  • Diuretic therapy
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8
Q

Precautions for calcium channel blockers (3)

A
  • Use caution in patients taking digoxin and beta blockers
  • Don’t use in patients with heart failure, heart blocks, bradycardia
  • No grapefruit juice
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9
Q

Side/adverse effects for calcium channel blockers (4)

A
  • Constipation
  • Reflex tachycardia
  • Peripheral edema
  • Toxicity
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10
Q

Things to monitor while on ACE/ARBs (2)

A
  • Potassium
  • Blood pressure
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11
Q

Nursing interventions for calcium channel blockers (3)

A
  • IV injection given over 2-3 minutes
  • Slowly taper
  • Monitor heart rate and bp
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12
Q

Alpha adrenergic blockers action

A

Selectively inhibits alpha1 adrenergic receptors causing dilation in peripheral arteries and veins and lowering bp

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13
Q

Alpha adrenergic blockers meds (2)

A
  • Prazosin
  • Doxazosin mesylate
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14
Q

Therapeutic use of alpha adrenergic blockers (2)

A
  • Primary HTN
  • Doxazosin used to treat BPH
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15
Q

Precautions for alpha adrenergic blockers (2)

A
  • Increased risk for hypotension/syncope if taken with other antihypertensives, beta blockers, diuretics
  • NSAIDS decrease effectiveness of Prazosin
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16
Q

Nursing interventions for alpha adrenergic blockers (2)

A
  • Monitor heart rate/bp
  • Take at bedtime to decrease effects of hypotension
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17
Q

Side/adverse effects of alpha adrenergic blockers (2)

A
  • Dizziness
  • Fainting
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18
Q

Centrally acting alpha2 agonists action

A

Stimulate alpha2 in brain reducing peripheral vascular resistance, heart rate, bp

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19
Q

Centrally acting alpha2 agonists meds (3)

A
  • Clonidine
  • Guanfacine HCL
  • Methyldopa
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20
Q

Therapeutic use for centrally acting alpha2 agonists (3)

A
  • Primary HTN
  • Hypertensive crisis
  • Severe cancer pain (epidural)
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21
Q

Precautions for centrally acting alpha2 agonists (4)

A
  • Can’t be used with anticoagulants, hepatic failure, MAOIs
  • Methyldopa can’t be given through the same IV as barbiturates, sulfonamides
  • Use caution in CVA, MI, diabetes, major depression, chronic renal failure
  • Don’t use if lactating
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22
Q

Side/adverse effects of centrally acting alpha2 agonists (5)

A
  • Dry mouth
  • Drowsiness/sedation that resolves over time
  • Rebound HTN
  • Black/sore tongue
  • Leukopenia
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23
Q

Nursing interventions for centrally acting alpha2 agonists (4)

A
  • Monitor for adverse CNS effects, CBC, heart rate, bp, weight gain, edema
  • Watch for rebound HTN 48 hours after stopping
  • Never skip a dose
  • Take at bedtime to decrease hypotension
  • Notify provider of involuntary, jerky movements, prolonged dizziness, rash, yellow skin
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24
Q

Beta blocker action

A

Blocks stimulation of receptor sites causing decreased cardiac excitability, cardiac output, myocardial oxygen demand, lowers bp by decreasing release of renin in kidneys

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25
Q

Therapeutic uses for beta blockers (5)

A
  • Primary HTN
  • Angina
  • Tachydysrhythmias
  • Heart failure
  • MI
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26
Q

Precautions for beta blockers (4)

A
  • Don’t give to patients with AV block, sinus bradycardia
  • Don’t give non-selective beta blockers to patients with asthma, bronchospasm, heart failure
  • Propranolol can mask symptoms of hypoglycemia in diabetic patients
  • Don’t give labetalol in same IV as furosemide
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27
Q

Selective beta blocker meds (3)

A
  • Metoprolol
  • Metoprolol succinate
  • Atenolol
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28
Q

Non-selective beta blocker meds (3)

A
  • Propranolol
  • Nadolol
  • Labetalol
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29
Q

Side/adverse effects of beta blockers (5)

A
  • Bradycardia
  • Nasal stuffiness
  • AV block
  • Rebound myocardium excitation when stopped abruptly
  • Bronchospasm
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30
Q

Nursing interventions for beta blockers (4)

A
  • Administer 1-2 times daily
  • Don’t stop without talking to provider
  • Hold med if systolic bp <100 or pulse is <60
  • Monitor diabetic patients for s/s of hypoglycemia
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31
Q

Vasodilators action

A

Direct vasodilation of arteries and veins causing rapid reduction of bp

32
Q

Vasodilator meds (4)

A
  • Nitroglycerin
  • Enalaprilat
  • Nitroprusside
  • Hydralazine
33
Q

Therapeutic uses of vasodilators

A
  • Hypertensive emergencies
34
Q

Precautions for vasodilators (3)

A
  • Patients with hepatic/renal disease
  • Older adults
  • Electrolyte imbalances
35
Q

Side/adverse effects of vasodilators (5)

A
  • Dizziness
  • Headache
  • Profound hypotension
  • Cyanide toxicity
  • Thiocyanate poisoning
36
Q

Nursing interventions for vasodilators (4)

A
  • Nitroprusside can’t be mixed with any other medication
  • Apply protective covering to container
  • Throwout unused fluid after 24 hours
  • Monitor continuous ECG/bp
37
Q

Cardiac glycosides action (2)

A
  • Increase force/velocity of myocardial contractions to improve stroke volume/cardiac output
  • Slow conduction rate allowing for increased ventricular filling
38
Q

Cardiac glycoside meds

A

Digoxin

39
Q

Therapeutic uses of cardiac glycosides (2)

A
  • Heart failure
  • Afib
40
Q

Precautions with cardiac glycosides (3)

A
  • Thiazide/loop diuretics increase risk of hypokalemia and precipitate digoxin toxicity
  • ACE/ARBs increase risk of hyperkalemia
  • Verapamil increases risk of toxicity
41
Q

GI effects of digoxin toxicity (4)

A
  • Anorexia
  • Nausea
  • Vomiting
  • Abdominal pain
42
Q

CNS effects of digoxin toxicity (5)

A
  • Fatigue
  • Weakness
  • Diplopia
  • Blurred vision
  • Yellow, green, white halos around objects
43
Q

Nursing interventions for cardiac glycosides (5)

A
  • Assess apical pulse for 1 minute before giving med
  • Notify provider of heart rate less than 60 for adults, 70 for kids, 90 for babies
  • Monitor for signs of toxicity, hypokalemia, hypomagnesemia
  • Notify provider of sudden increase in pulse rate that was previously normal/low
  • Maintain therapeutic level
44
Q

Digoxin toxicity management (4)

A
  • Stop med/potassium wasting meds
  • Treat dysrhythmias with phenytoin/lidocaine
  • Treat bradycardia with atropine
  • Excess overdose give digoxin immune FAB to prevent absorption
45
Q

Antianginal meds actions (2)

A
  • Relax peripheral vascular smooth muscles causing dilation of arteries/veins and reducing venous blood return leading to decreased oxygen demands on the heart
  • Increase myocardial oxygen supply by dilating large coronary arteries and redistributing blood flow
46
Q

Antianginal meds therapeutic uses (2)

A
  • Acute angina attack
  • Prophylaxis for chronic stable/variant angina
47
Q

Precautions for antianginal meds (3)

A
  • Can’t be used in patients with head injuries
  • Hypotensive risk with antihypertensive meds
  • Not given to patients taking erectile dysfunction meds - causes life threatening hypotension
48
Q

Side/adverse effects of antianginal meds (4)

A
  • Headache
  • Orthostatic hypotension
  • Reflex tachycardia
  • Tolerance
49
Q

Nursing interventions for Nitrostat/Nitrolingual (7)

A
  • Sublingual
  • Rest for 5 minutes, not relieved after 1st tablet call 911, take a 2nd, wait 5 minutes and if not relieved take a 3rd
  • Keep in original dark container
  • Nitrolingual can be used for prophylaxis 5-10 minutes before exercising
  • Don’t shake nitrolingual
  • Replace NTG tablets every 6 months
  • Wear medical alert id
50
Q

Nitro-bid (topical) nursing interventions (5)

A
  • Wear gloves when administering
  • Don’t massage/rub area
  • Apply to area without hair
  • Cover area with clear plastic wrap and tape
  • Gradually reduce dose/frequency over 4-6 weeks
51
Q

Nitro dur (patch) nursing interventions (3)

A
  • Skin irritation can alter medication absorption
  • Apply to upper chest, side, pelvis, inner/upper arm
  • Rotate sites and worn for 12-14 hours
52
Q

Antidysrhythmic meds (3)

A
  • Adenosine
  • Amiodarone
  • Atropine
53
Q

Adenosine action

A

Slows conduction time through
AV node, interrupts AV node pathways to restore NSR

54
Q

Amiodarone action

A

Prolongs repolarization, relaxes smooth muscle, decreases vascular resistance

55
Q

Atropine action

A

Increases heart rate by counteracting the muscarine like actions of acetylcholine and other choline esters

56
Q

Therapeutic uses of adenosine

A

Convert SVT to sinus rhythm

57
Q

Side/adverse effects of adenosine (4)

A
  • Flushing
  • Nausea
  • Bronchospasm
  • Prolonged asystole
58
Q

Nursing interventions for adenosine (2)

A
  • Rapid IV push (1-2 seconds)
  • Flush immediately after with normal saline
59
Q

Therapeutic uses of amiodarone (2)

A
  • Vfib
  • Unstable ventricular tachycardia
60
Q

Side/adverse effects of amiodarone (3)

A
  • Bradycardia
  • Cardiogenic shock
  • Pulmonary disorders
61
Q

Nursing interventions for amiodarone (3)

A
  • Incompatible with heparin
  • Can be given PO as maintenance dose
  • Monitor for respiratory complications
62
Q

Therapeutic uses of atropine (3)

A
  • Bradycardia
  • Known exposure to chemical nerve agent
  • Reduce secretions
63
Q

Side/adverse effects of atropine

A

None when used in emergencies

64
Q

Nursing interventions for atropine

A
  • Monitor for dry mouth, blurred vision, photophobia, urinary retention, constipation
65
Q

Antilipemic meds action

A

Lowers LDL levels and increases HDL levels

66
Q

Therapeutic uses of antilipemic meds (3)

A
  • Primary hypercholesterolemia
  • Prevent coronary events
  • Protect against MI/stroke in diabetic patients
67
Q

Precautions for antilipemic meds (2)

A
  • Stopped during pregnancy
  • Use caution in patients with renal dysfunction
68
Q

Side/adverse effects of antilipemic meds (4)

A
  • Muscle aches
  • Hepatotoxicity
  • Rhabdomyolysis
  • Peripheral neuropathy
69
Q

Nursing interventions for antilipemic meds (3)

A
  • Take in evening
  • Monitor liver/renal function lab profiles
  • Low fat/high fiber diet
70
Q

Statin meds action

A

Interferes with hepatic enzyme HMG-CoA to reduce formation of cholesterol precursors

71
Q

Statin precautions (2)

A
  • Prolonged bleeding in patients taking warfarin
  • Interacts with digoxin, warfarin, thyroid hormones, thiazide diuretics, phenobarbital, NSAIDS, tetracycline, beta blockers, gemifibrozil, glipizide, glyburide, oral contraceptives, phenytoin
72
Q

Nursing interventions for statins

A
  • Don’t give with grapefruit juice
73
Q

Cholesterol absorption inhibitor meds action

A

Blocks absorption of cholesterol secreted in bile and from food

74
Q

Cholesterol absorption inhibitor med

A
  • Ezetimibe
75
Q

Nursing interventions for cholesterol absorption inhibitors (2)

A
  • Take 2-4 hours after other antilipemics
  • Liver damage increases when taken with statins

NCLEX (40 decks)

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