Final: Antiarrhythmics

Question 1

Metoprolol

Answer 1

Beta blocker, Afib, aflutter, paroxysmal SVT, PAT, severe recurrent ventricular tachycardia, PVCs

Adverse effects: Dysrhythmia, bradycardia, heart failure, hypotension, bronchoconstriction, fatigue, monitor for edema/weight, caution with DM

DO NOT STOP ABRUPTLY

Question 2

Diltiazem (Calcium Channel Blocker)

Answer 2

Calms the heart similar to beta blockers

SVTs, rate control afib and atrial flutter

Adverse effects: Peripheral edema, constipation, bradycardia, worsened heart failure, hypotension

Monitor: Dizziness, weight gain, edema, eat fiber, NO GRAPEFRUIT

Question 3

Adenosine

Answer 3

Termination of SVT

Administration: Must be given IV, very short half life, push as fast as possible followed by quick saline flush, need resuscitation equipment in room

NORMAL TO SEE ASYSTOLE FOR A FEW SECONDS AFTER ADMINISTRATION

Question 4

Digoxin

Answer 4

Lowers HR

Heart failure, afib, atrial flutter, SVT

Administration: IV: Slow over 5-10 minutes; Oral: Once daily compliance essential

Assess: Apical pulse prior to administration, hold for <60 bpm, hold for change in rhythm

Antidote: Digoxin Immune FAB (IV) Digibind

Adverse reaction: Digoxin toxicity (Green and Yellow Halos, blurred vision), arrhythmia worsened with hypokalemia, careful with renal impairment

Question 5

Nursing considerations for all antiarrhythmia medications

Answer 5

Continuous heart monitoring
Look for toxicities
Watch for other dysrhythmias
Monitor respiratory status