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MedSurg Nursing; N1110 > Medications: Cardiovascular > Flashcards

Medications: Cardiovascular Flashcards

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1
Q

What are the drug classes of Acetylsalicyclic Acid (ASA) aka Aspirin

A

Anti-Platelet Aggregator
Salicylate
NSAID

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2
Q

Of its many drug classes, which is the reason ASA (Aspirin) is given for cardiovascular health?

A

Anti-Platelet Aggregator

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3
Q

How does ASA (Aspirin) work in the body as an Anti-Platelet Aggregator?

A

Inhibits platelet aggregation in the arteries

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4
Q

How does ASA (Aspirin) work in the body as a Salicylate and a NSAID

A

Inhibits prostaglandin synthesis to reduce pain and fever

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5
Q

What route is ASA (Aspirin) administered? When is it administered?

A

Given PO
Given daily for anti-platelet aggregator effects
Given daily or PRN for salicylate and NSAID effects

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6
Q

What lab should be monitored when the patient is taking daily ASA (Aspirin)

A

Platelets

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7
Q

What complications are ideally being prevented by administering a daily ASA (Aspirin)

A

Transischemic Attack (TIA)
Stroke
Myocardial Infarction (MI)
Coronary Artery Disease (CAD)

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8
Q

When a patient takes ASA (Aspirin) or Plavix (Clopidogrel) daily, what are they at increased risk for? What education needs to be provided?

A

Increased risk for bleeding
Educate the patient on increased bruising and bleeding more easily
Educate the patient on s/s of bleeding (blood in urine or stool)

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9
Q

If a patient presents with s/s of bleeding, what labs must the nurse assess?

A

Hemoglobin
Hematocrit
RBCs
Platelets

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10
Q

What is the drug class of Plavix (Clopidogrel)?

A

Anti-Platelet Aggregator

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11
Q

How does Plavix (Clopidogrel) work in the body?

A

Inhibits platelet aggregation in the arteries

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12
Q

What complications are ideally being prevented by administering a daily Plavix (Clopidogrel)?

A 
Transischemic Attack (TIA)
Stroke
Myocardial Infarction (MI)
Coronary Artery Disease (CAD)
Stenosis of coronary stents
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13
Q

What are medications that fall under the drug class of a statin?

A

Simvastatin (Zocor)
Atorvastatin (Lipitor)
Pravastatin (Pravachol)

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14
Q

What drug class are the following medications:
Simvastatin (Zocor)
Atorvastatin (Lipitor)
Pravastatin (Pravachol)

A

Statin

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15
Q

How does a statin work?

A

Reduces LDL and total cholesterol by reducing cholesterol synthesis in the liver
Statins can increase HDL levels
Statins can decrease triglyceride level

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16
Q

How is a statin administered? When is it administered? Why?

A

Administered PO

Administered daily, at night; because this is when cholesterol synthesis is the highest

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17
Q

What labs need to be monitored when a patient is taking a statin?

A

HDL, LDL, Triglycerides, Total Cholesterol: These labs will tell us how well the statin is working

AST, ALT, ALP: These labs will tell us if liver function is impaired (statins are hepatotoxic)

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18
Q

How long must a patient remain on a statin?

A

Lifelong, unless other measures (like diet and exercise) are taken to reduce cholesterol.
If high cholesterol is genetic, modifiable risk factors will not change cholesterol levels

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19
Q

What medications fall under the drug class of a loop diuretic?

A

Bumetanide (Bumex)
Furosemide (Lasix)
Tosemide (Demadex)

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20
Q

The medications Bumetanide (Bumex), Furosemide (Lasix), and Tosemide (Demadex) are in what drug class?

A

Loop Diuretic

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21
Q

How does a loop diuretic work?

A

It is a potent diuretic
It increases renal secretion of sodium, chloride, potassium, and water
It increases urine output - thus removing fluid from the body
When fluid is removed, it will decrease intravascular fluid volume, thus lowering blood pressure and decreasing cardiac workload

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22
Q

About how long does it take for diuresis to begin after administration of a PO loop diuretic? How long will it work in the body?

A

Diuresis begins in about 60 minutes

Lasts about 8 hours

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23
Q

What are some reasons diuretic (all types) are given?

A 
To manage:
Hypertension
Chronic Heart Failure
Pulmonary Edema
Edema
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24
Q

When can diuretics be given during the day?

A

They can be given daily or multiple times a day

If only given once a day it should be scheduled in the morning to prevent nocturia

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25
What vital sign should be assessed before and after administering any type of diuretic?
Blood pressure
26
What should be monitored when a patient is taking any type of diuretic?
``` Blood pressure; monitor for hypotension Intake and output Signs and symptoms of dehydration Weight daily Electrolyte levels S/s of electrolyte imbalances ```
27
What medications fall under the drug class of a Thiazide diuretic?
Hydrochlorothiazide - aka HCTZ - (Microzide or Hydrouril) Chlorothiazide (Diuril) Metolazone
28
The medications Hydrochlorothiazide - aka HCTZ - (Microzide or Hydrouril), Chlorothiazide (Diuril) and Metolazone are in what drug class?
Thiazide Diuretic
29
How does a Thiazide diuretic work?
It increases renal secretion of sodium, chloride, potassium, and water It increases urine output - thus removing fluid from the body When fluid is removed, it will decrease intravascular fluid volume, thus lowering blood pressure and decreasing cardiac workload
30
What is the difference between a Thiazide diuretic and a Loop diuretic?
A loop diuretic is much more potent than a Thiazide diuretic, it does not produce as much diuresis Thiazide diuretics aren't effective in decreased kidney function
31
About how long does it take for diuresis to begin after administration of a PO Thiazide diuretic? How long will it work in the body?
Diuresis begins about 2 hours after administration | Works up to 12 hours
32
What medication falls under the drug class of a Potassium Sparing diuretic?
Spironolactone (Aldactone)
33
The medication Spironolactone (Aldactone) is in what drug class?
Potassium Sparing Diuretics
34
How does a Potassium Sparing Diuretic work?
Blocks actions of aldosterone Increased excretion of sodium and fluid Retains potassium
35
What foods should be avoided when the patient is taking a potassium sparing diuretic?
Foods rich in potassium
36
What medications fall under the drug class of an Angiotensin Converting Enzyme Inhibitor (ACE Inhibitor)?
Lisinopril (Prinivil) Enalapril (Vasotec) Captopril (Capoten) Quinapril (Accupril)
37
The medications Lisinopril (Prinivil), Enalapril (Vasotec), Captopril (Capoten), and Quinapril (Accupril) are in what drug class?
Angiotensin Converting Enzyme Inhibitor (ACE Inhibitor)
38
How does an Angiotensin Converting Enzyme Inhibitor (ACE Inhibitor) work?
It blocks synthesis of Angiotensin II This prevents vasocontriction (promotes vasodilation of arteries --> decreased blood pressure) Prevents release of aldosterone (increased excretion of sodium and fluid, decreased fluid volume --> decreased blood pressure) These actions ultimately reduce peripheral vascular resistance which decreases blood pressure Cardiac workload decreases
39
Why is an Angiotensin Converting Enzyme Inhibitor (ACE Inhibitor) given?
Treatment of: Hypertension Chronic Heart Failure
40
What symptoms does the nurse need to educate on and monitor for when the patient is taking an Angiotensin Converting Enzyme Inhibitor (ACE Inhibitor)
New-onset dry, irritating, persistent, nonproductive cough Angioedema (swollen tongue and lips, narrowed airway --> emergency!)
41
What vital signs should be assessed before and after administration of an Angiotensin Converting Enzyme Inhibitor (ACE Inhibitor)
Blood pressure Monitor for hypotension
42
What electrolyte does an Angiotensin Converting Enzyme Inhibitor (ACE Inhibitor) retain? What imbalance should be monitored for?
Potassium | Monitor for s/s of hyperkalemia
43
What medications fall under the drug class of an Angiotensin II Receptor Blocker (ARB)?
Candesartan (Atacand) Losartan (Cozaar) Olmesartan (Benicar)
44
The medications Candesartan (Atacand), Losartan (Cozaar), and Olmesartan (Benicar) are in what drug class?
Angiotensin II Receptor Blocker (ARB)
45
How does an Angiotensin II Receptor Blocker (ARB) work?
Blocks Angiotensin II Receptors Prevents Angiotensin II from binding to receptors Promotes vasodilation (reduces blood pressure) Decreased release of aldosterone (increases excretion of sodium and fluid --> reduces fluid volume --> decreases blood pressure) These actions ultimately reduce peripheral vascular resistance which decreases blood pressure Cardiac workload decreases
46
Why is an Angiotensin II Receptor Blocker (ARB) given?
Treatment of: Hypertension Chronic Heart Failure
47
What symptoms does the nurse need to educate on and monitor for when the patient is taking an Angiotensin II Receptor Blocker (ARB)?
New-onset dry, irritating, persistent, nonproductive cough Angioedema (swollen tongue and lips, narrowed airway --> emergency!)
48
What electrolyte does an Angiotensin II Receptor Blocker (ARB) retain? What imbalance should be monitored for?
Potassium | Monitor for s/s of hyperkalemia
49
What vital signs should be assessed before and after administration of an Angiotensin II Receptor Blocker (ARB)
Blood pressure Monitor for hypotension
50
Would a patient be prescribed both an Angiotensin II Receptor Blocker (ARB) and an Angiotensin Converting Enzyme Inhibitor (ACE Inhibitor)?
No, they have the same actions on the body.
51
What medications fall under the drug class of a Calcium Channel Blocker (CCB)?
Amlodipine (Norvasc) Nicardipine (Cardene) Nifedipine (Procardia) Diltiazem (Cardizem)
52
The medications Amlodipine (Norvasc), Nicardipine (Cardene), Nifedipine (Procardia), and Diltiazem (Cardizem) are in what drug class?
Calcium Channel Blocker (CCB)
53
How does a Calcium Channel Blocker (CCB) work?
Prevents movement of extracelluar calcium from entering the cell (cardiac cells, smooth muscle cells) ``` Promotes vasodilation (decreases blood pressure) Decreases afterload (decreases cardiac workload and blood pressure) Slows cardiac conduction system (decreases contractility of the myocardium, decreases cardiac workload, decreased myocardial oxygen demand) ```
54
Why is a Calcium Channel Blocker (CCB) given?
To treat: Hypertension Cardiac dysrhythmias (atrial fibrillation)
55
What symptoms does the nurse need to educate on and monitor for when the patient is taking a Calcium Channel Blocker (CCB)?
Monitor and educate on cardiac dysrhythmias and bradycardia
56
What vital signs should be assessed before and after administration of a Calcium Channel Blocker (CCB)
Blood pressure and heart rate Monitor for hypotension and bradycardia
57
When should a Calcium Channel Blocker (CCB) not be given?
If the heart rate is less than 60 bpm
58
What medications fall under the drug class of a Beta Blocker? (differentiate between cardio selective and non selective)
Cardio Selective: Metoprolol Tartrate (Lopressor) Metoprolol Succinate Extended Release (Toprol XL) Atenolol (Tenormin) Non Selective: Propranolol
59
The medications Metoprolol Tartrate (Lopressor) Metoprolol Succinate Extended Release (Toprol XL) Atenolol (Tenormin), and Propranolol are in what drug class?
Beta Blocker
60
How does a Beta Blocker work?
``` Blocks beta receptors from binding to epinephrine, which causes: Decreased heart rate Decreased cardiac output Decreased cardiac workload Decreased myocardial oxygen demand Prevents release of renin ``` Indirectly decreases blood pressure
61
Why is a Beta Blocker given?
To treat: Hypertension Tachycardia
62
What symptoms does the nurse need to educate on and monitor for when the patient is taking a Beta Blocker?
Monitor and educate on hypotension and bradycardia | Hypoglycemic Unawareness in Diabetics
63
What vital signs should be assessed before and after administration of a Beta Blocker
Heart rate and blood pressure
64
When should a Beta Blocker not be given?
If heart rate is less than 60 bpm If blood pressure is less than 100 mmHg systolic Do not administer a nonselective beta blocker (propranolol) to a patient with asthma or COPD
65
What medications fall under the drug class of a combo drug (Alpha and Beta Blocker)?
Carvedilol | Labetalol
66
The medications Carvedilol and Labetalol are in what drug class?
Combo drug (Alpha and Beta Blocker)
67
How does a combo drug (Alpha and Beta Blocker) work?
Blocks alpha and beta receptors from binding to epinephrine, which causes the follow effects ``` Beta Antagonist Actions: Decreased heart rate Decreased cardiac output Decreased cardiac workload Decreased myocardial oxygen demand Prevents release of renin ``` Indirectly decreases blood pressure Alpha Antagonist Actions: Promotes vasodilation of arteries (decreased blood pressure)
68
Why is a combo drug (Alpha and Beta Blocker) given?
To treat: Hypertension Tachycardia
69
What symptoms does the nurse need to educate on and monitor for when the patient is taking a combo drug (Alpha and Beta Blocker)?
Monitor and educate on hypotension and bradycardia | Hypoglycemic Unawareness in Diabetics
70
What vital signs should be assessed before and after administration of a combo drug (Alpha and Beta Blocker)
Heart rate and blood pressure
71
When should a combo drug (Alpha and Beta Blocker) not be given?
If heart rate is less than 60 bpm If blood pressure is less than 100 mmHg systolic Do not administer a nonselective beta blocker (propranolol) to a patient with asthma or COPD
72
Are combo drugs (Alpha and Beta Blocker) cardio selective or non selective?
Non selective
73
How does a direct vasodilator work?
Relaxes smooth muscle (arteries) | Vasodilates arteries, decreases blood pressure
74
What medication falls under the drug class of an Antidysrhythmic Agent?
Amiodarone (Cordarone or Pacerone)
75
The medications Amiodarone (Cordarone or Pacerone) are in what drug class?
Antidysrhythmic Agent
76
How does an Antidysrhythmic Agent work?
Decreases cardiac contractility Promotes dilation of coronary arteries and peripheral blood vessels Controls rhythm and rate during atrial fibrillation
77
Why is an Antidysrhythmic Agent given?
To control heart rate and rhythm
78
What vital signs should be assessed before and after administration of an Antidysrhythmic Agent
Blood pressure and heart rate | Also need to assess heart rhythm
79
What medication falls under the drug class of a Cardiac Glycoside/Inotrope?
Digoxin (Lanoxin)
80
The medication Digoxin (Lanoxin) is in what drug class?
Cardiac Glycoside/Inotrope
81
Why is a Cardiac Glycoside/Inotrope given?
To control heart failure
82
What symptoms does the nurse need to educate on and monitor for when the patient is taking a Cardiac Glycoside/Inotrope
Digitalis Toxicity Bradycardia S/S of hypokalemia
83
How does a Cardiac Glycoside/Inotrope work?
Increases the force of contraction within the ventricles Increases stroke volume This increases cardiac output so that heart rate can decrease and heart doesn't have to work as hard Heart works smarter not harder.. each beat/pump of the ventricles is efficient, so its rate doesn't have to increase to maintain cardiac output.
84
What education needs to be given to the patient when they are taking a Cardiac Glycoside/Inotrope?
Take the medication at the same time each day Educate on the signs and symptoms of Digitalis Toxicity If Digitalis Toxicity s/s are present, report ASAP Monitor heart rate before taking the medication, do not take if <60 bpm
85
What serum levels should be monitored when the patient is taking Digoxin? What is the appropriate range?
Digoxin Levels | Should be between 0.8-2.0 ng/mL
86
If serum Digoxin levels are < 0.8 ng/mL, what does this mean?
There is not enough medication in the body, the medication is not working to its full potential
87
If serum Digoxin levels are > 2.0 ng/mL, what does this mean?
The patient is at risk for or may have developed Digitalis Toxicity. This needs to be treated immediately
88
What vital signs should be assessed before and after administration of a Cardiac Glycoside/Inotrope
Heart rate Do not administer if heart rate is <60 bpm Monitor for bradycardia
89
What can cause Digitalis Toxicity?
High serum levels of Digoxin
90
List the signs and symptoms of Digitalis Toxicity. If these symptoms occur, what does the nurse do?
Bradycardia Anorexia (Loss of appetite) Nausea, Vomiting, Diarrhea Abdominal Discomfort Blurred vision, yellow/green halos visualized Fatigue Confusion Decreased LOC If these s/s are noted or reported the nurse must inform the provider
91
What is the drug class of the medication Nitroglycerin
Direct Vasodilator
92
How does Nitroglycerin work?
Promotes vasodilation of veins and arteries to reduce preload and afterload Reduces oxygen consumption of myocardial tissue Improves oxygen delivery to tissues
93
Why is Nitroglycerin given?
To prevent or treat angina
94
What must you assess before and after Nitroglycerin administration?
BP, HR, pain level

MedSurg Nursing; N1110 (15 decks)

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