Mod 2 Antianginals

Question 1

What do anti-anginals treat?

Answer 1

They treat the symptoms, they do not address the root cause.

Question 2

What is indication for anti-anginals?

Answer 2

Treatment and prevention-patients have cardiac insufficiency

Question 3

How must nitro be stored and what must nurse do when administering? Why?

Answer 3

Cool dark place, wear gloves because med is a tiny sublingual pill and will absorb into hands

Question 4

What doanti-anginals do?

Answer 4

Vasodilation

Question 5

How can nitroglycerin be administered?

Answer 5

Sublingual and transdermal

Question 6

What is dosing for acute nitro?

Answer 6

Take 1 SL tab wait 5 min, if no resolution, take another SL tab, wait 5 min, if still no resolution, take another tab and call 911.

Question 7

What does it mean if 3 tabs of nitro Won’t resolve angina symptoms?

Answer 7

Complete blockage, need to call 911

Question 8

What is onset of nitro?

Answer 8

1-3 min

Question 9

What negative effects can nitro have?

Answer 9

Decreases BP and heart rate

Question 10

What is PO version of nitro called?

Answer 10

Isosorbide mononitrate

Question 11

If you are having an acute attack of angina, would you take PO?

Answer 11

No, don’t have time to wait and see if it works.

Question 12

What else does isosorbide mononitrate help with beside angina?

Answer 12

CHF

Question 13

Will NSAIDS help with cardic pain?

Answer 13

No, pain not due to inflammation, it’s due to lack of oxygen and aspirin doesn’t increase oxygen only decreases inflammation.

Question 14

What is an arrhythmia?

Answer 14

Abnormal cardiac rhythm

Just because you have an abnormal rhythm does not mean you have an abnormal rate

Question 15

What does an arrhythmia cause?

Answer 15

Dizziness, palpitations, SOB, fainting, fatigue

Question 16

What are you at an increase risk of if you have an arrhythmia?

Answer 16

Heart attack, stroke, or blood clots

Question 17

What does digoxin do?

Answer 17

Slows the heart rate and increases the force of contraction

Question 18

How is digoxin administered?

Answer 18

PO IV IM

Question 19

What are indications for digoxin?

Answer 19

A-fib

A-flutter

Atrial tachycardia

Question 20

What increases the risk of digoxin toxicity?

Answer 20

Low electrolytes

Question 21

What is the antidote for digoxin?

Answer 21

Immune Fab/Digibind

Question 22

What are the symptoms of digoxin toxicity?

Answer 22

Abdominal pain, nausea, vomiting, visual disturbances, bradycardia, anorexia

Question 23

What is the therapeutic serum range for digoxin?

Answer 23

.5-2 ng/mL

Question 24

What are nursing management precautions for digoxin? 5 of them

Answer 24

Monitor apical pulse for one complete minute prior to administration

Monitor electrolytes (K+, Ca, Mg)

Periodic ECG monitoring

Falls precaution

Patient education

Question 25

What is action of calcium channel blockers?

Answer 25

Blocks calcium entry into cells of vascular smooth muscle and myocardium which results in widening of vessels and easier cardiac pumping

Question 26

What do calcium channel blockers prevent?

Answer 26

Coronary artery spasms

Question 27

What are the contraindications for CCB?

Answer 27

Bradycardia, heart block, uncontrolled arrhythmia

Question 28

What are 3 nursing management tasks for patients on CCB?

Answer 28

Monitor BP Cardiac monitoring for angina and arrhythmia Monitor for signs of CHF

Question 29

What are the nutritional restrictions for amlodipine?

Answer 29

None

Question 30

Which CCB interacts with digoxin?

Answer 30

Dilitiazem HCL---can cause digoxin toxicity

Question 31

How is amlodipine administered?

Answer 31

PO

Question 32

What should be avoided if taking a CCB?

Answer 32

Grape fruit juice

Question 33

What are the two CCBs?

Answer 33

Amlodipine Diltiazem HCL

Question 34

If a patient already has a sick heart, should CCBs be taken?

Answer 34

No!!! Because pressure is needed so the effects of these drugs can cause CHF

Question 35

Where do beta 1 receptors lie?

Answer 35

Adrenergic receptors in heart

Question 36

Where do beta 2 receptors lie?

Answer 36

Adrenergic receptors in heart, uterus, and lungs

Question 37

If beta one is blocked what will happen?

Answer 37

Deceased HR, vasodilation, reduced AV conduction

Question 38

If beta 2 is blocked what happens?

Answer 38

Vasodilation, broncho vasculture constriction, uterine contractions

Question 39

What are contraindications for BB?

Answer 39

CHF, bronchospasms, heart block, bradyarrhythmias

Question 40

Should a patient take a non-selective BB?

Answer 40

No! Will cause broncho constriction

Question 41

What kind of drug is metoprolol tartrate?

Answer 41

Beta 1 selective beta blocker

Question 42

What type of drug is propranolol HCL?

Answer 42

Non-selective beta blocker

Question 43

What kind of drug is carvedilol?

Answer 43

Non-selective beta blocker

Question 44

How does angiotensin cascade work?

Answer 44

Angiotensin I is a protein that promotes release of aldosterone Aldosterone causes angiotensin I to convert to angiotensin II and cause Vasoconstriction

Question 45

Which drugs would to be prescribed in African Americans alone?

Answer 45

ACE inhibitors, they will not work

Question 46

What kind of drug is benazepril?

Answer 46

ACE

Question 47

What is contraindicated for benazepril?

Answer 47

Angioedema

Question 48

What follows water out of cells?

Answer 48

Na +

Question 49

What do diuretics do?

Answer 49

Excrete water and selective electrolytes

Question 50

What are indications for diuretics?

Answer 50

CHF, HTN, increased intra cranial/intra occular pressure

Question 51

What are contraindications for diuretics

Answer 51

Renal/hepatic disease

Question 52

What might diuretics cause?

Answer 52

Photosensitivity

Question 53

Where does furosemide work? What does this mean?

Answer 53

Works in loop of henle so it is not potassium sparing Patient should be on high potassium diet

Question 54

What kind of drug is furosemide and how is it administered?

Answer 54

Diuretic and PO IV IM

Question 55

What kind of drug is spironolactone? How is it administered?

Answer 55

Diuretic, PO

Question 56

What type of diet should patients on spironolactone be on?

Answer 56

Low potassium because this drug is potassium sparing

Question 57

What is angina?

Answer 57

Chest pain caused by inadequate blood supply to heart

Question 58

How is HCTZ administered? Is it potassium sparing?

Answer 58

PO and no, it is not potassium sparing

Question 59

What is mannitol used for?

Answer 59

Hydrocephalus and intra cranial pressure

Question 60

What is administration of mannitol?

Answer 60

IV only, osmotic

Question 61

In addition to typical BP med monitoring, what else do you have to measure?

Answer 61

Weight, labs, intake and output

Question 62

If a patient is on furosemide and digoxin what do you have to be cautious of?

Answer 62

Dehydration, electrolyte imbalance because low electrolytes can cause digoxin toxicity

Question 63

What is most important pediatric medication dosage consideration?

Answer 63

Weight