ACE Inhibitors and Nitrates are:
a)diuretics
b)vasodilators
c)beta-adrenergic agonists
Vasodilators
An example of a "1st line" med.
1-ACE inhibitor
2-Nitrate
Diuretics decrease blood ______.
volume
Beta-adrenergic agonists increase ______ flow.
calcium
Increased calcium in the muscles results in increased ________.
contractions
Digoxin _____ the HR.
slows.
Digoxin used for ________.
tachycardias.
Afterload is
The pressure the heart must overcome to eject blood to the rest of the body.
Preload is
the amount of blood sitting in the heart before it contracts (diastolic volume).
Cardiac output is
the amount of blood pumped by the heart in one minute.
Stroke Volume is
the amount of blood pumped by the heart with each beat.
Cardiac output=
CO=SV x HR
The ______ side of the heart pumps oxygenated blood into the arteries.
left
Deoxygenated blood returns to the heart via the venous system into the _____ side of the heart.
right
Coronary artery disease is characterized by
progressive luminal narrowing of coronary arteries, typically due to atherosclerosis.
Ischemic means
lack of oxygen to a specific part of the body.
A vasospasm is
a sudden constriction or narrowing of a coronary artery.
A vasospasm is
a sudden constriction or narrowing of a coronary artery.
Angina
Intense chest pain caused by lack of blood supply.
An ACE inhibitor
blocks conversion of angiotensin I to angiotensin II
A common side effect of an ACE inhibitor is
a cough.
ACE inhibitors block conversion of Angiotensin I to II, resulting in a decrease in BP and a decrease in __________.
aldosterone
An important drug-to-drug reaction to remember with ACE inhibitors is
Allopurinol (for gout).
An important drug-to-drug interaction to remember with Angiotensin II receptor blockers (ARBS) is
Phenobarbital (for seizures).
Calcium channel blockers work by
inhibiting the movement of calcium ions across the membranes.
After inserting a foley catheter, the nurse knows to clamp the catheter after ____mL of fluid loss to prevent _______.
800, hypotension (from extreme fluid loss).
Care step 1 of hypertension treament is
lifestyle modifications.
Beta-blockers, ACE inhibitors and calcium channel blockers are all ____________ medications that just work a little differently.
antihypertensive
Loop diuretics deplete _________
potassium.
A patient that is on Lasix needs a __________ supplement.
potassium
Before administering an antihypertensive, the nurse knows she must assess ___ and ___.
BP & HR
HR and BP must be over ___ /___in order to administer an antihypertensive.
60; 90/60
ARBS work by
blocking receptor sites.
A key action of ACE inhibitors is
preventing ACE from converting angiotensin I to angiotensin II.
ACE inhibitors work by
1-
2-
3-
4-
1-blocks conversion of angiotensin I to
angiotensin II.
2-decrease aldosterone
3-small increase in serum potassium
4-decrease BP
This antihypertensive class is known to give you a cough.
ACE inhibitor
This class of antihypertensives controls your blood pressure by inhibiting the movement of calcium ions.
Calcium channel blockers
Nitroprusside (Nitropress) is used for
hypertensive crisis.
Nitroprusside (Nitropuss) belongs to this class of hypertensives.
Vasodilators
True or false:
It is ok for a pregnany woman to take an antihypertensive medication.
False
The nurse knows that benazepril, captopril and enalapril are all ________ hypertensives b/c they end in "il".
ACE inhibitors
The nurse knows that Iosartan (Cozaar) and Candesartan (Atacand) belong to this class of hypertensives because they ends in "tan".
Angiotensin II receptor blockers
The nurse knows Diltiazem (Cardizem) belongs to this class of antihypertensives, even though its drug name doesn't end in "pine" like it's sister drugs, Amlodipine, Felodipine, Isradipine and Nicardipine.
Calcium channel blocker
Nitroprusside (Nitropress) belongs to this class of hypertensives.
vasodilators
A nurse knows to double check the order for Diltiazem (Cardizem) CR because?
to make sure the continued release form is correctly ordered for the patient.
A key contraindication of ACE inhibitors and Angiotensin II-receptor blockers is
impaired renal function
Captopril (Capoten) belongs to this class of hypertensives.
ACE inhibitors
Enalapril (Vasotec) belongs to this class of antihypertensives.
ACE inhibitors.
A nurse knows a patient's condition of impaired renal function could be exacerbated if an ______ _______ is taken.
ACE inhibitor
The absorption of ACE inhibitors _______with food.
decreases
Serious side effects of Captopril (Capoten) are
1-
2-
3-
1-sometimes fatal pancytopenia
2-cough
3-GI distress
A patient taking Phenobarbital is prescribed Losartan. What class of antihypertensives is Losartan and what are the nursing actions?
Angiotensin II receptor-blocker; monitors the patient closely for a drug-to-drug interaction.
True or False:
Digoxin is fast-acting and is given in an emergency situation.
False
Digoxin toxicity indicators usually include:
1-
2-
3-
1-confused
2-nausea/vomitting
3-visual disturbances
During assessment of a 5'0" elderly woman, weighing 100lbs with confusion, nausea/vomitting and visual disturbances and is taking Digoxin, the nurses knows
her blood levels should be checked for Dixoxin toxcity.
Digoxin ______ force of contraction.
increases
Dixoxin belongs to which class of drugs.
cardiac glycosides
Your child is playing in the yard and you found him eating foxglove leaves. How will that effect your child? And what drug is derived from the foxglove plant.
Digoxin.
Cardiac glycosides work immediately or take a while?
They take a while, not fast acting.
Digibind does what?
Binds with Digoxin incase of Digoxin toxicity. It's the antidote for Digoxin.
Cardiac glycosides most important drug to drug interactions to remember are:
1-
2-
3-
4-
1-verapamil
2-amiodarone
3-erythromycin
4-tetracycline
Thyroid hormones _______ the effects of Digoxin.
decrease
Before administering Dixogin, you test?
apical heart rate
Heart block means that sinus node is blocked (electrical signal) so it would be a _______ heart rate.
slower
Since cardiac glycosides act like diuretics, an important contraindication would be _______ insufficiency.
renal
Phosphodiesterase inhibitors are used for treatment of patients in?
heart failure
Phosphodiesterase inhibitors give the heart a ______ and are primarily used in a _______.
crisis
Inamrinone (Inocor) & Milrinone (Primacor) are what class of drugs?
phosphodiesterase inhibitors
The class of drugs known to give the heart a "boost" are
phosphodiesterase inhibitors
An example of a phosphodiesterase inhibitor known as a cardio "tonic" to give the heart a "boost" is
1-Inamrinone (Inocor)
2-Milrinone (Primacor)
What is happening in Phase I of the action potential of the cardiac muscle of the heart?
sodium is equal inside and outside of the heart
During which phase of the action potential of the cardiac muscle does the sodium decline, calcium slowly enter and potassium begin to leave?
Phase II
What is happening during phase III of the action potential of the cardiac muscle cell?
1-rapid depolarization
2-sodium gates close
3-potassium leaves
What is happening during phase II of the action of the cardiac muscle cell?
1-sodium declines
2-calcium comes in
3-potassium
The action potential phase of the cardiac muscle cell in which the heart reaches a point of stimulation.
phase 0
Sodium is equal in which phase of the action potential of the cardiac muscle?
phase I
Sodium declines, calcium begins to enter and potassium begins to leave occurs during which phase of action of cardiac muscle cell?
Phase II
Name five causes of cardiac dysrhythmias
1-acidosis or accumulation of waste products
2-electrolyte disturbances
3-structural damage changing the
conduction pathway thru the heart
4-drugs
5-decrease in oxygen to cells
Lidocaine (xylocaine) in layman terms, _____ the heart muscle.
numb
Lidocaine (xylocaine) belongs to class
a) 1a
b) 1b
c) 1c
1b
Three important characteristics of lidocaine
1-
2-
3-
1-given IV
2-bolus push, then drip if needed
3-short half-life
Common side effects of Lidocaine are
dizziness/drowsiness
propafenone (Rhythmol) is used for ______ _______.
ventricular dysrhythmias
Propafenone (Rhythmol) belongs to this class of antiarrythmics.
1c
Propranolol (Inderal) belongs to this class of antiarrythmics.
Class II
Class II antiarrhythmics are _____ _______.
beta blockers
Beta blockers actions are:
1-block beta receptor sites in the heart
& kidneys.
2-decrease HR
3-decrease cardiac exciteability
4-decrease cardiac output
Beta blockers _______ blood pressure.
decrease
Beta blockers are used for treatment of
1-
2-
1-supraventricular tachycardia
2-PVC's (that extra beat)
Any drug with an "lol" at the end is a?
beta-blocker
Before administering a beta blocker, what must always be assessed and why?
1-HR
2-pulse
b/c if it's too low already you will not administer
Bradycardia and low BP are serious contraindications of this class of antiarrythmics.
beta blockers
Name two serious contraindications of beta blockers.