cardiovascular agents power point

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cwawrzyn
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80707
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cardiovascular agents power point
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2011-04-21 11:53:42
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cardiovascular agents power point
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  1. Site where electrical impulse originates
    pacemaker of the heart
    SA node - sinoatrial node
  2. Depolarization
    Na & Ca enter a cardiac cell, irritate the cell & cause contraction
  3. Repolarization
    Return of the cell to resting after depolarization; caused by K ions
  4. Cardiac output: CO
    The volume of blood expelled from the heart in one minute
  5. Stroke volume: SV
    • The amount of blood ejected from the left ventricle with each heart beat
    • ( CO = SV x HR )
  6. Factors affecting stroke volume
    • (PAC)
    • Preload-the volume of blood in the L ventricle before it contracts.
    • Afterload-the resistance against which the L ventricle must pump in order to get blood into the systemic circulation
    • Contractility-force of contrction
  7. Name three cardiac disorders
    • CHF
    • Angina Pectoris
    • Cardiac Dysrhythmias
  8. What is CHF
    • Heart unable to pump adequately
    • Weak enlarged geart muscle
    • Blood backs up into the lungs & peripheral tissue
    • L side failure --> pulmonary
    • R side failure --> peripheral congestion
  9. What is Angina Pectoris
    • Acute cardiac pain from inadequate bliid flow through coronary arteries --> anoxia --> pain
    • May occur with exertion, stress, or extreme cold
    • Usually transient (lasting 3-5 minutes)
    • Subsides when precipitating factor relieved
  10. What is Cardiac Dysrhythmia
    • Deviation from normal HR and rhythm: bradycardia, tachycardia, irregular HR
    • Named by site of origin: atrial, ventricular, nodal
    • Atrial dysrhythmia: prevent proper filling of ventricles resulting in lower CO
    • Ventricular dysrhythmia-results in lower or absent CO: life threatening
  11. Use of cardiac glycosides
    • Treatment of CHF
    • Atrial fibrillation
    • Flutter
  12. Action of cardiac glycosides
    • Raise force of contraction
    • Lower HR
    • Lower conduction
  13. S.E. of cardiac glycosides
    • GI: anorexia, N & V, diarhea
    • CV: badycardia, PVC's
    • EENT: blurred vision, haloes
    • Electrolyte: lower K
  14. Nursing intervention for cardiac glycosides
    • Administer: with food
    • Monitor: AP for one ful minute. Hold if <60 bpm and report
    • Monitor for hypokalemia: muscle weakness, arrhythmias. higher K in diet
    • High Risk For Toxicity
  15. Cardiac glycosides:
    1.Toxicity
    2.Antidote
    3.Implications
    • 1.bradycardia, dysrhythmias, headaches, nausea and vomiting, visual illusions: green and yellow haloes, confusion\delirium
    • 2. Digibind (binds with digoxin)
    • 3.Monitor serum digitalis levels:
    • A.Therapeutic range:
    • I. 0.5 - 2.0 nanograms\ml
    • B.*Very narrow:high risk for toxicity
  16. Antianginal Agents:
    1. Uses
    2. categories
    • 1. used to treat angina pectoris
    • 2. categories:(NBC)
    • - Nitrates
    • - Beta Blockers
    • - Calcium Channel Blockers
    • -(watching NBC on tv relieves heart pain)
  17. Nitrates:
    1. action
    2. common drugs
    3. administation tips
    • Nitrates:
    • 1. lower cardiac oxygen demands by lower preload and afterload. Vasodilatation of collateral coronary vessels
    • 2. nitroglycerin (Nitrostat)
    • 3. store tablets in glass container in cool, dark place\ SL - offer sips of water first\ May repeat dose q 5 min up to 3X\ transdermal patch - wear gloves
  18. Nitrates:
    1. SE (nursing interventions)
    • Nitrates:
    • 1. tachycardia(monitor pulse)
    • 2. hypotension(monitor BP, move slowly)
    • 3. headache, dizziness(avoid alcohol)
    • 4. weakness(monitor safety)
  19. Action of Beta blockers.
    block beta 1 receptor site thereby blocking the release of epiniphrine and norepinephrine resulting in lower oxygen demand, lower HR and lower BP
  20. Common beta blocker drugs
    • atenolol (Tenormin)
    • propranolol (Inderal)
  21. Antianginal Agents
    • Nitrates
    • Beta blockers
    • Calcium channel blockers
  22. SE and nursing internventions of beta blockers
    • SE ( nursing interventions )
    • 1. hypotension(monitor BP, arise slowy)
    • 2. bradycardia(monitor pulse)
    • 3. bronchspasm(assess lung sounds
    • 4. impotence(warn client)
  23. Action of CCB's
    lower oxygen demand by lowering cardiac contractility and workead; relaxes coronary arteries
  24. common CCB drugs
    • diltiazem(Cardizem)
    • verapamil(Calan)
    • nifedipine(Procardia)
  25. SE (nursing interventions)
    • 1.headache (report)
    • 2.dysrhythmias (monitor pulse)
    • 3.hypotension, dizziness (monitor BP,arise slowly)
    • 4.flushing, rash (report)
  26. Antidysrhythmics are used for what?
    To treat cardiac dysrhythmias
  27. Types of antidysrhythmics
    • Class I: sodium channel blockers
    • Class II: Beta blockers
    • ClassIII: drugs that prolong repolarization
    • Class IV: Ca channel blockers
  28. Action of class I SCB
    • Action of SCB:
    • Lower Na influx to cardiac cells then Lowers conduction velocity
    • Lower automaticity
    • Raises repolarization
  29. Common SCB drugs
    • lidocaine (xylocaine)
    • procainamide (pronestyl)
  30. Action of class II Beta blockers
    To block beta 1 receptors blocking epinephrine and norepinephrine release to lower HR and Bp and lower conduction automaticity
  31. Common Class II beta blocker drugs
    propranolol(Inderal)
  32. Class III antidysrhytmics:
    Action and Common drugs
    • Action- prolongs repolarization
    • Common drugs:
    • bretylium (Bretylol)
    • amiodarone HCL (Cordarone)
  33. Class IV Ca channel blockers:
    Action and common drugs
    • Action: lower oxygen demand by lowering carkeac contractility and workliad; relaxes coronary arteries
    • Common drugs:
    • verapamil (Calan)
    • dilitiazem (Cardizem)
  34. Antidysrhtyhmics:
    SE (nursing interventions)
    • Bradycardia (monitor pulse)
    • Dysrhythmias (monitor EKG)
    • Orthostatic hypotinsion (monitor Bp, arise slowly)
    • Dizziness (monitor safety, avoid alcohol)
    • Anorexia, nausea (take with food)
    • Vomiting, diarrhea (report)
    • Rash, flushing,, pruritis (report)

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