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Digoxin
- Normal range 0.5 - 2.0
- Atrial Dysrhythmia w/ dig toxicity (A-Fib at 180)
- Signs of toxicity= N/ Anorexia/ Blurred vision
- Watch out for renal insufficiency
- Quinidine and Digoxin make Dig toxic
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PT of patient 39, ctrl 27. Dose is too low. Target is 1.5-2.5 ctrl. So, titrate drip.
Patient report is 110, 2 hours later.
Now, too high. Protamine
Sulfate is antidote to Heparin.
She goes back on Coumadin bc she goes home with it. 3-5 days therapeutic. Target INR is 2-3. Stay on Coumadin for 6 mo atleast. Keep going on Heparin
till INR is at target. If stopped too soon, could dislodge clot. Hep is short half live, Coumadin is few days.
Follow up lab tests are PT/INR. Teach to watch for bruising/bleeding. Vit K foods maintain consistent consumptions. Spinach, greens. No high risk activities.
FFP for acute hemorrhage on Coumadin
Reverse coag w/ Vit K
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Cardioverted Nursing Implications
- How long in A-fib?
- If longer than 48 hrs than need anticoagulating.
- hr control by Valsalva, Try BB, Carotid massage – if still
- tachy, cardiovert
- informed consent understanding,
- anesthesia/airway,
- Turn sync switch on. No shocking on T wave
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Test prior to compression of venous stasis ulcer
ABI
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Complications from anterior MI
acute mitral regurge bc of capillary muscle rupture
-
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assess before AceI admin
BP, BUN, creat, K and Na
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Valv heart disease results in this cardiac complication?
L vent. Hypertrophy, LVH to HF
-
IVC filter for prevention of?
PE in DVT
-
3rd degree heart block needs?
emergent pacing
-
mechanical Prosthetic heart valves need?
Anticoag, and Ab endocarditis prophy….target INR is 2.5-3.5 for mech. Valves
-
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prolong survival of HF
ACEI and BB
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assess therap effect of Warfarin (Coumadin)
PT/INR
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MI diagnosis
TPN and CKMB
-
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Aortic dissection from limbs
unequal perfusion of limbs
-
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with A-Fib, at risk for?
stroke
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Left HF
congestion in lungs
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Best indicator of renal perfusion after AAA
urine output
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Pre-diabetic =
insulin resistance, hyperlipidemia, albinuria
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