Exam 4 - HF - Chapter 27

  1. the degree of myocardial fiber stretch prior to contraction
  2. what drug reduces preload?
  3. the pressure in aorta that must be overcome before blood is ejected from left ventricle?
  4. what class of drugs reduces afterload?
    ACE inhibitors
  5. the strength of contraction?
  6. what drug increases contractility?
    positive intrope (DIGOXIN)
  7. what class of drugs decrease contractility?
    negative intrope (BETA-BLOCKERS)
  8. name s/s of left-sided heart failure
    • cough
    • crackles in lungs
    • SOB
    • anxiety
    • cough with pink-frothy sputum
  9. what are the s/s of right-sided heart failure?
    • peripheral edema
    • jugular venous distension
    • hepatomegaly
    • splenomegaly
    • fatigue
    • activity intolerance
  10. Name a cardiac glycoside drug
    digoxin (Lanoxin)
  11. what is the mechanism of action of digoxin?
    • to cause more forceful heartbeat
    • slower heart rate
  12. what are the side effects of digoxin?
    • N/V
    • bradycardia
    • neutropenia
    • dysrhythmias
    • dig toxicity
    • hold if HR <60
  13. what is the therapeutic range for digoxin?
    0.8 - 2.0 ng/ml
  14. what are the s/s of digoxin toxicity (>2.0 ng/ml)?
    • N/V/D
    • flu-like symptoms
    • visual disterbances
    • dysrhythmias
    • brady/tachy
    • hypotension
    • heart block
    • ...
  15. what is the antidote for digoxin toxicity?
  16. what potentiates digoxin toxicity?
  17. what meds can precipitate digoxin toxicity?
    antibiotic with dig
  18. What is the mechanism of action of metoprolol (Lopressor)?
    • to slow heart rate and B/P
    • reducing workload of the heart
  19. What are the side effects of metoprolol (Lopressor)?
    • hypotension
    • bradycardia
    • sexual dysfunction
    • drowsiness
    • fatigue
    • insomnia
  20. What is a potential side effect of beta-blockers metoprolol (Lopressor) on diabetics?
    • may enhance hypoglycemic effects of insulin
    • also may interfere with oral hypoglycemics
  21. Nursing considerations of beta-blockers (metoprolol)?
    • assess BP and HR prior to admin
    • hold if HR <60
    • never stop abruptly
    • monitor labs
  22. Why are non-selective beta-blockers not a good treatment option for pts with COPD?
    beta-blockers can cause bronchospasms (bronchoconstriction) and exacerbate COPD
  23. What is the antidote for metoprolol overdose?
    atropine or isoproterenol for bradycardia

    dopamine or dobutamine for hypotension
  24. ACE inhibitors can cause what adverse effects relating to blood cell counts?
    • agranulocytosis
    • neutropenia (captopril only)
  25. What is the mechanism of action of ACE inhibitors (lisinopril, captopril) when treating HF?
    to enhance excretion of Na+ and H2O
  26. What are the side effects of ACE inhibitors (lisinopril, captopril)?
    • first-dose hypotension
    • cough
    • hyperkalemia
    • renal failure
    • neutropenia
  27. what are the nursing considerations for patients taking beta blockers and digoxin?
Card Set
Exam 4 - HF - Chapter 27
Exam 4 - HF - Chapter 27