Exam 4 - HF - Chapter 27

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the degree of myocardial fiber stretch prior to contraction

preload
what drug reduces preload?

diuretics
the pressure in aorta that must be overcome before blood is ejected from left ventricle?

afterload
what class of drugs reduces afterload?

ACE inhibitors
the strength of contraction?

contractility
what drug increases contractility?

positive intrope (DIGOXIN)
what class of drugs decrease contractility?

negative intrope (BETA-BLOCKERS)
name s/s of left-sided heart failure
- cough
- crackles in lungs
- SOB
- anxiety
- cough with pink-frothy sputum
what are the s/s of right-sided heart failure?
- peripheral edema
- jugular venous distension
- hepatomegaly
- splenomegaly
- fatigue
- activity intolerance
Name a cardiac glycoside drug

digoxin (Lanoxin)
what is the mechanism of action of digoxin?
- to cause more forceful heartbeat
- slower heart rate
what are the side effects of digoxin?
- N/V
- bradycardia
- neutropenia
- dysrhythmias
- dig toxicity
- hold if HR <60
what is the therapeutic range for digoxin?

0.8 - 2.0 ng/ml
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
- ...
what is the antidote for digoxin toxicity?

digibind
what potentiates digoxin toxicity?

hypokalemia
what meds can precipitate digoxin toxicity?

antibiotic with dig
What is the mechanism of action of metoprolol (Lopressor)?
- to slow heart rate and B/P
- reducing workload of the heart
What are the side effects of metoprolol (Lopressor)?
- hypotension
- bradycardia
- sexual dysfunction
- drowsiness
- fatigue
- insomnia
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
Nursing considerations of beta-blockers (metoprolol)?
- assess BP and HR prior to admin
- hold if HR <60
- never stop abruptly
- monitor labs
Why are non-selective beta-blockers not a good treatment option for pts with COPD?

beta-blockers can cause bronchospasms (bronchoconstriction) and exacerbate COPD
What is the antidote for metoprolol overdose?

atropine or isoproterenol for bradycardia

dopamine or dobutamine for hypotension
ACE inhibitors can cause what adverse effects relating to blood cell counts?
- agranulocytosis
- neutropenia (captopril only)
What is the mechanism of action of ACE inhibitors (lisinopril, captopril) when treating HF?

to enhance excretion of Na+ and H2O
What are the side effects of ACE inhibitors (lisinopril, captopril)?
- first-dose hypotension
- cough
- hyperkalemia
- renal failure
- neutropenia
what are the nursing considerations for patients taking beta blockers and digoxin?

Bradycardia

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cbennett

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Exam 4 - HF - Chapter 27

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Exam 4 - HF - Chapter 27

Updated

2017-04-08T18:27:57Z

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