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Questions and Answers
The Vaughan Williams classification categorizes amiodarone as a Class III drug. How does this drug work?
The Vaughan Williams classification categorizes amiodarone as a Class III drug. How does this drug work?
- By blocking slow calcium channels
- By prolonging action potential duration (correct)
- By blocking sodium channels and affecting phase 0
- By decreasing spontaneous depolarization and affecting phase 4
Which is an adverse effect associated with the use of procainamide (Procan SR®)?
Which is an adverse effect associated with the use of procainamide (Procan SR®)?
- Tinnitus
- Constipation
- Shortened QT interval
- Diarrhea (correct)
Which nursing diagnosis is appropriate for a patient receiving antidysrhythmics?
Which nursing diagnosis is appropriate for a patient receiving antidysrhythmics?
- Risk for infection
- Risk for injury to self (correct)
- Excess fluid volume
- Impaired skin integrity
A patient will be discharged on quinidine sulphate (Apo-Quin-G®) extended-release tablets for the treatment of ventricular ectopy. What important information should the nurse give the patient about this medication?
A patient will be discharged on quinidine sulphate (Apo-Quin-G®) extended-release tablets for the treatment of ventricular ectopy. What important information should the nurse give the patient about this medication?
What is the drug of choice for acute ventricular dysrhythmias associated with myocardial infarction (MI)?
What is the drug of choice for acute ventricular dysrhythmias associated with myocardial infarction (MI)?
What important precaution should the nurse remember when giving this medication?
What important precaution should the nurse remember when giving this medication?
Which medication can cause a systemic lupus erythematosus-like syndrome in about 30% of patients?
Which medication can cause a systemic lupus erythematosus-like syndrome in about 30% of patients?
A patient has been started on lidocaine (Xylocaine®). The nurse will monitor the patient for which adverse effect of this drug?
A patient has been started on lidocaine (Xylocaine®). The nurse will monitor the patient for which adverse effect of this drug?
What should be monitored closely in a patient who is taking Class IV antidysrhythmics?
What should be monitored closely in a patient who is taking Class IV antidysrhythmics?
Which instructions are appropriate for the nurse to give a patient who is taking an antidysrhythmic drug? (Select all that apply.)
Which instructions are appropriate for the nurse to give a patient who is taking an antidysrhythmic drug? (Select all that apply.)
A female patient has been prescribed warfarin (Coumadin®) in addition to a heparin infusion. What is the reason for her receiving two anticoagulants?
A female patient has been prescribed warfarin (Coumadin®) in addition to a heparin infusion. What is the reason for her receiving two anticoagulants?
Which is a true statement about dipyridamole (Persantine®)?
Which is a true statement about dipyridamole (Persantine®)?
What is the most frequent adverse effect of thrombolytic therapy?
What is the most frequent adverse effect of thrombolytic therapy?
What is the recommended antidote for warfarin (Coumadin) toxicity?
What is the recommended antidote for warfarin (Coumadin) toxicity?
The nurse is administering heparin subcutaneously. Which instruction for doing this is correct?
The nurse is administering heparin subcutaneously. Which instruction for doing this is correct?
Which statement is true for the patient receiving long-term therapy with acetylsalicylic acid (aspirin)?
Which statement is true for the patient receiving long-term therapy with acetylsalicylic acid (aspirin)?
Tissue plasminogen activator (t-PA) is prescribed to someone after a heart attack. The patient asks why he is being prescribed this drug. The nurse's best response is to tell him that the drug is being prescribed to:
Tissue plasminogen activator (t-PA) is prescribed to someone after a heart attack. The patient asks why he is being prescribed this drug. The nurse's best response is to tell him that the drug is being prescribed to:
Which laboratory study is used to monitor the therapeutic effects of heparin?
Which laboratory study is used to monitor the therapeutic effects of heparin?
A patient has started on anticoagulant drugs. What is the primary goal of this therapy?
A patient has started on anticoagulant drugs. What is the primary goal of this therapy?
A patient is taking anticoagulant therapy. Which natural health product should the patient avoid taking?
A patient is taking anticoagulant therapy. Which natural health product should the patient avoid taking?
A patient who is taking warfarin (Coumadin) therapy has a headache and wants to take a pain reliever. Which action is recommended?
A patient who is taking warfarin (Coumadin) therapy has a headache and wants to take a pain reliever. Which action is recommended?
Which laboratory study is used to monitor the therapeutic effects of warfarin (Coumadin)?
Which laboratory study is used to monitor the therapeutic effects of warfarin (Coumadin)?
Which drug is the recommended antidote for heparin toxicity?
Which drug is the recommended antidote for heparin toxicity?
Cholestyramine (Novo-Cholamine®) and colestipol (Colestid®) are most effective in the treatment of which type of hyperlipoproteinemia?
Cholestyramine (Novo-Cholamine®) and colestipol (Colestid®) are most effective in the treatment of which type of hyperlipoproteinemia?
A patient is receiving an antilipemic drug. The nurse should tell the patient to do what in regard to this medication?
A patient is receiving an antilipemic drug. The nurse should tell the patient to do what in regard to this medication?
What should be a patient be told to do to minimize the undesirable adverse effects of nicotinic acid?
What should be a patient be told to do to minimize the undesirable adverse effects of nicotinic acid?
A patient reports that the cholestyramine resin powder (Olestyr®) that was started yesterday clumps and sticks to the glass when being mixed. What is the nurse's best suggestion to the patient for mixing this medication for administration?
A patient reports that the cholestyramine resin powder (Olestyr®) that was started yesterday clumps and sticks to the glass when being mixed. What is the nurse's best suggestion to the patient for mixing this medication for administration?
A patient is taking gemfibrozil to lower her cholesterol level. Which adverse effect of this medication should the nurse tell the patient about?
A patient is taking gemfibrozil to lower her cholesterol level. Which adverse effect of this medication should the nurse tell the patient about?
Patients who are receiving antilipemic drugs need to be closely monitored for the development of which adverse effect?
Patients who are receiving antilipemic drugs need to be closely monitored for the development of which adverse effect?
Which patient meets all the metabolic syndrome criteria to initiate drug therapy?
Which patient meets all the metabolic syndrome criteria to initiate drug therapy?
Which lipoproteins are indicative of a high risk for developing an atherosclerotic plaque formation?
Which lipoproteins are indicative of a high risk for developing an atherosclerotic plaque formation?
A patient who has recently started therapy with a statin drug asks the nurse how long it will take for an effect on his serum cholesterol to be seen. Which is the nurse's best response to the patient's question?
A patient who has recently started therapy with a statin drug asks the nurse how long it will take for an effect on his serum cholesterol to be seen. Which is the nurse's best response to the patient's question?
The nurse should monitor for myopathy (muscle pain) when a patient is taking which class of antilipemic drugs?
The nurse should monitor for myopathy (muscle pain) when a patient is taking which class of antilipemic drugs?
A patient is beginning antilipemic therapy with an HMG-CoA reductase inhibitor. What food should the nurse tell the patient about when discussing possible drug-food interactions?
A patient is beginning antilipemic therapy with an HMG-CoA reductase inhibitor. What food should the nurse tell the patient about when discussing possible drug-food interactions?
Ezetimibe (Ezetrol®), a newer antilipemic drug, works by doing what?
Ezetimibe (Ezetrol®), a newer antilipemic drug, works by doing what?
What is the most important advise to give a patient that is taking an antilipemic?
What is the most important advise to give a patient that is taking an antilipemic?
Which are considered positive risk factors for coronary artery disease? (Select all that apply.)
Which are considered positive risk factors for coronary artery disease? (Select all that apply.)
Which is a true statement about carbonic anhydrase inhibitors (CAIs)?
Which is a true statement about carbonic anhydrase inhibitors (CAIs)?
Patients who are placed on spironolactone (Aldactone®) should be assessed continuously for which condition?
Patients who are placed on spironolactone (Aldactone®) should be assessed continuously for which condition?
The physician has ordered mannitol (Osmitrol®) for a patient. How should this drug be administered?
The physician has ordered mannitol (Osmitrol®) for a patient. How should this drug be administered?
A patient with a new prescription for furosemide (Lasix®) is being discharged. What should the nurse say to this patient concerning this new prescription?
A patient with a new prescription for furosemide (Lasix®) is being discharged. What should the nurse say to this patient concerning this new prescription?
Which statement is true of loop diuretics?
Which statement is true of loop diuretics?
The nurse is teaching a patient about using hydrochlorothiazide. The nurse should ensure the patient knows to be cautious when taking which medication with hydrochlorothiazide?
The nurse is teaching a patient about using hydrochlorothiazide. The nurse should ensure the patient knows to be cautious when taking which medication with hydrochlorothiazide?
Flashcards
Amiodarone (Class III)
Amiodarone (Class III)
Inhibits repolarization, prolongs refractoriness and action potential duration in heart cells.
Antidysrhythmics: Risks
Antidysrhythmics: Risks
Dizziness, fatigue, and orthostatic hypotension can cause falls.
Quinidine toxicity signs
Quinidine toxicity signs
Symptoms include tinnitus, hearing loss, and blurred vision.
Ezetimibe Mechanism
Ezetimibe Mechanism
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Heparin sub-Q injection
Heparin sub-Q injection
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Dipyridamole
Dipyridamole
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Warfarin antidote
Warfarin antidote
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Minimizing Nicotinic acid side effects
Minimizing Nicotinic acid side effects
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Anticoagulants: Ginkgo
Anticoagulants: Ginkgo
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Class IV antidysrhythmics Monitoring
Class IV antidysrhythmics Monitoring
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Study Notes
Anti-arrhythmics
- Amiodarone is a Class III drug that inhibits repolarization, prolongs refractoriness, and increases action potential duration.
- Diarrhea is a potential adverse effect of procainamide therapy.
- Antidysrhythmics may cause dizziness, fatigue, and orthostatic hypotension, increasing the risk for falls and injury.
- Quinidine, a cinchona alkaloid, may cause cinchonism symptoms like tinnitus, loss of hearing, or slight blurring of vision.
- Amiodarone hydrochloride is the drug of choice for ventricular dysrhythmias, has shown promise in managing difficult-to-treat atrial dysrhythmias
- A brief episode of asystole may occur after administering adenosine, given as a fast IV push because of its short half-life.
- Procainamide hydrochloride can cause a systemic lupus erythematosus-like syndrome in about 30% of patients on long-term therapy.
- Convulsions are possible with lidocaine overdose.
- Heart rhythm and blood pressure are monitored closely in patients taking Class IV antidysrhythmics.
- Extended-release medications should not be crushed or chewed, take with food when needed, and caffeine is not recommended when taking antiarrhythmics.
Anticoagulants
- Heparin is used to initiate therapy when oral anticoagulants are prescribed, until lab tests indicate adequate response with warfarin.
- Dipyridamole is used with warfarin to prevent postoperative thromboembolic complications.
- Bleeding, including internal, superficial, and intracranial, is the most frequent adverse effect of thrombolytic therapy.
- Vitamin K is the antidote for warfarin toxicity.
- Heparin is administered subcutaneously using a new, sterile 1.5-cm 25- to 28-gauge needle.
- Liver and clotting functions should be monitored in patients on long-term aspirin therapy.
- Tissue plasminogen activator (t-PA) is a thrombolytic drug that dissolves thrombi in the coronary arteries.
- Activated partial thromboplastin time (aPTT) is monitored during heparin therapy.
- Anticoagulants prevent thrombus formation.
- Avoid ginkgo with anticoagulant therapy, particularly warfarin.
- Acetaminophen is safe in regular doses for pain relief when taking warfarin, but high doses of acetaminophen, aspirin, and NSAIDs may cause increased anticoagulant effects.
- International normalized ratio (INR) is a routine test to evaluate coagulation with warfarin.
- Protamine sulfate is the antidote for heparin toxicity, reversing its anticoagulant properties.
Anti-Lipemics
- Cholestyramine and colestipol are most effective in treating type II hyperlipoproteinemia.
- Extra servings of raw vegetables, bran, and fruits prevent constipation, a possible adverse effect of antilipemic drugs.
- Taking small doses of aspirin with nicotinic acid can minimize cutaneous flushing.
- Cholestyramine powder should be mixed thoroughly with food or fluids, with additional fluids to dissolve any undissolved portions
- Gemfibrozil may cause abdominal discomfort, diarrhea, drowsiness, and dizziness.
- Liver function should be closely monitored in patients receiving antilipemic drugs.
- Elevated LDL levels indicate a high risk for developing an atherosclerotic plaque formation.
- Maximum lipid-lowering may not occur until 6 to 8 weeks after starting statin therapy.
- Muscle pain should be monitored when taking HMG-CoA reductase inhibitors.
- Taking HMG-CoA reductase inhibitors with grapefruit juice may cause complications.
- Ezetimibe selectively inhibits cholesterol absorption in the small intestine.
- Patients receiving statin therapy should be advised to report any unexplained muscular pain or discomfort immediately.
- Positive risk factors for CAD include being male aged 40+ years, cigarette smoking, hypertension (BP higher than 140/90 mm Hg), and family history of premature CAD.
Carbonic Anhydrase Inhibitors and Diuretics
- CAIs can elevate blood glucose levels in patients with diabetes.
- Hyperkalemia may occur with potassium-sparing diuretics like spironolactone.
- Mannitol should be administered via IV infusion through a filter.
- Orthostatic hypotension is a possible problem with diuretic therapy.
- Loop diuretics have a rapid onset of action, making them useful when rapid diuresis is desired.
- Hydrochlorothiazide therapy may lead to hypokalemia, increasing the risk of digitalis toxicity.
- Weakness is a manifestation of hypokalemia.
- Diuretic medication should be taken early in the morning to prevent urination at nighttime.
- Intake, output, and daily weights are the best reflections of a patient's fluid volume status.
- Thiazide diuretics are an option for first-line drug treatment of hypertension.
- Mannitol is used to reduce intracranial pressure and cerebral edema resulting from head trauma.
- Symptoms of hypokalemia include anorexia, nausea, lethargy, muscle weakness, mental confusion, and hypotension.
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