Cardiotonics and AntiArryhtmias
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Questions and Answers

Which nursing implication is important when administering Quinidine?

  • Monitoring potassium levels (correct)
  • Avoiding dairy products
  • Checking for skin discoloration
  • Giving on an empty stomach

    • What is a common adverse effect of Lidocaine (Xylocaine) usage?

  • Respiratory depression
  • Hyperglycemia
  • Neurological symptoms like dizziness and confusion (correct)
  • Hypertension

    • What is the primary action of Beta Blockers in the heart?

  • Stimulate epinephrine production
  • Increase heart rate
  • Lengthen the action potential of myocardial cells
  • Block the sympathetic response in the heart (correct)

    • What is the primary indication for Amiodarone (Pacerone, Nexterone)?

    <p>Atrial fibrillation</p> Signup and view all the answers

    What is a common adverse effect of Verapamil (Calan) and Diltiazem (Cardizem)?

    <p>Peripheral edema</p> Signup and view all the answers

    Why is it important to monitor kidney function when administering antiarrhythmics?

    <p>To monitor drug clearance</p> Signup and view all the answers

    Which class of drugs blocks sodium movement into myocardial cells?

    <p>Class I Sodium Channel Blockers</p> Signup and view all the answers

    What is a common adverse effect of Flecainide (Tambocor) and Propafenone (Rythmol)?

    <p>Headache and dizziness</p> Signup and view all the answers

    When administering Disopyramide (Norpace), what should the nurse monitor closely?

    <p>Skin discoloration</p> Signup and view all the answers

    What is a common nursing implication when administering Digoxin (Lanoxin)?

    <p>Monitor apical heart rate</p> Signup and view all the answers

    Which of the following is NOT a mechanism of action for cardiotonic drugs?

    <p>Inhibiting sodium-potassium ATPase in myocardial cells</p> Signup and view all the answers

    Which of the following is the LEAST accurate statement regarding the loading dose of digitalis?

    <p>The loading dose is given intravenously to ensure rapid therapeutic effect.</p> Signup and view all the answers

    Which of the following is NOT a factor that predisposes a patient to digoxin toxicity?

    <p>Hyperthyroidism</p> Signup and view all the answers

    Which of the following is the MOST accurate statement regarding the therapeutic serum digoxin levels?

    <p>The therapeutic serum digoxin levels range from 0.8 to 2 ng/mL.</p> Signup and view all the answers

    Which of the following is the BEST initial treatment for digoxin toxicity-induced bradycardia?

    <p>Atropine</p> Signup and view all the answers

    Which of the following is the MOST accurate statement regarding the mechanism of action of Digoxin Immune Fab (Digibind)?

    <p>It treats digoxin as an antigen and binds to it.</p> Signup and view all the answers

    Which of the following is an EARLY sign of digoxin toxicity?

    <p>Nausea and vomiting</p> Signup and view all the answers

    Which of the following is the MOST accurate statement regarding the administration of digitalis?

    <p>Digitalis can be administered orally or intravenously.</p> Signup and view all the answers

    Which of the following is NOT a contraindication for the use of digoxin?

    <p>Heart failure</p> Signup and view all the answers

    Which of the following is the MOST accurate statement regarding the adverse reactions of digoxin?

    <p>Cardiac dysrhythmias are common adverse reactions.</p> Signup and view all the answers

    What is the primary indication for Phosphodiesterase Inhibitors?

    <p>Short-term management of heart failure when digoxin is ineffective</p> Signup and view all the answers

    Which drug is a Class I-A Sodium Channel Blocker derived from Cinchona bark?

    <p>Quinidine</p> Signup and view all the answers

    What is a common adverse effect of Mexiletine, a Class I-B drug?

    <p>Neurological dizziness</p> Signup and view all the answers

    Which of the following is an action of Amiodarone (Pacerone, Nexterone)?

    <p>Decreases heart rate</p> Signup and view all the answers

    What is a common adverse effect of Flecainide (Tambocor) and Propafenone (Rythmol)?

    <p>Bradycardia</p> Signup and view all the answers

    Which of the following is true regarding Beta Blockers?

    <p>They block cardiac cell response to epinephrine</p> Signup and view all the answers

    What is a potential adverse effect associated with Class IV - Ca Channel Blockers?

    <p>Peripheral edema</p> Signup and view all the answers

    Which antiarrhythmic drug is derived from Cinchona bark?

    <p>Quinidine</p> Signup and view all the answers

    What is the primary action of Phosphodiesterase Inhibitors in the heart?

    <p>Decrease contractility of left ventricles</p> Signup and view all the answers

    What is a common nursing implication when administering Disopyramide?

    <p>Take apical pulse</p> Signup and view all the answers

    Which of the following statements about the route and dosing of cardiotonics is INCORRECT?

    <p>The loading dose for digitalization is typically given every 6 to 8 hours initially.</p> Signup and view all the answers

    Which of the following is NOT a factor that can predispose a patient to digoxin toxicity?

    <p>Hyperthyroidism</p> Signup and view all the answers

    Which of the following is the RECOMMENDED initial treatment for digoxin toxicity-induced bradycardia?

    <p>Atropine</p> Signup and view all the answers

    Which of the following adverse reactions is NOT associated with digoxin toxicity?

    <p>Hypotension</p> Signup and view all the answers

    Which of the following statements about the mechanism of action of cardiotonics is INCORRECT?

    <p>They block the movement of potassium into myocardial cells.</p> Signup and view all the answers

    Which of the following conditions is NOT listed as an indication for the use of cardiotonics?

    <p>Ventricular tachycardia</p> Signup and view all the answers

    Which of the following statements about the treatment of digoxin toxicity is CORRECT?

    <p>Digoxin Immune Fab (Digibind) is an antidote that treats digoxin as an antigen.</p> Signup and view all the answers

    Which of the following statements about the adverse reactions of digoxin is INCORRECT?

    <p>Respiratory depression is a common adverse reaction.</p> Signup and view all the answers

    Which of the following factors is NOT listed as a contraindication for the use of digoxin?

    <p>Atrial flutter</p> Signup and view all the answers

    Which of the following statements about the administration of cardiotonics is CORRECT?

    <p>Digitalization refers to a series of doses given until the drug begins to exert full therapeutic effect.</p> Signup and view all the answers

    What is the primary mechanism of action of cardiotonics?

    <p>Decrease conduction velocity through SA and AV nodes</p> Signup and view all the answers

    Which electrolyte imbalance is NOT a predisposing factor for digoxin toxicity?

    <p>Hypophosphatemia</p> Signup and view all the answers

    What visual disturbances are associated with digoxin toxicity?

    <p>Blurred vision, halo vision</p> Signup and view all the answers

    What is the therapeutic range for serum digoxin levels?

    <p>1.5 - 3.0 ng/mL</p> Signup and view all the answers

    Which adverse reaction is an early sign of digoxin toxicity?

    <p>Nausea and vomiting</p> Signup and view all the answers

    What is the antidote for serious digoxin toxicity?

    <p>Digoxin Immune Fab (Digibind)</p> Signup and view all the answers

    Which condition does NOT predispose a patient to digoxin toxicity?

    <p>Hyperthyroidism</p> Signup and view all the answers

    What is the loading dose range for digitalization with cardiotonics?

    <p>$0.5 - 1.25 mg every 6 to 8 hours$</p> Signup and view all the answers

    What is the primary action of Potassium channel blockers in the heart?

    <p>Lengthen action potential of myocardial cells</p> Signup and view all the answers

    Which antiarrhythmic drug is known for its vasodilating properties and its ability to decrease heart rate and contractility of the left ventricles?

    <p>Amiodarone</p> Signup and view all the answers

    What is a common adverse effect of Quinidine, a Class I-A Sodium Channel Blocker derived from Cinchona bark?

    <p>Bone marrow suppression</p> Signup and view all the answers

    Which drug is used as a Class I-C antiarrhythmic to decrease conduction in the Bundle of His and Purkinje Fiber?

    <p>Flecainide</p> Signup and view all the answers

    What is a common nursing implication when administering Milrinone, a Phosphodiesterase Inhibitor?

    <p>Monitor peripheral circulation</p> Signup and view all the answers

    Which class of drugs blocks calcium uptake by myocardial cells?

    <p>Class IV Ca Channel Blockers</p> Signup and view all the answers

    What is the main action of Amiodarone (Pacerone, Nexterone) in the heart?

    <p>Lengthen action potential of myocardial cells</p> Signup and view all the answers

    What is a common adverse effect associated with Mexiletine, a Class I-B antiarrhythmic drug?

    <p>Respiratory depression</p> Signup and view all the answers

    Which statement best describes the primary action of Digitalis glycosides like Digoxin?

    <p>Increase sodium influx into cardiac cells</p> Signup and view all the answers

    What nursing implication is important when administering Propafenone (Rythmol)?

    <p>Monitor for pulmonary toxicity</p> Signup and view all the answers

    Which of the following statements accurately describes the nursing implications for administering Quinidine, a Class I-A antiarrhythmic drug?

    <p>Administer with food, avoid citrus fruits, and monitor for cinchonism.</p> Signup and view all the answers

    Which of the following statements regarding the mechanism of action of Beta Blockers is correct?

    <p>They reduce sympathetic excitation in the heart and block cardiac cell response to epinephrine.</p> Signup and view all the answers

    Which of the following adverse effects is most commonly associated with the use of Amiodarone (Pacerone, Nexterone), a Class III antiarrhythmic drug?

    <p>Pulmonary toxicity and photosensitivity</p> Signup and view all the answers

    Which of the following statements regarding the use of Lidocaine (Xylocaine), a Class I-B antiarrhythmic drug, is correct?

    <p>It should be avoided in patients with respiratory depression.</p> Signup and view all the answers

    Which of the following statements regarding the use of Verapamil (Calan) and Diltiazem (Cardizem), Class IV calcium channel blockers, is incorrect?

    <p>They are used as first-line treatment for ventricular tachycardia and fibrillation.</p> Signup and view all the answers

    Study Notes

    • Digoxin (Lanoxin) nursing implications include monitoring apical heart rate for a full minute, blood pressure, lung sounds, respirations, intake and output, daily weights, and examining extremities for edema and neck for jugular vein distention.
    • Nursing implications for digoxin administration emphasize taking the medication at the same time each day, oral preparation without regard to meals, avoiding antacids, monitoring potassium levels, and conducting periodic EKG, electrolyte, liver, and kidney function tests.
    • Positive outcomes of administering phosphodiesterase inhibitors include decreased urine output, weight, edema, shortness of breath, and fatigue relief, as they exhibit positive inotropic activity and vasodilating properties in short-term heart failure management when digoxin is ineffective.
    • Anti-arrhythmic drugs like quinidine, disopyramide, lidocaine, mexiletine, phenytoin, flecainide, and propafenone are categorized into classes I-A, I-B, I-C, and II based on their mechanisms of action and indications for treating various types of arrhythmias.
    • Beta blockers such as propranolol and acebutolol are used to manage supraventricular tachycardia and ventricular arrhythmias by reducing sympathetic excitation in the heart and blocking beta receptors, with common adverse effects on different body systems.
    • Class III anti-arrhythmics like amiodarone are potassium channel blockers that lengthen action potential in myocardial cells to treat ventricular arrhythmias effectively.
    • Class IV drugs like verapamil and diltiazem are calcium channel blockers that block calcium uptake by myocardial cells to manage various cardiac arrhythmias, with potential adverse effects on different body systems.
    • Cardiotonics, also known as cardiac glycosides or digitalis glycosides, enhance calcium movement into myocardial cells to increase cardiac output through positive inotropic activity and decrease conduction velocity through SA and AV nodes, commonly used in heart failure, atrial fibrillation, flutter, and supraventricular tachycardia.

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    Description

    Learn about cardiotonics, also known as cardiac glycosides or digitalis glycosides. Explore their indications for heart conditions like heart failure, atrial fibrillation, and atrial flutter, as well as their drug action in enhancing calcium movement into myocardial cells and increasing cardiac output.

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