63 Questions
Which nursing implication is important when administering Quinidine?
Monitoring potassium levels
What is a common adverse effect of Lidocaine (Xylocaine) usage?
Neurological symptoms like dizziness and confusion
What is the primary action of Beta Blockers in the heart?
Block the sympathetic response in the heart
What is the primary indication for Amiodarone (Pacerone, Nexterone)?
Atrial fibrillation
What is a common adverse effect of Verapamil (Calan) and Diltiazem (Cardizem)?
Peripheral edema
Why is it important to monitor kidney function when administering antiarrhythmics?
To monitor drug clearance
Which class of drugs blocks sodium movement into myocardial cells?
Class I Sodium Channel Blockers
What is a common adverse effect of Flecainide (Tambocor) and Propafenone (Rythmol)?
Headache and dizziness
When administering Disopyramide (Norpace), what should the nurse monitor closely?
Skin discoloration
What is a common nursing implication when administering Digoxin (Lanoxin)?
Monitor apical heart rate
Which of the following is NOT a mechanism of action for cardiotonic drugs?
Inhibiting sodium-potassium ATPase in myocardial cells
Which of the following is the LEAST accurate statement regarding the loading dose of digitalis?
The loading dose is given intravenously to ensure rapid therapeutic effect.
Which of the following is NOT a factor that predisposes a patient to digoxin toxicity?
Hyperthyroidism
Which of the following is the MOST accurate statement regarding the therapeutic serum digoxin levels?
The therapeutic serum digoxin levels range from 0.8 to 2 ng/mL.
Which of the following is the BEST initial treatment for digoxin toxicity-induced bradycardia?
Atropine
Which of the following is the MOST accurate statement regarding the mechanism of action of Digoxin Immune Fab (Digibind)?
It treats digoxin as an antigen and binds to it.
Which of the following is an EARLY sign of digoxin toxicity?
Nausea and vomiting
Which of the following is the MOST accurate statement regarding the administration of digitalis?
Digitalis can be administered orally or intravenously.
Which of the following is NOT a contraindication for the use of digoxin?
Heart failure
Which of the following is the MOST accurate statement regarding the adverse reactions of digoxin?
Cardiac dysrhythmias are common adverse reactions.
What is the primary indication for Phosphodiesterase Inhibitors?
Short-term management of heart failure when digoxin is ineffective
Which drug is a Class I-A Sodium Channel Blocker derived from Cinchona bark?
Quinidine
What is a common adverse effect of Mexiletine, a Class I-B drug?
Neurological dizziness
Which of the following is an action of Amiodarone (Pacerone, Nexterone)?
Decreases heart rate
What is a common adverse effect of Flecainide (Tambocor) and Propafenone (Rythmol)?
Bradycardia
Which of the following is true regarding Beta Blockers?
They block cardiac cell response to epinephrine
What is a potential adverse effect associated with Class IV - Ca Channel Blockers?
Peripheral edema
Which antiarrhythmic drug is derived from Cinchona bark?
Quinidine
What is the primary action of Phosphodiesterase Inhibitors in the heart?
Decrease contractility of left ventricles
What is a common nursing implication when administering Disopyramide?
Take apical pulse
Which of the following statements about the route and dosing of cardiotonics is INCORRECT?
The loading dose for digitalization is typically given every 6 to 8 hours initially.
Which of the following is NOT a factor that can predispose a patient to digoxin toxicity?
Hyperthyroidism
Which of the following is the RECOMMENDED initial treatment for digoxin toxicity-induced bradycardia?
Atropine
Which of the following adverse reactions is NOT associated with digoxin toxicity?
Hypotension
Which of the following statements about the mechanism of action of cardiotonics is INCORRECT?
They block the movement of potassium into myocardial cells.
Which of the following conditions is NOT listed as an indication for the use of cardiotonics?
Ventricular tachycardia
Which of the following statements about the treatment of digoxin toxicity is CORRECT?
Digoxin Immune Fab (Digibind) is an antidote that treats digoxin as an antigen.
Which of the following statements about the adverse reactions of digoxin is INCORRECT?
Respiratory depression is a common adverse reaction.
Which of the following factors is NOT listed as a contraindication for the use of digoxin?
Atrial flutter
Which of the following statements about the administration of cardiotonics is CORRECT?
Digitalization refers to a series of doses given until the drug begins to exert full therapeutic effect.
What is the primary mechanism of action of cardiotonics?
Decrease conduction velocity through SA and AV nodes
Which electrolyte imbalance is NOT a predisposing factor for digoxin toxicity?
Hypophosphatemia
What visual disturbances are associated with digoxin toxicity?
Blurred vision, halo vision
What is the therapeutic range for serum digoxin levels?
1.5 - 3.0 ng/mL
Which adverse reaction is an early sign of digoxin toxicity?
Nausea and vomiting
What is the antidote for serious digoxin toxicity?
Digoxin Immune Fab (Digibind)
Which condition does NOT predispose a patient to digoxin toxicity?
Hyperthyroidism
What is the loading dose range for digitalization with cardiotonics?
$0.5 - 1.25 mg every 6 to 8 hours$
What is the primary action of Potassium channel blockers in the heart?
Lengthen action potential of myocardial cells
Which antiarrhythmic drug is known for its vasodilating properties and its ability to decrease heart rate and contractility of the left ventricles?
Amiodarone
What is a common adverse effect of Quinidine, a Class I-A Sodium Channel Blocker derived from Cinchona bark?
Bone marrow suppression
Which drug is used as a Class I-C antiarrhythmic to decrease conduction in the Bundle of His and Purkinje Fiber?
Flecainide
What is a common nursing implication when administering Milrinone, a Phosphodiesterase Inhibitor?
Monitor peripheral circulation
Which class of drugs blocks calcium uptake by myocardial cells?
Class IV Ca Channel Blockers
What is the main action of Amiodarone (Pacerone, Nexterone) in the heart?
Lengthen action potential of myocardial cells
What is a common adverse effect associated with Mexiletine, a Class I-B antiarrhythmic drug?
Respiratory depression
Which statement best describes the primary action of Digitalis glycosides like Digoxin?
Increase sodium influx into cardiac cells
What nursing implication is important when administering Propafenone (Rythmol)?
Monitor for pulmonary toxicity
Which of the following statements accurately describes the nursing implications for administering Quinidine, a Class I-A antiarrhythmic drug?
Administer with food, avoid citrus fruits, and monitor for cinchonism.
Which of the following statements regarding the mechanism of action of Beta Blockers is correct?
They reduce sympathetic excitation in the heart and block cardiac cell response to epinephrine.
Which of the following adverse effects is most commonly associated with the use of Amiodarone (Pacerone, Nexterone), a Class III antiarrhythmic drug?
Pulmonary toxicity and photosensitivity
Which of the following statements regarding the use of Lidocaine (Xylocaine), a Class I-B antiarrhythmic drug, is correct?
It should be avoided in patients with respiratory depression.
Which of the following statements regarding the use of Verapamil (Calan) and Diltiazem (Cardizem), Class IV calcium channel blockers, is incorrect?
They are used as first-line treatment for ventricular tachycardia and fibrillation.
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.
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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