Cardiovascular Medications: Thrombosis & Arrhythmia

• Commonly used medications affecting thrombosis in the CV system include fibrinolytics, anticoagulants, and platelet inhibitors.

Fibrinolytics

• Act by breaking down existing clots
• Examples: Alteplase (tPA), Tenecteplase (TNK-tPA)

Anticoagulants

• Prevent new clots from forming or existing clots from growing
• Examples: Heparin, Warfarin, Enoxaparin (LMWH)

Platelet Inhibitors

• Prevent platelets from clumping together to form clots
• Examples: Aspirin, Clopidogrel (Plavix)

Antiarrhythmic Drugs

• Four classes exist

Class I: Sodium Channel Blockers

• Affect the rate of cardiac conduction

Class II: Beta-Blockers

• Block adrenergic receptors, slowing heart rate and decreasing blood pressure, which can help with rhythm control

Class III: Potassium Channel Blockers

• Prolong repolarization, which can help with arrhythmias

Class IV: Calcium Channel Blockers

• Slow conduction through the AV node

Cardiovascular Disease (CVD) Medications

Inotropes

• Strengthen the heart's contractions
• Used in heart failure
• Example: Digoxin

Phosphodiesterase III Inhibitors

• Increase cardiac contractility and cause vasodilation
• Example: Milrinone

Renin–Angiotensin Inhibitors

• Lower blood pressure and reduce strain on the heart
• Examples: ACE inhibitors, ARBs

Vasodilators

• Relax blood vessels, reducing blood pressure and workload on the heart
• Example: Nitroglycerin

Antihyperlipidemic Drugs

• Lower cholesterol levels to prevent or slow the progression of atherosclerosis
• Examples: Statins

Percutaneous Coronary Interventions (PCIs)

Indications

• Angina
• Acute myocardial infarction

Nursing Care

• Monitoring vital signs
• Assessing the insertion site for bleeding
• Ensuring patient comfort

Complications of PCI Procedures

• Bleeding
• Hematoma
• Arterial occlusion

Interventions for PCI Complications

• Applying pressure to the insertion site
• Monitoring distal pulses

PCI for Peripheral Arterial Disease (PAD) and Valvular Heart Disease

• PCI can be used to open blocked peripheral arteries and to repair or replace heart valves

Intra-Aortic Balloon Pump (IABP) Therapy

• Involves the insertion of a balloon into the aorta that inflates during diastole and deflates during systole
• This increases coronary perfusion and reduces afterload

Ventricular Circulatory Assistance

• Mechanical devices that support heart function

Indications for IABP Therapy

• Cardiogenic shock
• Unstable angina

Contraindications for IABP Therapy

• Aortic insufficiency
• Aortic dissection

Nursing Interventions for IABP Therapy

• Monitoring vital signs
• Ensuring proper balloon timing

Nursing Interventions for Ventricular Circulatory Assistance

• Preventing infection
• Monitoring for bleeding

Extracorporeal Membrane Oxygenation (ECMO)

• Provides cardiac and respiratory support by oxygenating blood outside of the body

Indications for ECMO

• Severe respiratory failure
• Cardiogenic shock

Nursing Care for ECMO

• Monitoring for bleeding
• Preventing infection

Electrical Cardioversion

• Delivery of an electrical shock to reset the heart's rhythm

Indications for Electrical Cardioversion

• Unstable atrial fibrillation
• Ventricular tachycardia

Procedure for Electrical Cardioversion

• Sedating the patient
• Delivering a synchronized shock

Nursing Management for Electrical Cardioversion

• Monitoring vital signs
• Assessing skin condition

Complications of Pacing

• Infection
• Lead dislodgement

Interventions for Pacing Complications

• Antibiotics for infection
• Repositioning or replacing leads

Nursing Management of the Patient with a Pacemaker

• Monitoring the incision site
• Educating the patient on pacemaker function

Implantable Cardioverter-Defibrillator (ICD)

• Device that monitors heart rhythm and delivers a shock to correct life-threatening arrhythmias

Indications for ICD

• Ventricular tachycardia
• Ventricular fibrillation

Components of ICD

• Pulse generator
• Leads

Functions of ICD

• Antitachycardia pacing
• Cardioversion
• Defibrillation

Nursing Management of a Patient with an ICD

• Monitoring the incision site
• Educating the patient on ICD function

Causes of Cardiopulmonary Arrest

• Myocardial infarction
• Respiratory failure

Steps of Cardiopulmonary Resuscitation (CPR)

• Chest compressions
• Airway management
• Breathing support

Role of Resuscitation Team Members

• Ensuring effective chest compressions
• Administering medications

Chronic Aortic Aneurysm

• Gradual bulging of the aorta over time
• Often asymptomatic until rupture

Acute Aortic Dissection

• Sudden tear in the aorta's wall
• Severe pain
• Can be life-threatening

Clinical Findings of Chronic Aortic Aneurysm

• Pulsating mass in the abdomen

Clinical Findings of Acute Aortic Dissection

• Sudden, severe chest or back pain

Indications for Coronary Artery Bypass Grafting (CABG) Surgery

• Significant blockages in multiple coronary arteries

Indications for Valvular Surgery

• Stenosis or regurgitation of heart valves

Nursing Care Before CABG and Valve Surgery:

• Preoperative teaching
• Ensuring patient stability

Nursing Care After CABG and Valve Surgery

• Monitoring vital signs
• Managing pain

Mitral and Aortic Valves

Stenosis

• Valves that don't open fully
• Obstructing blood flow

Insufficiency

• Regurgitation
• Valves that don't close properly
• Causing blood to leak backward

Pathophysiologic Implications of Stenosis

• Increased workload on the heart

Pathophysiologic Implications of Insufficiency

• Decreased cardiac output

Nursing Interventions to Prevent Complications After Cardiac Surgery:

• Early ambulation
• Respiratory support

Carotid Endarterectomy

• Surgical procedure to remove plaque from the carotid artery

Indications for Carotid Endarterectomy

• Significant carotid artery stenosis

Nursing Care Before Carotid Endarterectomy

• Neurological assessment

Nursing Care After Carotid Endarterectomy

• Monitoring for signs of stroke

Overview of medications used in cardiovascular disease (CVD), focusing on thrombosis and arrhythmia. Includes fibrinolytics, anticoagulants, platelet inhibitors, and antiarrhythmic drug classifications. Details mechanisms and examples of each class.