Exam 21 - Drugs for Cardiac I
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Questions and Answers

What is the primary use of fibrinolytics in treating myocardial infarction?

  • Dissolving the clot occluding a coronary artery (correct)
  • Reducing cholesterol levels
  • Lowering blood pressure
  • Preventing allergic reactions

What is the maximum time window after the onset of ischemic stroke for a patient to be considered for fibrinolytics?

  • 48 hours
  • 3 hours (correct)
  • 24 hours
  • 72 hours

Which condition is a contraindication for the use of fibrinolytics?

  • Known bleeding disorders (correct)
  • Elevated cholesterol
  • Low blood pressure
  • Diabetes

What is a common side effect of fibrinolytic medications?

<p>Bleeding (A)</p> Signup and view all the answers

What is the mechanism of action of fibrinolytics?

<p>Activating plasminogen to form plasmin (C)</p> Signup and view all the answers

What is a primary treatment goal for acute myocardial infarction (AMI)?

<p>Establish reperfusion (A)</p> Signup and view all the answers

Which of the following is an initial medical treatment for AMI?

<p>Providing adequate oxygenation to the myocardium (A)</p> Signup and view all the answers

What does MONA stand for in the context of initial AMI therapy?

<p>Morphine, Oxygen, Nitroglycerin, Aspirin (C)</p> Signup and view all the answers

Which medication is commonly used to prevent platelet aggregation in AMI?

<p>Aspirin (C)</p> Signup and view all the answers

Besides medications what is an important element of AMI treatment?

<p>Emotional support (D)</p> Signup and view all the answers

Restoring blood flow to the myocardium can be achieved through?

<p>Thrombolytic therapy (C)</p> Signup and view all the answers

Which class of medications might be used to control irregular heart rhythms after an AMI?

<p>Antidysrhythmics (D)</p> Signup and view all the answers

What is the purpose of administering oxygen in the initial treatment of AMI?

<p>To improve oxygenation of the heart muscle (B)</p> Signup and view all the answers

What is the primary use of morphine sulfate in the initial treatment of Acute Myocardial Infarction (AMI)?

<p>Pain relief and anxiety reduction (B)</p> Signup and view all the answers

Morphine binds to opioid receptors in which part of the body?

<p>Central nervous system (A)</p> Signup and view all the answers

Which of the following is a common side effect of morphine sulfate?

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

What medication is used to reverse the adverse effects of morphine?

<p>Naloxone (Narcan) (D)</p> Signup and view all the answers

Nitrates are used during AMI for what purpose?

<p>To reduce ischemic pain and increase coronary perfusion (D)</p> Signup and view all the answers

Nitrates cause vasodilation by relaxing what kind of tissue?

<p>Smooth muscle (C)</p> Signup and view all the answers

Which of the following is a common side effect of nitrate administration?

<p>Headache (C)</p> Signup and view all the answers

Taking nitrates with what type of drug can cause severe hypotension?

<p>Erectile dysfunction drugs (A)</p> Signup and view all the answers

When administering sublingual nitroglycerin for acute angina, how many doses can a patient take before calling 911 if symptoms persist?

<p>Three doses (B)</p> Signup and view all the answers

How should NTG tablets be stored?

<p>In a dark glass container (D)</p> Signup and view all the answers

Which medication is given immediately to patients with suspected acute coronary syndrome (ACS)?

<p>Aspirin (325 mg) (D)</p> Signup and view all the answers

What is the primary mechanism of action of platelet inhibitors?

<p>Inhibit platelet clumping (A)</p> Signup and view all the answers

Which of the following is a common side effect of platelet inhibitors?

<p>Bleeding (A)</p> Signup and view all the answers

Abruptly stopping platelet inhibitors may lead to which adverse effect?

<p>New-onset cardiovascular event (B)</p> Signup and view all the answers

Which vitamin can decrease the effects of anticoagulants when consumed in large amounts?

<p>Vitamin K (A)</p> Signup and view all the answers

Which food is known to interfere with anticoagulants?

<p>Dark leafy greens (D)</p> Signup and view all the answers

Before administering platelet inhibitors, what assessment is most important for the nurse to perform?

<p>Assess if the patient takes medications, herbs, or OTC drugs that can increase bleeding. (D)</p> Signup and view all the answers

Flashcards

Reperfusion

Restoring blood flow to the heart muscle.

Reduce Infarct Size

Limiting the amount of heart tissue damage during a heart attack.

Treat AMI Complications

Addressing issues like arrhythmias, heart failure after a heart attack.

AMI: Emotional Support

Providing information and support to help patients cope with a heart attack.

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Restore Blood Flow

Drugs or interventions to open blocked arteries.

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MONA for AMI

Emergency protocol: IV-line, Oxygen, Aspirin, NTG, and Morphine.

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Antidysrhythmics (AMI)

Medications to stabilize heart rhythm after a heart attack.

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Beta Blockers (AMI)

Medications to slow heart rate and reduce heart's workload.

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Morphine's Action

Binds to opioid receptors in the CNS, reducing pain and anxiety.

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Morphine's Common side effects

Hypotension, respiratory depression, bradycardia, nausea, and sedation.

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Morphine's Adverse Effects

Bradypnea, severe hypotension, decreased urine output, hypothermia, and excessive sedation.

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Monitoring Morphine

Monitor level of consciousness, blood pressure, respiratory rate, and oxygen saturation.

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Nitrates Mechanism

Relaxes smooth muscle, causing vasodilation, decreasing myocardial oxygen demands, and increasing coronary artery perfusion.

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Nitrates Side Effects

Headache, flushing, tachycardia, dizziness, and orthostatic hypotension.

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Nitrates Adverse Effects

Severe postural hypotension, reflex tachycardia, paradoxical bradycardia, vertigo, and weakness.

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Drugs Increase Nitrate Effect

Alcohol, antihypertensive drugs, opioids, and diuretics.

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Drugs Decrease Nitrate Effect

Caffeine, pseudoephedrine, methylphenidate, and certain antidiabetic drugs.

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Nitrates - Nursing Assessment

Patient history and baseline vital signs before administration.

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Fibrinolytics

Medications that dissolve blood clots.

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Fibrinolytic Time Window

Less than 12 hours from symptom onset (ischemic stroke: 3hrs).

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Fibrinolytics: Mechanism

Dissolves clots by activating plasminogen to form plasmin.

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Fibrinolytics: Side Effects

Bleeding, hypotension, allergic reactions.

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Fibrinolytics: Contraindications

History of bleeding disorders, recent stroke, uncontrolled hypertension, head trauma, aortic dissection, pregnancy.

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Aspirin in ACS

An antiplatelet drug used in suspected ACS cases to prevent platelet aggregation.

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Platelet Inhibitors

Drugs that prevent blood clot formation by inhibiting platelet clumping.

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Common Side Effects of Platelet Inhibitors

Bleeding, epigastric discomfort, bruising and gastric ulceration.

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Adverse Effects of Platelet Inhibitors

Excessive bleeding, allergy to aspirin or NSAIDs and new-onset cardiovascular event if stopped abruptly.

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Alcohol Interaction with Platelet Inhibitors

Alcohol because it increases risk of GI bleeding.

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Dietary Interactions with Platelet Inhibitors

Foods, herbs, and supplements can interfere with anticoagulants.

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Nursing Assessments for Platelet Inhibitors

Assess for other meds (including OTC & herbs), bruising/bleeding, and signs of internal bleeding.

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Patient Education: Platelet Inhibitors

Report any signs of abnormal bleeding to the Healthcare provider.

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Platelet Inhibitors and Pregnancy/Breastfeeding

Avoid taking the drugs during the last trimester of pregnancy and while breastfeeding.

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Platelet Count Monitoring

Notify HCP for platelet levels below 100,000 per microliter.

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