Questions and Answers
What should a nurse monitor for in a patient receiving calcium channel blockers?
What is a crucial instruction for patients taking β-adrenergic blockers?
Which statement regarding insulin and β-adrenergic blockers is true?
What should be monitored to assess liver function in patients on calcium channel blockers?
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What is an important nursing intervention for patients being treated for angina?
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What effect do β-adrenergic blockers have on heart activity?
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What can rebound effects from abruptly stopping β-adrenergic blockers include?
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Which of the following is a nursing responsibility for patients on heart medications?
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Which medication is specifically indicated for short-term management of heart failure in patients who have not responded to other treatments?
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What is a common adverse effect associated with dobutamine therapy?
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Which of the following actions should a nurse take if a patient receiving dobutamine experiences a drop in blood pressure?
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In nursing management, which element is specifically monitored in patients receiving Inamrinone?
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What adverse effect indicates hepatotoxicity in a patient receiving heart failure medications?
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Which medication improves cardiac performance by increasing myocardial contractility?
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What nursing intervention is critical when administering Milrinone Lactate before a heart transplant?
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Which solution should Inamrinone NOT be mixed with during administration?
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What is the main action of Clopidogrel in the prevention of thromboembolic events?
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What should a nurse instruct a patient about taking Clopidogrel regarding gastrointestinal upset?
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Which of the following interventions is critical before a patient undergoes surgery while on Clopidogrel?
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Dopamine is used in acute heart failure primarily for which reason?
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Which of the following describes the effect of positive inotropic agents?
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What is a common use for negative inotropic agents such as propranolol?
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What outcome is desired when administering positive inotropic medications?
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In patients with unstable angina, which medication can be utilized for thrombi prophylaxis?
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Study Notes
Dobutamine
- Utilized for short-term management of heart failure (HF).
- Enhances myocardial contractility, thereby improving cardiac performance.
Inamrinone Lactate (Inocor)
- Intended for short-term management of HF in patients unresponsive to cardiac glycosides, diuretics, and vasodilators.
Milrinone Lactate
- Administered for short-term management of HF.
- May be used prior to heart transplantation.
Adverse Effects and Toxicity
- Hepatotoxicity: Indicated by elevated liver enzymes.
- Hypersensitivity reactions: Includes symptoms such as wheezing, shortness of breath, pruritus, urticaria, clammy skin, and flushing.
Nursing Interventions for Positive Inotropic and Cardiotonic Medications
- Administer medications via IV.
- Stop infusion for significant blood pressure drops or dysrhythmias.
- Avoid mixing Inamrinone with glucose-containing solutions.
- Monitor apical pulse and blood pressure.
- Observe for signs of hypersensitivity and respiratory distress, such as wheezing and dyspnea.
- Assess for reduction in edema and improvement in symptoms of HF (dyspnea, orthopnea, fatigue).
- Regularly monitor electrolyte levels, liver enzymes, platelet counts, and renal function.
- Advise patients to report dizziness or lightheadedness.
- Caution against abrupt medication cessation to prevent rebound effects.
- Inform diabetic patients that β-adrenergic blockers can obscure hypoglycemia symptoms.
- Encourage slow position changes to prevent orthostatic hypotension.
- Recommend patients avoid over-the-counter medications, particularly cold and nasal decongestants.
Calcium Channel Blockers
- Reduce cardiac contractility, diminishing the heart's workload and oxygen demand.
- Promote vasodilation of coronary and peripheral vessels.
- May be combined with anticoagulants.
Clopidogrel (Plavix)
- Therapeutic Class: Antiplatelet drug (oral).
- Pharmacologic Class: ADP receptor blocker.
- Prolongs bleeding time by irreversibly inhibiting ADP binding to its receptor, affecting platelets for their lifespan.
Indications for Clopidogrel
- Prevents thromboembolic events in patients post-myocardial infarction (MI), stroke, or with peripheral artery disease.
- Also indicated for unstable angina and patients undergoing vascular bypass or percutaneous coronary interventions (PCI).
- Used off-label for patients with coronary artery stents and to prevent postoperative deep venous thrombosis.
Positive Inotropic and Cardiotonic Medications
- Enhance heart contractility (positive inotropic effect).
- Examples include epinephrine, norepinephrine, thyroid hormones, and dopamine.
- Negative inotropic agents like quinidine and beta-blockers (e.g., propranolol) decrease contractility.
- Utilized for advanced heart failure management, increasing cardiac output, kidney function, and circulation.
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Description
This quiz covers important medications used in the short-term management of heart failure, including Dobutamine, Inamrinone Lactate, and Milrinone Lactate. It discusses their uses, adverse effects, and nursing interventions necessary for safe administration. Test your understanding of these vital cardiac medications!
