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Chapter 44: Agents for Treating Heart FailureAce Your Karch’s Focus on Nursing Pharmacology, 9th Ed., Tucker Classes and Exams with Picmonic: #1 Visual Mnemonic Study Tool for Registered Nurse (RN) Students
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Karch’s Focus on Nursing Pharmacology, 9th Ed., Tucker | Registered Nurse (RN) School Study Aid
Types of Heart Failure
- Left Sided
- Pulmonary Congestion
- Right Sided
- Peripheral Edema
- High Output
- Unable to Meet Metabolic Needs
1 min
Heart Failure Interventions
- Diagnostic Tests
- Echocardiogram
- Invasive Hemodynamic Monitoring
- Improve Gas Exchange
- High Fowler's Position
- Oxygen
- Advanced Airway
- Drugs and Devices
- Diuretics
- Beta Blockers
- Angiotensin II Receptor Blockers (ARBs)
- ACE Inhibitors
- Digoxin (Lanoxin)
- Pacemaker
2 mins
Right Heart Failure Assessment
- Jugular Venous Distention (JVD)
- Peripheral Edema
- Hepatosplenomegaly
- Nocturia
- Weight Gain
- Ascites
- Fatigue
1 min
Left Heart Failure Assessment
- Pulmonary Assessment
- Pulmonary Congestion
- Pink Frothy Sputum
- Wheezing or Crackles
- Dyspnea with Exertion
- Cough
- Systemic Assessment
- Fatigue
- Tachycardia
- Weak Peripheral Pulse
- S3, S4 Heart Sounds
1 min
Digoxin (Lanoxin)
- Mechanism of Action
- Increases Inotropy
- Indications
- Heart Failure
- Atrial Fibrillation
- Side Effects
- Bradycardia
- Fatigue
- Contraindications
- Heart Block
- Nursing Considerations
- Heart Rate Below 60
- Hypokalemia
- Monitor for Toxicity and Visual Changes
- Digibind
2 mins
Acute Digoxin Toxicity
- Clinical Symptoms
- Hyperkalemia
- Cholinergic (Nausea, Vomiting, Diarrhea)
- Blurry Yellow Green Vision with Halo of Light
- Arrhythmia
- Bradycardia
- EKG Changes
- Prolonged PR interval
- Decreased QT
- Scooping on EKG
- T Wave Inversion
2 mins
Digoxin Toxicity Treatment
- Activated Charcoal
- Slowly Normalize K+
- Digibind (Anti-Digoxin Fab)
- Magnesium Sulfate
- Lidocaine
- Cardiac Pacing
2 mins
Milrinone and Amrinone
- Mechanism of Action
- Phosphodiesterase 3 Inhibitor
- Potentiates Beta Receptor Effects
- Inotrope
- Vasodilator
- Indication
- Acute Decompensated Heart Failure
- Side Effects
- Ventricular Arrhythmias
- Hypotension
2 mins
Myocardial Infarction Interventions
- MONA
- Morphine
- Oxygen
- Nitrates
- Aspirin
- Thrombolytics (tPA)
- Invasive Procedures
- Cardiac Catheterization
- Stent Placement
- Angioplasty
- Coronary Artery Bypass Grafting (CABG)
- Considerations
- Decrease Modifiable Risk Factors
- Resuming Activity (Physical, Sexual)
2 mins
Nitroglycerin
- Mechanism of Action
- Decreases Preload
- Indications
- Angina
- Up to 3 doses q 5 mins
- Side Effects
- Headache
- Hypotension
- Contraindications
- Viagra (Sildenafil)
- Nursing Considerations
- Assess Blood Pressure
- Protect From Light
- Use Glass Bottle and Special Tubing
- Gloves for Applying Topically
2 mins
Hypertension Medications
- Diuretics
- ACE Inhibitors
- Angiotensin Receptor Blockers (ARBs)
- Beta Blockers
- Dihydropyridine Calcium Channel Blockers
2 mins
Angiotensin II Receptor Blockers (ARBs)
- Ends in "-sartan"
- Mechanism of Action
- Blocks Angiotensin II Receptor
- Indications
- Hypertension
- Side Effects
- Angioedema
- Contraindications
- Renal Artery Stenosis
- Pregnancy
1 min
Cardiac Enzyme Evaluation: Creatine Kinase CK-MB
- Measures
- Skeletal or Cardiac Muscle Injury
- Time Ranges
- Onset: 4-8 Hours
- Peak: 12-24 Hours
- Return to Normal: 2-3 Days
1 min
Troponin Lab Values
- Troponin T (cTnT)
- < 0.1 ng/mL Normal
- Troponin I (cTnI)
- < 0.5 ng/mL Normal
- > 2.3 ng/mL Myocardial Injury
2 mins
Cardiac Tamponade
- Mechanism
- Fluid in the Pericardial Sac
- Pericarditis
- Decreased Cardiac Output
- Signs/Symptoms
- Beck's Triad
- Hypotension
- Jugular Venous Distention (JVD)
- Distant Heart Sounds
- Pulsus Paradoxus
- Electrical Alternans
- Treatment
- Pericardiocentesis
1 min
Cardiac Catheterization
- Considerations
- Fluttering Sensation
- Contrast Media
- NPO 6-12 Hours
- After Procedure
- Bed Rest
- Assess Circulation
- Assess for Bleeding
- Monitor Vital Signs
2 mins
Cardiac Cycle - Diastole
- Characteristics
- Aortic Valve Closes
- Pulmonary Valve Closes
- Ventricles Relax
- Mitral Valve Opens
- Tricuspid Valve Opens
- Ventricles Fill
- Sinoatrial (SA) Node Fires
- Atrial Contraction
3 mins
Cardiac Cycle - Systole
- Characteristics
- AV Node
- AV Node Conducts Signal to Bundle of His
- Bundle of His Signals Purkinje Fibers to Contract Ventricles
- Tricuspid Valve Closes
- Pulmonary Valve Opens
- Mitral Valve Closes
- Aortic Valve Opens
2 mins
