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Karch’s Focus on Nursing Pharmacology, 9th Ed., Tucker
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Chapter 44: Agents for Treating Heart Failure

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Karch’s Focus on Nursing Pharmacology, 9th Ed., Tucker | Registered Nurse (RN) School Study Aid

Chapter 44: Agents for Treating Heart Failure
18 Picmonics to Learn | 31 mins
Types of Heart Failure
Left Sided
Pulmonary Congestion
Right Sided
Peripheral Edema
High Output
Unable to Meet Metabolic Needs
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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
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2 mins
Right Heart Failure Assessment
Jugular Venous Distention (JVD)
Peripheral Edema
Hepatosplenomegaly
Nocturia
Weight Gain
Ascites
Fatigue
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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
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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
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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
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2 mins
Digoxin Toxicity Treatment
Activated Charcoal
Slowly Normalize K+
Digibind (Anti-Digoxin Fab)
Magnesium Sulfate
Lidocaine
Cardiac Pacing
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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
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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)
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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
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2 mins
Hypertension Medications
Diuretics
ACE Inhibitors
Angiotensin Receptor Blockers (ARBs)
Beta Blockers
Dihydropyridine Calcium Channel Blockers
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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
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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
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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
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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
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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
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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
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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
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2 mins

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