Arrhythmia
Amiodarone is an antiarrhythmic medication typically used for patients in atrial fibrillation and or ventricular arrhythmia. What are some adverse reactions of being on this drip that you should monitor for as the nurse? List 3
-Cardiovascular: Bradyarrhythmia, hypotension and prolonged QT
-GI: Nausea/vomiting
-Hepatic: Increased liver enzymes
You have a patient on a lasix drip. There urine output has slowed down, but they still have more weight to lose. What medication do you anticipate the doctor trying next?
Diuril IV push or switching to bumex drip.
What is adenosine used for?
SVT. To pause the heart rate in hopes to convert patient.
Your patients blood sugars have been running high >400's throughout the shift. They are receiving high doses of novolog with out improvement. You notice they are on steroids' for COPD exacerbation. What would you anticipate the doctor ordering?
Endotool
What are some drip medications that your patient might receive after stent placement?
Integrilin, cangrelor
Diltiazem indication is for rate control typically for patients in atrial fibrillation. What adverse reactions should you monitor for? List 3
-Cardiovascular: bradyarrhythmia, hypotension, heart failure, heart block, MI, peripheral edema,
-Respiratory: Cough, dyspnea
-Neurological: Headache, dizziness, weakness
-Dermatological: Rash
-GI: Hepatotoxicity, dyspepsia
When is a lasix albumin drip indicated?
Ongoing hypotension
You have a patient with a sheath in place post angiogram. You pull the sheath per protocol and hold pressure. The patient vasovagal with nausea and heart rates in the 30's. What medication should you give?
Atropine
Medications can vary on what to hold for PET stress tests. What do you for sure want the patient to avoid for 24 hours prior to the test?
Caffeine (including decaf coffee)
Your patient starts Imdur as part of the medication management post angiogram with out intervention. What education would you provide in how this medication works?
This medication acts like nitroglycerin where it is a vasodilator, but is long acting. We will need to keep a close eye on your blood pressure.
Isuprel increases heart rate, contractility, and vasodilates peripheral vasculature. You will see this medication ordered for bradyarrhythmia and torsade's. The MD will have you titrate for a goal heart rate. What else do you foresee being done for this patient during this hospital stay?
Pacemaker
What procedures would you typically see ordered for further evaluation of patients CHF?
Echo
Right heart cath
Cardiac MRI
What are the two emergency medications that you learn in ALS to give during a code and why?
Amiodarone and Epinephrine. The amio is an antiarrhythmic in hopes to get patient back into a non-lethal rhythm. Epinephrine is a hormonal dump to help increase adrenaline.
What are the typical medication classes that you see ordered post MI?
Antiplatelet, Beta-blocker, Ace-inhibitor, Statin, PRN Nitro, Aspirin
What medications do you want to avoid for patients with SCAD?
Blood thinners
Patient's EF is 15% and is having runs of V-tach. Medications are adjusted but patient continues to have runs of V-tach. What other possible interventions would you consider the cardiologist to order? (2 answers)
V-tach ablation, Life vest
Your patient is diuresing and blood pressure is low due to low cardiac output. What IV drip medications would you consider the MD initiating?
Milrinone, dobutamine, dopamine
You are educating how to take nitro at home in case of an emergency. What are all the things they should know to safely administer.
Your patient has an order to place a zio patch at discharge. What are some key teachings? (List 3)
-The Zio patch is always recording
-Use the diary to make note of any symptoms you had and what you were doing while you had them
-Click the bottom when you feel anything abnormal
-Do not shower for 24 hours
-No submerging in water
-Send the Zio patch in the provided back to local post office as soon as possible
Your patient comes back from cath lab. No intervention. They have a CV surgery consult. The patient has chest pain upon arrival to the floor. What medications are you going to question starting for this patient?
Nitro and heparin gtt
What rhythm qualify a patient for a micra pacemaker?
A-fib
Dr. Kealhofer discussed in her in service about heart failure. She mentioned 5 drug categories we should ideally have these patient's on. What are they?
Beta blocker, ARNI/ACE/ARB, Aldosterone antagonist, SGLT2, Vasodilators
Your patients blood work comes back with high potassium and they are not a dialysis patient. What medications would you consider the doctor ordering to shift the potassium to a normal level.
Calcium gluconate: Protects the heart from going into a lethal rhythm
Insulin: Shifts the potassium back into the cells
Diuretics: Excretes the potassium
Patient has elevated creatinine with morning labs. Which medications would you consider holding or addressing with MD.
Lisinopril, Lasix, plavix, metoprolol, sub q heparin, metformin, hydralazine, Synthroid
Lisinopril, Lasix, metformin
What medications are held 24 hours prior to a TAVR?
DOAC's, diuretics, diabetic meds, beta-blockers, Diltiazem, Verapamil