Terms in this set (45)
1st line drug for bradyarrythmias, 2nd line drug for asystole or PEA
Parasympatholytic that blocks acetylcholine effects on post cholinergic receptors in smooth muscle and SA/AV nodes therefore increasing SA node automaticity and AV conduction
Atropine nursing considerations
Give rapidly as 0.5mg IV push; may repeat to dose of 3mg.
Be aware that less than 0.5mg in adult can cause HR to decrease to a worse bradycardia.
Monitor pt for reflexive tachycardia.
Caution with myocardial ischemia & tachycardia.
2nd line drug for bradyarrythmias
sympathomimetic agent that causes peripheral vasoconstriction (alpha effects) and muscle vasodilation (beta effects) resulting in increased C.O, S.V., myocardial contractility, renal blood flow, urine output, and increase in HR
Dopamine nursing considerations
Dopamaine must be given using CVC. Monitor site carefully for extravasation which causes tissue necrosis, ischaemia, and sloughing of the area. Immediate filtration of area must be done immediately with Phentolamine diluted in NS. Must be weaned.
1st line for vfib, pulseless VT, & PEA. Used after atropine with bradyarrythmias. Used to treat severe hypotension.
Sympathomimetic that stimulates alpha, beta 1&2 receptors resulting in cardiac stimulation. Increases systemic vascular resistance and BP; improves coronary and cerebral perfusion and myocardial contractility.
Epinephrine nursing considerations
Administer 1mg every 3-5 mins IV push or via ETT. Avoid adding to IV lines containing alkaline solutions (bicarb).
IV push 0.5mg. Repeat q 3-5 mins to max of 3mg
IV gtt 2-10mcg/kg/min
Used to treat unstable tachyarrythmias (VT) if regular and monomorphic; Slows atrial conduction through AV node
Antiarrhythmic that slows conduction time through AV node restores sinus rhythm in PSVT (paroxysmal SVT)
Adenosine nursing considerations
Causes brief period of asystole
Rapid IV push 6mg followed by NS flush; Second dose of 12mg if required
Antiarrhythmic infusion for stabel wide QRS Tachycardia. Used to treat life-threatening ventricular tachycardia or symptomatic PVCs
Decreases excitability, conduction velocity, automaticity, and membrane responsiveness with prolonged refractory period.
Procainamide nursing considerations
Monitor electrolytes as hypokalemia predisposes pt to arrythmias. Monitor pt for hypotension, esp. elderly.
IV 20-50mg/min until arrhtymia suppressed, hypotension ensues, QRS duration increases >50%, or max dose 17mg/kg given. Maintenance infusion 1-4mg/min; Avoid if prolonged QT or CHF.
Antiarrythmic used to treat atrial/ventricular tachyarrhythmias.
Decreases sinus rate, increases PR and QT intervals, relaxes smooth muscle reducing afterload.
Amiodarone nursing considerations
Monitor BP for hypotension and HR for bradycardia.
IV initial dose: 150mg over 10 mins. REpeat as needed if VT recurs. Follow by maintenance infusion of 1mg/min for first 6 hours.
Antiarrythmic infusion for stable wide QRS Tachycardia
Depresses sinus heart rate, slows AV conduction, decreases cardiac output, and lowers systolic and diastolic blood pressure.
Solatol nursing considerations
Beta blocker indications
Used in stable symptomatic tachycardia that is persistent and does not have a wide QRS-Treatment for SVT-Dose 1-3mg q 5 mins not to exceed 0.1mg/kg
Calcium channel blocker indications
Used in stable symptomatic tachycardias that are persistent and do not have wide QRS-Treatment for Afib & PSVT-Dose 5-10mg over 2 mins, may repeat
Alternate with epinephrine in pt with pulseless VFib/VTach. Used only one time!!
Hormone that causes vasoconstriction. Increases systemic vascular resistance and BP
Vasopressin nursing considerations
Will cause symptoms of water intoxication.
IV dose of 40 units to replace first or second dose of epinephrine. Used only one time!!!!!
2nd line drug for VT/VF
Antiarrythmic that increases electrical threshold of ventricles during diastole
Lidocaine nursing considerations
Monitor pt for heart block and respiratory depression
IV 50-100mg (1-1.5mg/kg) bolus at 25-50mg/min. Repeated q 3-5mins not to exceed 300mg in one hour.
Heart block and ventricular arrythmias-Rarely used for cardiac?
Sympathomimetic that results in pronounced stimulation of beta1 & beta2 receptors of heart and bronchi
Isuprel nursing considerations
Drug may cause increase in SBP and decrease in DBP
IV 0.02-0.06mg then 0.01-0.2mg or 5mcg/minute
Magnesium sulfate indication
Treats Torsades de Pointes, VF. used after amiodarone and Lidocaine.
Magnesium sulfate action
Electrolyte that causes all muscles to contract. Results in depression early after depolarization.
Magnesium sulfate nursing considerations
Keep IV calcium gluconate available to reverse magnesium intoxication; use cautiously in digitalized pt
Magnesium sulfate dose
To treat paroxysmal Atrial Tachycardia-3-4g IV over 30 sec.
To treat ventricular tachycardia & Torsades-1-6g IV over several mins then continuos infusion of 3-20mg/min for 5-48 hours. Base treatment on pt. response and serum magnesium level.
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