Mark Klimek Audio Lectures: Lecture 3 Cardiac Medications, Cardiac rhythms, Chest tubes, Newborn Heart Defects, Isolation Precautions: - It takes 3 things to pass the NCLEX exam - Knowledge - Confidence - Exam Proficiency

- It takes 3 things to pass the NCLEX exam - Knowledge - Confidence - Exam Proficiency - You can’t apply what you don't know, but you have to be able to apply what you do know. - Go with majority: if something is 75% fatal, consider it fatal. - If you try to learn everything you will master nothing. Lecture 3 Cardiac Medications, Cardiac rhythms, Chest tubes, Newborn Heart Defects, Isolation Precautions Cardiac Medications - Calcium Channel Blockers: - Calcium channel blockers are like Valium (sedative) for your heart. - Valium calms you down, which means calcium channel blockers calm the heart down - Example: if at patients heart is tachycardic a calcium channel blocker will calm the heart and reduce the heart rate. - Calcium channel blockers should only be used if the heart needs to rest. If it does not need a rest, do not give calcium channel blockers. - Calcium channel blockers classification: - Negative Inotropic: weaken force of muscular contractions. - Negative Chronotropic: decrease heart rate through electrical conduction. - Negative Dromotropic: slows the electrical conduction through the heart. - Together these effects calm the heart down. - When would a Calcium channel blocker be used? - A: Anti Hypertensive: relax heart and blood vessels. - AA: Anti Angina drugs: relax the heart, which decreases oxygen demand. - AAA: Anti Atrial Arrhythmia: treats atrial arrhythmias. - Side effects: - H and H: Headache and Hypotension - Names of Calcium channel blockers: - Calcium channel blockers are any medication ending in “dipine” - Examples - Amlodipine - Felodipine Has to have the “di” before “pine” - Nifedipine - There are two Calcium channel blockers that do not end in “dipine”. - Verapamil - Diltiazem (Cardizem): only one that can be on continuous drip. - When on a calcium channel blocker you must monitor blood pressure. - Do not give a Calcium channel blocker if systolic is below 100. Cardiac rhythms - Must know these 4 cardiac rhythms by sight. 1. Normal sinus rhythm. - There is a P wave before each QRS complex followed by a T wave - Each P wave is equal in size and length and the QRS follows an equal rhythm 2. Ventricular Fibrillation (v-fib) - Chaotic squiggly line (no pattern) 3. Ventricular Tachycardia (v-tach) - Sharp, jagged lines that follows a pattern. 4. Asystole