NRSG 3100 Exam #4 (Questions and Answers A+ Graded 100% Verified)

NRSG 3100 Exam #4 (Questions and Answers A+ Graded 100% Verified) Ventricular pulse rate Correct Ans: 40-30 AV pacer rate Correct Ans: 60-405 What is makes up stroke volume Correct Ans: preload, afterload, and contractility Normal stroke volume Correct Ans: 60-70% TTE vs TEE Correct Ans: transthoracic vs transesophageal echocardiogram. TEE is more sensitive and accurate for finding vegetations preload Correct Ans: Degree of stretch of the ventricular cardiac muscles at the end of diastole Afterload: Correct Ans: Resistance to ejection of blood from the ventricle; systemic or pulmonary vascular resistance Sodium channel blockers Correct Ans: procainamide (Pronestyl) lidocaine (Xylocaine) Beta blockers Correct Ans: propranolol (Inderal) esmolol (Brevibloc) Potassium channel blockers Correct Ans: amiodarone (Cordarone) Calcium channel blockers Correct Ans: diltiazem (Cardizem) verapamil (Calan) Class 1 Antidysrhythmics Correct Ans: Sodium channel blockers ONE dash of SALT Class 2 antiarrhythmics Correct Ans: Beta-blockers 2 Bs Class 3 antiarrhythmics Correct Ans: Potassium channel blockers 3 rhymes with P Class 4 antiarrhythmics Correct Ans: calcium channel blockers 4 letters in milk What is the largest group of antiarrhythmics Correct Ans: Sodium channel blockers group MOA of sodium channel blockers Correct Ans: prevent depolarization Suppresses ectopic pacemaker activity Signs of cardiotoxicty caused by Na channel blockers Correct Ans: increased PR and QT intervals and/or widening QRS Class IA Na channel blockers Correct Ans: Procainamide (Pronestryl) Class IB Na channel blockers Correct Ans: lidocaine (Xylocaine) Class of Procainamide (Pronestyl) Correct Ans: Broad spectrum anti-dysrthymias used for both atrial and ventricular arrhythmias MOA of procainamide (Pronestyl) Correct Ans: blocks sodium channels in myocardial cells; reducing automaticity and slowing velocity of the action potential across the myocardium When is procainamide given Correct Ans: Considered a drug of last resort for cardiac life support due to its toxicity; used when other drugs have failed to reverse severe dysrhythmia Most common, serious side effects of procainamide Correct Ans: Confusion of psychosis BBW for procainamide (Pronestyl) Correct Ans: Chronic use may result in a lupus-like syndrome (increased ANAs) Blood dyscrasias (monitor CBC, discontinue at first sign of possible dyscrasias) When to not give procainamide (Pronestyl) Correct Ans: 2nd or 3rd degree AV block!!! severe HF, peripheral neuropathy, myasthenia gravis, lupus!!! use caution with bone marrow depression NC for procainamide (Pronestyl) Correct Ans: Supine position during IV administration due to risk of severe hypotension Terminate if QRS widens more than 50% Narrow therapeutic index (serum levels 4-8 mcg/mL) Patient education about procainamide (Pronestyl) Correct Ans: Do not take any other medications or supplements without physician approval Report any excessive bruising or bleeding (blood dyscrasias) MOA of lidocaine (Xylocaine) Correct Ans: Lidocaine raises the ventricular stimulation threshold during diastole Which arrhythmias does lidocaine (Xylocaine) treat Correct Ans: Ventricular AE of lidocaine Correct Ans: Hypotension Lidocaine Toxicity: Confusion, anxiety, tremors, seizures, comatose, respiratory arrest. Lidocaine Toxicity: Correct Ans: Confusion, anxiety, tremors, seizures, comatose, respiratory arrest. NC for lidocaine Correct Ans: Given IV bolus or infusion; rarely IM or SQ Serum levels should be 2-6 mcg/mL Careful to use the correct lidocaine formulation - lidocaine for anesthesia may contain preservatives and epinephrine Which drugs are used to treat atrial arythmias Correct Ans: Lidocaine Beta-blocker Ca channel blockers