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

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Mark Klimek Audio Lectures: Lecture 3 Cardiac Medications, Cardiac rhythms, Chest tubes, Newborn Heart Defects, Isolation Precautions 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 - 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 - No conduction of a heart beat. - Terminology: - QRS depolarization always relates to ventricular - A lack of QRS waves means asystole - P wave is always related to atrial. - “Saw-toothed” means flutter. - Example: saw-toothed p wave (atrial flutter) - “Chaotic” means fibrillation. - Example: chaotic QRS (v-fib) - “Bizarre” means tachycardia. - Example: Bizarre QRS (v-tach) - Premature ventricular contractions “PVC” - Low priority patient, unless 3 things happen: - If there are more than 6 PVC in a minute - If there are more than 6 PVC in a row - If the PVC falls on the T wave - Lethal arrhythmias: (high priority) - Asystole - Ventricular fibrillation - Both of these arrhythmias have zero cardiac output. - Potentially lethal arrhythmias: (high priority) - Ventricular tachycardia - Still has some cardiac output. Treatment of Arrhythmias - PVC and Ventricular tachycardia treatment: - Use Lidocaine or Amiodarone - Atrial arrhythmias (supraventricular arrhythmias) - Use the ABCD’s - A: Adenocard (adenosine): push in less than 8 seconds, then 20mL of Normal saline, patient may go into asystole for a max of 30 seconds - B: Beta-blockers: all beta-blockers end in “lol”. Beta-blockers are Anti-inotropic, Anti-chronotropic, and anti-dromotropic drugs. Used just like calcium channel blockers, which treat atrial arrhythmias. - C: Calcium channel blockers: for same reason as beta-blockers - D: Digitalis (digoxin, lanoxin): - Ventricular fibrillation: - For v-fib you de-fib :::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::CONTINUED IN THE ATTACHMENT:::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::: [Show More]

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