Pharmacology and the Nursing Process, 9th Ed., Lilley, Rainforth Collins & Snyder, 2019 | Practical Nurse (LPN) School Study Aid
Types of Heart Failure
- Left Sided
- Pulmonary Congestion
- Right Sided
- Peripheral Edema
- High Output
- Unable to Meet Metabolic Needs
Right Heart Failure Assessment
- Jugular Venous Distention (JVD)
- Peripheral Edema
- Hepatosplenomegaly
- Nocturia
- Weight Gain
- Ascites
- Fatigue
Left Heart Failure Assessment
- Pulmonary Congestion
- Pink Frothy Sputum
- Wheezing or Crackles
- Dyspnea with Exertion
- Cough
- Fatigue
- Tachycardia
- Weak Peripheral Pulse
- S3, S4 Heart Sounds
Heart Failure Interventions
- Echocardiogram
- Invasive Hemodynamic Monitoring
- High Fowler's Position
- Oxygen
- Advanced Airway
- Diuretics
- Beta Blockers
- Angiotensin II Receptor Blockers (ARBs)
- ACE Inhibitors
- Digoxin (Lanoxin)
- Pacemaker
Angiotensin II Receptor Blockers (ARBs)
- Ends in "-sartan"
- Blocks Angiotensin II Receptor
- Hypertension
- Angioedema
- Renal Artery Stenosis
- Pregnancy
Beta Blockers
- "-olol" suffix
- Decreases Heart Rate and Contractility
- Decreases Peripheral Vascular Resistance
- Decreases Renin Release
- Hypertension
- Heart Failure
- Angina Pectoris
- Asthma and Heart Block Patients
- Assess Blood Pressure and Heart Rate
- Masking Signs of Hypoglycemia
- Do Not Stop Abruptly
Hydralazine (Apresoline)
- Severe Hypertension
- CHF
- Reduced Afterload
- Pregnancy
- Vasodilates Arterioles
- Drug-induced Lupus
- Reflex Tachycardia
- Hypotension
- Combined with Diuretic and Beta Blocker
Digoxin (Lanoxin)
- Increases Inotropy
- Heart Failure
- Atrial Fibrillation
- Bradycardia
- Fatigue
- Heart Block
- Heart Rate Below 60
- Hypokalemia
- Monitor for Toxicity and Visual Changes
- Digibind
ECG: Atrial Fibrillation
- Variable Rate
- Irregular Rhythm
- No P Wave
- No PR Interval
- QRS < 0.12 Seconds
Digoxin Toxicity Treatment
- Activated Charcoal
- Slowly Normalize K+
- Digibind (Anti-Digoxin Fab)
- Magnesium Sulfate
- Lidocaine
- Cardiac Pacing
Spironolactone (Aldactone)
- Inhibition of Aldosterone
- Potassium Retention
- Hypertension
- Edema
- Heart Failure
- Hyperkalemia
- Endocrine Effects
- Avoid Potassium Supplements