Mark Klimek Audio Lectures - 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 : A nti Hypertensive: relax heart and blood vessels. - AA : A nti A ngina drugs: relax the heart, which decreases oxygen demand. - AAA : A nti A trial A rrhythmia : treats atrial arrhythmias. - Side effects: - H and H : Headache and Hypotension - Names of Calcium channel blockers: - Calcium channel blockers are any medication ending in “ di pine ” - Examples - Amlo dipine - Felo dipine Has to have the “ di ” before “pine”
- Nife dipine - 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.
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- Winter '15