NURS 2004 Chapter Notes - Chapter 45: Atropine, Qt Interval, Atrial Fibrillation
28 Jan 2017
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Chapter 45 calcium channel blockers nursing implications. Therapeutic goal: verapamil and diltiazem are indicated for hypertension, angina pectoris, and cardiac dysrhythmias (atrial fibrillation, atrial flutter, and paroxysmal supraventricular tachycardia). Baseline data: for all patients, determine bp and pulse rate, and obtain laboratory evaluations of liver and kidney function. For patients with angina pectoris, obtain baseline data on the frequency and severity of anginal attacks. Identifying high risk patients: verapamil and diltiazem are contraindicated for patients with severe hypotension, sick sinus syndrome (in the absence of electronic pacing), and second-degree or third- degree av block. Use with caution in patients with heart failure or liver impairment and in patients taking digoxin or beta blockers. Oral verapamil and diltiazem may be used for angina pectoris and essential hypertension. Verapamil may be used with digoxin to control ventricular rate in patients with atrial fibrillation and atrial flutter. Instruct patients to swallow sustained-release formulations whole, without crushing or chewing.
