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Pre-Work Assignment Cardiac Simulation Clinical

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Assigned pre-work for cardiac clinical simulation for NUR 114.

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  • November 26, 2023
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Cardiac Simulation Pre-Work


Review the following medication classes:
1. ACE inhibitors: (medications ending in -pril)
 Treats: HTN, heart failure, MI, diabetic/non-diabetic nephropathy
 Action: inhibits action of ACE, leading to vasodilation and excretion of Na+ and H2O and retention of
K+
 Side effects: orthostatic hypotension, cough, hyperkalemia, angioedema
 Contraindicated in: history of allergy/angioedema with ACE inhibitor use, bilateral renal artery
stenosis, salt or volume depletion
2. Cardiac glycosides:
 Treats: a-fib, a-flutter, CHF
 Action: inhibits Na+ K+ ATPase enzyme
 Side effects: unusual tiredness/fatigue, anxiety, hallucinations
 Contraindicated in: ventricular rhythms (v-fib, v-tach) and 2nd/3rd degree heart blocks
 1st Line Medications (Heart Failure): ACE inhibitors, ARBs, beta-blockers
3. Loop diuretics:
 Treats: HTN, pulmonary edema caused by HF, seizures, glaucoma, renal diseases not responsive to
other diuretics
 Action: inhibit reabsorption of Na+Cl- in proximal and distal convoluted tubules and Loop of Henle
 Side effects: orthostatic hypotension, hypokalemia, ototoxicity, hyponatremia, dehydration
 Contraindicated in: patients with anuria, electrolyte imbalances, severe kidney/liver dysfunction
4. Beta blockers: (medications end in -lol)
 Treats: HTN, heart failure, tachydysrhythmias, angina, MI, hyperthyroidism, glaucoma
 Action: blocks beta receptors in heart to decrease cardiac workload, decrease HR, vasodilate
 Side effects: bradycardia, orthostatic hypotension, pulmonary edema
 Contraindicated in: AV block, sinus bradycardia, heart failure (non-selective beta-blockers),
hypotension, asthma (cardioselective beta-blockers)



Give two examples of medications from the ACE inhibitor class and two examples of medications from
the beta blocker class.

 ACE Inhibitors: Captopril, Lisinopril
 Beta-blockers: Propranolol, Metoprolol

When administering medications from the classes listed above, what information do you need prior to
administering a medication from that class?
 ACE Inhibitors: serum K+ levels, BP, pulse, weight, I&O ratios,
 Cardiac Glycosides: serum K+ levels, BP, pulse, apical pulse x 1 min (<60 bpm, hold dose/notify
provider), digoxin levels (if medication being administered), I&O ratios
 Loop Diuretics: serum K+ levels, baseline data (orthostatic BP, pulse, weight, serum electrolytes,
location/extent of edema), I&O ratios, ECG rhythm
 Beta-blockers: apical pulse x 1 min (<50 bpm or arrhythmias occur, hold dose/notify provider), BP, HR,
ECG rhythm, serum glucose levels, I&O ratios

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