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Chapter Forty - Cardiac Glycosides, Anti-Anginals and Anti-Dysrhythmics Update 2025-2026 Questions and Correct Answers
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The heart muscle weakens and enlarges. It loses the ability to pump blood adequately. The lungs and periphery are congested. Acute Heart Failure The blood backs up in periphery. Right Heart Failure The blood backs up in the lungs. Left Heart Failure
When blood gets shunted away from the ___, these symptoms occur: peripheral edema, pulmonary edema, renal failure and shortness of breath. Kidney Which side of the heart collects oxygen rich blood from the lungs and sends it to the body? Left Which side of heart failure occurs with the symptoms of coughing, dyspnea, pulmonary edema, and shortness of breath? Left What is systolic heart failure? Pumping Which side of the heart collect oxygen poor blood from the body and sends it to the lungs? Right Which site of heart failure occurs with the symptoms of ascites, hepatic congestion, jugular venous distention, pedal edema, and systemic venous congestions? Right What is diastolic heart failure? Filling and Relaxation
What group of medication has Digitalis Preparations (Digoxin)? Cardiac Glycosides What medication changes the electrical conduction of the heart? Digoxin What effect is increased blood flow, myocardial contractility and stroke volume? As well as decreased preload. Positive What effect is decreased heart rate (improved efficiency) and prolonged cell relaxation? Negative What drug level is normal with Digoxin? 0.5 to 2 ng/mL What drug level should be monitored with Digoxin? Low Potassium What medication toxicity is a decreased kidney function is a common cause? Digoxin What medication toxicity is low potassium? Digoxin What is the antidote for digoxin toxicity? Digoxin Immune Fab
What medication cause a drug interaction with digoxin causing low potassium? Diuretics What medication causes a drug interaction with digoxin causing sodium retention? Cortisone What medication causes a drug interaction with digoxin causing a decrease of digitalis absorption? Antacids What should the patient know while taking Digoxin? Pulse Rate What medication should be held if the heart rate is below 60? Digoxin What is an insufficient supply of oxygen and nutrients to meet the demands of the heart which causes an ache? Angina What type of angina is predictable stress or exertion? Classic (Stable) What type of angina is progressive severity unrelated to activity - unpredictable stress, exertion and intensity? Unstable (Pre-Infarction) What results from unstable angina?
What medication requires a non-PVC IV tubing? Nitroglycerin What medication creates a burning sensation sublingually if it is working? Nitroglycerin What medication has lost potency after 3 months of opening? Nitroglycerin What group of medication blocks beta1 and beta2 receptor sites? It blocks the action of catecholamines. It decreases oxygen demand, heart rate, and heart workload. Beta Blockers What group of medication are atenolol, metoprolol, nadolol, and propranolol? Beta Blockers What group of medication decreases contractility, afterload, and resistance? It reduces cardiac workload and oxygen demands. It relaxes coronary artery spasm and peripheral arteries. Calcium Channel Blockers What group of medication are amlodipine, diltiazem, and nifedipine? Calcium Channel Blockers What is a discharge or contraction of cardiac muscle fibers?
Depolarization What is a relaxation of muscle fibers to prepare for the next contraction? Repolarization What class of anti-dysrhythmic is a sodium channel blocker? 1 What class is a slow conduction and prolonged repolarization? 1A What class is slow conduction and short repolarization? 1B What class is prolonged conduction with little to no effect of repolarization? 1C What class of anti-dysrhythmic is a beta-adrenergic blocker? 2 What decreases conduction velocity, automaticity, and recovery time? Beta-Adrenergic Blocker What class of anti-dysrhythmic prolongs action potential duration and repolarization? 3
What is ventricles contracting rapidly on their own? The response to atrioventricular impulses is rapid. It is more prolonged than nonsustained ventricular tachycardia. Sustained Ventricular Tachycardia What is worsened ventricular tachycardia? It responds to IV magnesium sulfate. It often progresses to ventricular fibrillation. Torsades de Pointes What is a rapid and ineffective ventricular contractions? It is fatal if not reversed. A defibrillation and advanced life support is required. Ventricular Fibrillation What medication is for life-threatening ventricular tachycardia and fibrillation? It will increase digoxin levels and thin out blood if interacted with warfarin. Amiodarone What medication is for angina, atrial flutter/fibrillation, hypertension, or PSVT? Diltiazem What medication is for atrial flutter/fibrillation, HTN, and SVT? Esmolol What medication decreases the sensitivity of the cell membrane? It makes it harder for the ventricles to develop dysrhythmias. It is only given through IV because of first-pass effect.
Lidocaine What medication is an unclassified anti-dysrhythmic? Adenosine What medication is used to convert PSVT to a sinus rhythm? It slows conduction through the AV node. It is only administered as a fast intravenous push. It may cause asystole for a few seconds. Adenosine What medication group requires ECG monitoring for abnormal patterns and findings? Anti-Dysrhythmic What medication group may cause dysrhythmias? Anti-Dysrhythmic What medication group may require use of a pump? Anti-Dysrhythmic A patient has angina pectoris. The patient's blood pressure is 10 0/60mmHg. The nurse administers nitroglycerin 0.4mg sublingually. It is most important for the nurse to assess the patient for the development of? Hypotension When administering anti-anginal drugs, the nurse identifies which as the most common response? Hypotension
Which side of the heart collect oxygen poor blood from the body and sends it to the lungs? Right Which site of heart failure occurs with the symptoms of ascites, hepatic congestion, jugular venous distention, pedal edema, and systemic venous congestions? Right What is diastolic heart failure? Filling and Relaxation What stage is the high risk of heart failure without symptoms or structural disease? 1 A What stage is where some levels of cardiac changes? 2 B What stage is where structural heart disease with symptoms of heart failure occur? 3 C What stage is severe structural heart disease with marked symptoms of heart failure at rest? 4 D
What type of treatment is limiting alcohol, salt, and saturated fat intake? As well as performing mild exercise and stopping smoking. Non-Pharmacologic What is the atrial natriuretic peptide level? 20 to 77 pg/mL 20 to 77 ng/L What is the desired value of brain natriuretic peptide? Less than 100 pg/mL What is positive value of brain natriuretic peptide? Greater than 100 pg/mL What group of medication has Digitalis Preparations (Digoxin)? Cardiac Glycosides What medication changes the electrical conduction of the heart? Digoxin What effect is increased blood flow, myocardial contractility and stroke volume? As well as decreased preload. Positive What effect is decreased heart rate (improved efficiency) and prolonged cell relaxation? Negative What drug level is normal with Digoxin?
What medication should be held if the heart rate is below 60? Digoxin What is an insufficient supply of oxygen and nutrients to meet the demands of the heart which causes an ache? Angina What type of angina is predictable stress or exertion? Classic (Stable) What type of angina is progressive severity unrelated to activity - unpredictable stress, exertion and intensity? Unstable (Pre-Infarction) What results from unstable angina? Myocardial Infarction What type of angina occurs during rest? Variant (Vasospastic) What group of medication is Nitroglycerin? Anti-Anginal What medication is known as isosorbide dinitrate? Nitroglycerin What medication is a large first-pass effect with oral forms? Nitroglycerin
What medication decreases preload and afterload? As well as promoting vasodilation. Nitroglycerin What is the max dose of nitroglycerin if taken orally, repeated every 5 to 10 minutes, or 5 to 10 minutes before strenuous activity? 3 Tablets How long is the nitroglycerin patch worn to allow continuous slow delievery? 6 to 8 Hours What medication requires a patient to sit, or lie down if taken for the first time? Nitroglycerin What medication requires a non-PVC IV tubing? Nitroglycerin What medication creates a burning sensation sublingually if it is working? Nitroglycerin What medication has lost potency after 3 months of opening? Nitroglycerin
What class is slow conduction and short repolarization? 1B What class is prolonged conduction with little to no effect of repolarization? 1C What class of anti-dysrhythmic is a beta-adrenergic blocker? 2 What decreases conduction velocity, automaticity, and recovery time? Beta-Adrenergic Blocker What class of anti-dysrhythmic prolongs action potential duration and repolarization? 3 What class of anti-dysrhythmic is calcium channel blockers? 4 What blocks calcium influx, decreases myocardial contractility, and improves circuitry in atrioventricular node? Calcium Channel Blockers What has flutter waves and often progresses to atrial fibrillation? Atrial Flutter
What is a rapid and ineffective atrial contraction? It is a supraventricular dysrhythmia and high risk of stroke. Atrial Fibrillation What has a heart rate of 180 to 200 beats per minute, or higher? Paroxysmal Supraventricular Tachycardia What is contractions generated by impulses arising from ecotopic foci (abnormal pacemaker sites) within ventricular myocardium? It is troublesome if frequent. It is common. Premature Ventricular Contraction What is a relatively brief period in which a ventricle contracts rapidly on its own? The response to atrioventricular impulses is rapid. Non-Sustained Ventricular Tachycardia What is ventricles contracting rapidly on their own? The response to atrioventricular impulses is rapid. It is more prolonged than nonsustained ventricular tachycardia. Sustained Ventricular Tachycardia What is worsened ventricular tachycardia? It responds to IV magnesium sulfate. It often progresses to ventricular fibrillation. Torsades de Pointes What is a rapid and ineffective ventricular contractions? It is fatal if not reversed. A defibrillation and advanced life support is required.
