Medicamentos Del Carro De Paro Cardiaco

Módulo #1
Medicamentos del Carro de Paro
Nombre: Edgardo J. Vázquez-Bruno Santiago Prof. Marilyn Rosario, RN MSN
NUR 1140 Sección 1 Fecha: 09 de Junio de 2012
MEDICAMENTO | DOSIS MÍNIMA/MÁXIMA Y VÍA DE ADMINISTRACIÓN | CATEGORÍA(PARA QUE SE USA) | INDICACIÓN Y ACCIÓN | EFECTOS SECUNDARIOS /ADVERSOS | INTERVENCIÓN DE ENFERMERÍA |
Adenocard/Adenosine | • Adult and child >50 kg: IV BOL 6 mg; if conversion to normal sinus rhythm does not occur within 1-2 min, give 12 mg by rapid IV BOL; may repeat 12 mg dose again in 1-2 min • Infant and child<50 kg: IV BOL 0.05-0.1 mg/kg; if not effective, increase dose by 0.05-0.1 mg/kg q2min to a max of 0.3 mg/kg/dose | Antidysrhythmic | Action:Can restore normal sinus rhythm in patients withparoxysmal supraventricular tachycardia (PSVT) Uses: PSVT, as a diagnostic aid to assess myocardial perfusion defects in CAD, | CV: Chest pain, pressure, atrial tachydysrhythmias, sweating, palpitations, hypotension, facial flushing, AV block, cardiac arrest, ventricular dysrhythmias | Assess: • I&O ratio, electrolytes (K, Na, Cl) • Cardiopulmonary status: B/P, pulse, respiration, rhythm, ECGintervals (PR, QRS, QT); check for transient dysrhythmias (PVCs, PACs, sinus tachycardia, AV block) • Respiratory status: rate, rhythm, lung fields for crackles, watch for respiratory depression; bilateral crackles may occur in CHF patient; increased respiration, increased pulse, product should be discontinued • CNS effects: dizziness, confusion, psychosis, paresthesias, seizures; product should bediscontinued Administer: • Therapeutic response: normal sinus rhythm or diagnosis of perfusion defect Teach patient/family: • To report facial flushing, dizziness, sweating, palpitations, chest pain; usually transient • To rise from sitting or standing slowly to prevent orthostatic hypotensionhypotension |
Atropine | • Adult: IV BOL 0.5-1 mg given q3-5min, max 3 mg • Child: IV BOL 0.01 mg/kg up to0.4 mg or 0.3 mg/m2; may repeat q4-6hr; min dose 0.1 mg to avoid paradoxical reaction | Antidysrhythmic, anti-cholinergic parasympatholytic, anti-muscarinic | Action: Blocks acetylcholine at parasympathetic neuroeffector sites; increases cardiac output, heart rate by blocking vagal stimulation in heart; dries secretions by blocking vagus Uses: Bradycardia <40-50 bpm, bradydysrhythmia, reversal ofanticholinesterase agents, insecticide poisoning, blocking cardiac vagal reflexes, decreasing secretions before surgery, antispasmodic with GU, biliary surgery, bronchodilator, AV heart block | CV: Hypo/hypertension, paradoxical bradycardia, angina, PVCs, tachycardia, ectopic ventricular beats | Assess:• I&O ratio; check for urinary retention, daily output • ECG for ectopic ventricular beats,PVC, tachycardia, in cardiac patients • For bowel sounds; check for constipation • Respiratory status: rate, rhythm, cyanosis, wheezing, dyspnea, engorged neck veins • Increased intraocular pressure: eye pain, nausea, vomiting, blurred vision, increased tearing • Cardiac rate: rhythm, character, B/PEvaluate: • Therapeutic response: decreased dysrhythmias, increased heart rate, secretions; GI, GUspasms; bronchodilationTeach patient/family: • To report blurred vision, chest pain, allergic reactions, constipation, urinary retention. |
Bicarbonato de Sodio 8.4% | Cardiac arrest • Adult and child: IV BOL 1 mEq/kg of 7.5% or 8.4% sol, then 0.5 mEq/kg q10min, then doses based on ABGs • Infant: IV 1 mEq/kg over several min (use only the 0.5 mEq/ml [4.2%] solution for inj) | Acidosis, cardiacarrest, | Action: increases plasma bicarbonate, which buffers H+-ion concentration; reverses acidosis IV. | CV: Irregular pulse, cardiac arrest, water retention, edema, weight gain | Assess: • Respiratory and pulse rate, rhythm, depth, lung sounds; notify prescriber of abnormalities • Fluid balance (I&O, weight daily, edema); notify prescriber of fluid overload• Electrolytes, blood pH, PO2,...