Calcium channel blockers nursing considerations
The nursing considerations for calcium channel blockers split by type. For verapamil and diltiazem, check the pulse and hold for bradycardia. For the -dipine drugs like amlodipine, watch for ankle edema and a reflex fast heart rate. For all of them, avoid grapefruit juice, which raises drug levels.
What calcium channel blockers do, and why the NCLEX tests them
Calcium channel blockers stop calcium from entering heart and blood-vessel muscle, which relaxes them. The -dipine drugs (amlodipine, nifedipine) mainly dilate arteries to lower blood pressure and treat angina. Verapamil and diltiazem also slow the heart and the AV node, so they treat fast rhythms like SVT and atrial fibrillation. The exam tests which effect goes with which drug.
Key nursing considerations for calcium channel blockers
These slow the heart, so hold and notify for bradycardia or heart block.
Amlodipine and nifedipine commonly cause peripheral (ankle) edema, plus flushing, headache, and reflex tachycardia.
Grapefruit raises calcium-channel-blocker levels and can cause toxicity and low blood pressure.
Increase fiber and fluids and check the pulse.
Orthostatic hypotension and dizziness are common; change positions slowly.
How the NCLEX turns calcium channel blockers into a question
Report for verapamil or diltiazem, a slow heart rate; for the -dipines, significant ankle edema; and the grapefruit interaction.
Priority check the pulse before giving verapamil or diltiazem and hold if bradycardic; check the blood pressure.
Teach avoid grapefruit juice, report swelling in the ankles or feet, and if you take verapamil, add fiber and fluids to prevent constipation.
A heart rate of 50 charted before a diltiazem dose (hold and notify), or new ankle edema on amlodipine (read the chart to tell an expected effect from worsening heart failure).
Quick answers
What is the difference between diltiazem and amlodipine?
Diltiazem (like verapamil) slows the heart and AV node, so it treats fast rhythms and you check the pulse before giving it. Amlodipine and the other -dipine drugs mainly dilate arteries to lower blood pressure and commonly cause ankle edema.
Why avoid grapefruit juice with calcium channel blockers?
Grapefruit blocks the enzyme that breaks these drugs down, which raises their level and can cause toxicity and dangerously low blood pressure.
Which calcium channel blocker causes constipation?
Verapamil is notorious for constipation. Teach the patient to increase fiber and fluids.
Keep studying
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