Diltiazem nursing considerations
Diltiazem's key nursing consideration is that it slows the heart, so check the apical pulse and blood pressure before giving it and hold for a heart rate under 60 or low blood pressure. Avoid grapefruit juice, and watch for bradycardia, heart block, and edema.
What diltiazem does, and why the NCLEX tests it
Diltiazem is a non-dihydropyridine calcium channel blocker. Along with verapamil, it slows conduction through the AV node and reduces heart rate as well as blood pressure, so it is used for hypertension, angina, and rate control in atrial fibrillation and SVT. The exam tests the pulse check and the grapefruit interaction.
Key nursing considerations for diltiazem
Hold and notify for a heart rate under 60, heart block, or low blood pressure.
It raises diltiazem levels and can cause toxicity and hypotension.
Report a slow or irregular pulse, dizziness, and swelling.
Orthostatic hypotension is common; change positions slowly.
IV diltiazem for rapid atrial fibrillation is given with continuous cardiac and blood-pressure monitoring.
How the NCLEX turns diltiazem into a question
Report a slow or irregular pulse, dizziness or fainting, and swelling.
Priority assess the apical pulse and blood pressure before giving; hold and notify for a heart rate under 60 or low blood pressure.
Teach avoid grapefruit juice, rise slowly, and report a slow or irregular heartbeat or swelling in the feet.
A patient in atrial fibrillation on IV diltiazem whose heart rate drops to 48 with a falling blood pressure. Hold or stop, notify, and monitor.
Quick answers
What do you assess before giving diltiazem?
The apical pulse and blood pressure. Hold the dose and notify the provider if the heart rate is under 60 or the blood pressure is low.
Is diltiazem used for atrial fibrillation?
Yes. Because it slows AV-node conduction, diltiazem is used for rate control in atrial fibrillation and SVT, sometimes as an IV infusion with cardiac monitoring.
Can you drink grapefruit juice on diltiazem?
No. Grapefruit raises the drug level and can cause toxicity and low blood pressure.
Keep studying
These pages build on each other. Work through the related classes, then pressure-test yourself against the free cheat sheet and the full guide.
Digoxin
Apical pulse, the 0.8 to 2 level, the potassium trap, and DigiFab.
Read the guide →Metoprolol
Hold for HR under 60, never stop abruptly, masks hypoglycemia.
Read the guide →Carvedilol
Beta-blocker holds plus give-with-food and start-low heart-failure care.
Read the guide →Lisinopril
The dry cough, the angioedema emergency, and high potassium.
Read the guide →All high-yield drug classes
The seven most-tested classes on one page, each decoded the same way.
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Every high-yield class, decoded the same way
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