When Should Beta Blockers Be Used? (Nursing)

00:01 So, what other things can we use them for? Well, they're actually helpful in treating angina, chest pain, especially after an MI. This has been shown to extend people's quality of life.

00:11 So chest pain, let's stop and think; why would that be helpful to use a beta blocker for chest pain? Well, hey, my heart isn't working as hard, right? It's not beating as fast.

00:22 It's not beating as hard.

00:24 So the cool part about that is my heart's not going to need as much oxygen.

00:29 Chest pain is a lack of adequate oxygen supply.

00:33 If you decrease my workload, then cool, I'm going to have less chest pain.

00:38 We use beta blockers for long-term prevention of angina or chest pain.

00:42 Now, after an MI, that heart's taken a hit, right? So we want to definitely decrease the workload on that heart too.

00:50 The reason beta blockers are helpful in hypertension.

00:55 Let's think about that.

00:56 Well, that one is one we've just hit, right? Hypertension, because I decrease the velocity of the electrical impulse racing through the heart, I decrease the heart rate. The heart's not pumping as fast or as hard.

01:10 Now, my cardiac output is lower, and therefore, my blood pressure will be lower, so that will help me treat hypertension.

01:19 Now this one is a little bit touchy. We're talking about cardiomyopathy, and that's when your heart can get kind of too big, or in CHF.

01:28 Okay, those hearts are kind of limping along.

01:30 So we walk this tightrope with this medication, because I want to decrease the workload of the heart just enough that it's easier for the patient, but not too much so I throw them into failure.

01:43 So this takes really good communication with the nurse, the patient, the other members of the healthcare team, to help the patient recognize when they're starting to get into trouble.

01:52 So, beta blockers are really helpful, but we're constantly watching that dosage and how the patient is responding to make sure that we don't get the heart so cranked down that it throws them into deeper failure.

02:05 Now, the last one we're talking in this slide is supraventricular arrhythmias.

02:09 So those are super-fast heart rates, you can see why beta blocker would be helpful for that.

02:15 So more importantly than memorizing a list is when you see the applications of a medication, is you say, "Why? Can I answer from the mechanism of action of this drug? Why would it be helpful for anigina? Why would it be helpful for MI?" So what I would encourage you to do is pause the video, and take just a minute to see if you can walk through without looking at your notes, see if you can walk through the reasons that we would use a beta blocker and how it would help your patient have a better quality of life to use it for all these diagnoses.

02:55 Okay, I hope you're starting to get the idea of the benefit of always asking "why?" Memorizing lists will get you nowhere. Well, it'll just get you confused.

03:04 If you really want to give the best patient care to your patients, this is what you do. Don't settle for memorization.

03:11 Understand the "why" behind what you're doing and you're going to be a fantastic nurse.

03:16 Now, let's look at some more. Anxiety. Okay.

03:20 Now, I gave you the answers on the first slide.

03:22 I want you to see if you can respond to these -- anxiety. Huh. Okay, what happens when you're anxious? I get real nervous, I get real sweaty. My heart rate goes real fast.

03:31 How would a beta blocker help me with that? Well, when I'm anxious, epinephrine and adrenaline is running through my body, right? So, if I give you a beta blocker, it's going to be on those receptors that make me have that response, so I'm going to be calmer. In fact, this is one of my favorite things to recommend to students who have true test anxiety. Not the, "Oh, crap. I didn't study," anxiety. I can't fix that because if I could, I'd be a good gajillionnaire, wouldn't I? We could just be smart without having to study.

04:05 But for true test anxiety, when your mind goes blank, and you can't think -- that type of anxiety -- beta blockers are an excellent option, because they block that panic response.

04:18 So, we've had fantastic results with recommending that students with true test anxiety talk to their health care provider, and they go on a low-dose beta blocker.

04:28 They only take it on test days. They don't have to take it for blood pressure control.

04:32 It doesn't make them sleepy. It's not like a sedative, but it just blocks that panic attack.

04:38 So if you're someone who suffers from test anxiety, consider that. It's a great option and they're even cheap.

04:44 So it's a really easy solution.

04:46 Essential tremors, same type of thing.

04:48 Migraine headaches.

04:50 We're not even sure why it works for migraine headaches.

04:53 And frankly, I wish we were better at treating migraine headaches than we are.

04:58 For those of you out there that suffer from migraine headaches, you have my full empathy.

05:03 When a student tells me they have a migraine headache, I don't need to hear anything else.

05:08 I will do whatever I need to to facilitate it because I don't have them, but my sister does, and I know that they are just brutal.

05:16 Some patients can actually be treated for migraine headaches and get some relief.

05:20 Also works for open-angle glaucoma and pheochromocytoma.

05:25 Okay, we're ending the trivia, right? We're getting into trivia land by this.

05:29 For this slide, the one that it's most important to me that you take away with you is anxiety.

05:34 So circle that one. That one you need to know, the others are nice to know. And let's be honest, you only have certain real estate in your brain, so part of the interesting part of nursing school is learning what is most important, and the nice-to-know stuff you could add at a later time.

05:53 But the need-to-know is understanding how beta blockers work, and why they help.

05:59 Make sure you know that they treat anxiety, but also, the major precautions that we listed on the previous slide.

06:07 So let's take a look at those one more time.

06:09 Chest pain, after an MI, hypertension, cardiomyopathy, and the super ventricular arrhythmias.

06:17 So, if the main list that I need to memorize would be those four plus anxiety, you're in really, really good shape.

06:25 And by keeping in mind the mechanism of action, you should be fine.