Pharm Exam 2
Xanthines Adverse Effects
- CV: tachycardia, palpitations, dysrhythmias - Neuro: dizziness, headache, irritability, restlessness, anxiety, insomnia, seizures - GI: abdominal cramping, N/V/D, anorexia
Digoxin Nursing Care
- Check apical pulse for 1 full minute - hold med if AP <60 and notify HCP - Monitor K level - Monitor digoxin blood level - Digibind is the antidote for digoxin toxicity
Nitrates Indications
- Chest pain - Stable & unstable angina - AMI - HF - Pulmonary edema
Asthma
- Chronic REVERSIBLE inflammation and airflow obstruction - Bronchoconstriction - Inflammation - Increased mucus production
Atrioventricular (AV) Node
- Lies near lower back section of interatrial septum - Slows the SA node rate before electrical impulse passes to ventricles
Bundle of HIS
- Located in between atria and ventricle - Conducts electrical impulse to heart's apex
Bronchitis (Acute)
- Inflammation of the large airways and their branches that result in mucus production
Beta Adrenergic Blockers (BB)
- end in -olol - Medications: atenolol, carvedilol, metoprolol
Alpha 1 Receptor Antagonists
- ends in -azosin - Medications: doxazosin, terazosin, prazosin
Leukotriene Antagonists
- ends in -lukast - Medications: Montelukast, zafirlukast
Calcium Channel Blockers (CCB)
- ends in -pine - Medication: amlodipine - Other medications: diltiazem & verapamil
Angiotensin-Converting Enzyme Inhibitors (ACE)
- ends in -pril - Medication: enalapril, fosinopril, benazepril, ramipril - Captopril & lisinopril - NOT a prodrug & appropriate for liver dysfunction patients
Corticosteroids
- ends in -sone/-one - Inhaled corticosteroids: beclomethasone, fluticasone - Oral corticosteroids: prednisone
Angiotensin II Receptor Blockers (ARB)
- ends in -tan - Medication: losartan, valsartan, irbesartan
Beta Blockers Adverse Effects
- CV: bradycardia, heart block, hypotension, OH, dizziness, edema - Resp: bronchoconstriction (asthma & COPD) - GI: diarrhea - GU: erectile dysfunction - Other: patients with diabetes at risk for hypoglycemia
Digoxin Adverse Effects
- CV: dysrhythmias due to cardiotoxicity
Nitrates Adverse Effects
- CV: hypotension, OH, reflex tachycardia, palpitations, dizziness - Neuro: headache - Other: flushing, tolerance
Central Acting Alpha 2 Agonists Adverse Effects
- CV: rebound HTN, tachycardia - Neuro: drowsiness, sedation - Other: dry mouth
Decongestants Adverse Effects
- CV: tachycardia, palpitations - CNS stimulation: agitation, nervousness, tremors - ENT: rebound congestion
Antiplatelets Indications
- ACS - Prevent AMI - Prevent re-infarction - Prevent CVA or TIA - Prevents ischemic stroke
Central Acting Alpha 2 Agonists MOA
- Acts on the CNS to decrease stimulation of adrenergic receptors, causing vasodilation - Decreases PVR, SBP, and DBP
Mucolytics Indications
- Acute & chronic respiratory disorders characterized by large amounts of thick secretions - Acetaminophen overdose
Antihistamines Indications
- Allergic reaction * - Anaphylaxis * - Allergic rhinitis - Insomnia - Motion sickness
Decongestants Indications
- Allergic rhinitis - Sinusitis
ACE Inhibitors Adverse Effects
- Angioedema - Cough - Orthostatic Hypotension (OH) - Hyperkalemia
Adenosine
- Anti-dysrhythmic - MOA: decreases SA node firing & decreases electrical conduction through AV node - Indications: SVT, PSVT - Adverse effects: dyspnea, bradycardia, transient asystole, hypotension, dizziness, flushing
Dilitazem and Verapamil
- Anti-dysrhythmic & Calcium Channel Blocker - Blocks calcium from entering the blood vessels and heart, prolongs cardiac conduction (resulting in decreased HR) - Indications: A-fib/flutter, SVT - Adverse effects: bradycardia, hypotension, OH, edema, dizziness, constipation
Atropine
- Anticholinergic - MOA: blocks the effects of ACh on the SA and AV node, increases SA and AV node firing - Indications: symptomatic bradycardia, heart block - Adverse effects: tachycardia, dry mouth, constipation, urinary retention
Heparin
- Anticoagulant - MOA: inactivates thrombin and prevents the conversion of fibrinogen to fibrin - Adverse Effects: bleeding, HIT, allergic reaction - Antidote: protamine sulfate - Monitoring: aPTT goal is 60-80secs
Enoxaparin
- Anticoagulant - Low Molecular Weight Heparin - MOA: inactivates factor Xa - Indications: angina, AMI, VTE (DVT and PE), prevent post-op complications - Adverse effects: bleeding, HIT, allergic reaction and toxicity - No monitoring required - For subQ administration: DO NOT ASPIRATE
Antiplatelets Adverse Effects
- Aspirin: bleeding, GI upset & GIB, ototoxicity, enteric-coated available (disintegrates in the small intestine what protects the stomach) - Clopidogrel: bleeding, GI, dyspepsia, diarrhea
Beta 2-Agonist Nursing Care
- Assess: respiratory status before & after treatment ; peak flow before and after treatment - Monitor for adverse effects
Xanthines Indications
- Asthma - COPD
Beta 2-Agonist Indications
- Asthma - COPD - Bronchospasm
Leukotriene Antagonists Indications
- Asthma - COPD - Seasonal allergies
Corticosteroids Indications
- Asthma - COPD - Bronchospasm
Alpha 1 Receptor Antagonists MOA
- Block alpha 1 adrenergic receptors in blood vessels, preventing vasoconstriction
Potassium-Sparing Diuretics MOA
- Blocks action of aldosterone - Results in Na excretion - Water excretion - K retention
Beta Blockers MOA
- Blocks beta-adrenergic receptor sites in the heart muscle and conduction system - Decreases HR, BP, force of contractions, workload of heart (decreases O2 demand) - Cardioprotective for post MI
CCBs MOA
- Blocks calcium entry into the cells - Smooth muscle relaxation: dilation of the blood vessels - Decreases contractility and HR
Anticholinergics MOA
- Blocks cholinergic and muscarinic receptors in bronchial smooth muscle resulting in bronchodilation
Antiplatelets MOA
- Blocks enzyme that prevents platelets from clumping together - Blocks platelet aggregation phase of clotting process
Corticosteroids MOA
- Blocks production & release of inflammatory mediators - Anti-inflammatory action - Decrease mucosa edema - Decrease airway mucus
Antihistamines MOA
- Blocks release of histamine
ARBs MOA
- Blocks the action of angiotensin II - Decreases the release of aldosterone, resulting in vasodilation & Na and water excretion
Adverse effects of CV drugs
- CV drugs have different MOA, however the end outcome is VASODILATION - ALL CV medications cause hypotension and orthostatic hypotension
CCBs Adverse Effects
- CV: bradycardia, edema, dizziness, OH - Resp: dyspnea - GI: constipation, nausea - Other: flushing, headache
Lidocaine
- Class IB anti-dysrhythmic - MOA: interferes with the conduction of impulses in cardiac cells by blocking Na+ channels in the cell membrane - Indications: ventricular dysrhythmias (VT and VF) - Adverse effects: respiratory depression, respiratory arrest, drowsiness, change in mental status, paresthesia, seizures
Amiodarone
- Class III anti-dysrhythmic - MOA: K+ channel blocker, prolongs refractory period, decreases repolarization - Indications: ventricular dysrhythmias (VT and VF) - Adverse effects: pulmonary toxicity (pulmonary fibrosis), bradycardia and heart block, hypotension, N/V
Beta 2-Agonists
- Class: bronchodilator - Short-acting beta agonist (SABA) - Medication: albuterol
Digoxin
- Class: cardiac glycoside - Positive inotropic effect - Increases the force of myocardial contraction: improves SV+HR=CO
Anticholinergics
- Class: inhaled anticholinergic - ends in -ium - Medication: ipratropium
Nitrates
- Class: vasodilator - Medication: nitroglycerin (NTG), isosorbide
Decongestants Nursing Care
- Contraindication in patients with CHD, cardiac dysrhythmias, HTN or glaucoma - Limit therapy to 3-5 days
Pneumonia S/S
- Cough - Fever - Chest pain - Lungs: coarse, crackles, wheezing
Thiazide Diuretics Adverse Effects
- Dehydration - Hypokalemia - Hyperuricemia (uric acid): associated w/ gout as well - Hyperglycemia
LOOP Diuretics Adverse Effects
- Dehydration (monitor BUN and creatinine) - Hypokalemia - Ototoxicity: toxicity of the ear & causes ringing in the ear, loss of hearing, issues with balance - OH - Hypotension
Dabigatran
- Direct thrombin inhibitor - MOA: inhibits thrombin - Indications: prevents CVA in patients with A-fib, treat VTE - Adverse Effects: bleeding, GI upset - NO monitoring required - Nursing care: take with food - Antidote: idarucizumab (praxbind)
Anticholinergics Adverse Effects
- Dry mouth * - Urinary retention * - Constipation * - Resp: bronchospasm, cough - CV: tachycardia, palpitations, hypotension - Neuro: dizziness, headache, nervousness
LOOP Diuretics Indications
- Fluid overload - Edema - HF - Pulmonary edema - Hyercalcemia
Leukotriene Antagonists Adverse Effects
- GI: N/V, hepatic impairment* - Neuro: dizziness, headache* M/S: myalgia - Psych: depression, suicidal ideations, behavioral changes - BLACK BOX WARNING
Expectorants Adverse Effects
- General: allergic reaction - Neuro: dizziness, drowsiness* - GI: GI upset
Digoxin Indications
- HF - Atrial fibrillation
CCBs Indications -
- HTN - Angina - HF - Diltiazem & verapamil: angina & dysrhythmias
Potassium-Sparing Diuretics Indications
- HTN - Edema - HF - Liver failure
ACE Inhibitors Indications
- HTN - HF - AMI - Diabetic (and non-diabetic) nephropathy
ARBs Indications
- HTN - HF - AMI - Protect against CV event - Diabetic nephropathy and retinopathy
Beta Blockers Indications
- HTN - HF - Angina - AMI - Dysrhythmias
Central Acting Alpha 2 Agonists Indications
- HTN - Manage withdrawal
Vasodilators Indications
- HTN & hypertensive emergencies
Mucolytics Nursing Care
- Has odor of rotten eggs - Have suction equipment at bedside - Monitor LFTs
Statins Adverse Effects
- Hepatotoxicity - Myopathy (muscle pain): can lead to rhabdomyolysis (kidney injury) - report muscle pain to MD - Contraindicated in pregnancy - Take medication at bedtime - NO GRAPEFRUIT JUICE
Vasodilators Adverse Effects
- Hydralazine: hypotension, dizziness, headache, anxiety, tachycardia, edema, dyspnea, N/V/D - Sodium nitroprusside: bradycardia, hypotension, decrease in platelet aggregation, cyanide toxicity - Contraindications: systemic hypotension
Expectorants Nursing Care
- Hydration* - Take w/ full glass of water - Take w/ food - Report cough lasting > 7 days
Potassium-Sparing Diuretics Adverse Effects
- Hyperkalemia - Endocrine effects: gynecomastia (breasts in men), hirsutism (excessive hair growth)
Corticosteroids Nursing Care
- ICS: oral care - rinse mouth or gargle after using; monitor for white patches on tongue - Oral steroids: do not stop medication abruptly; dose is tapered - Give oral doses w/ food
COPD
- IRREVERSIBLE destruction of lungs from chronic inflammation - Bronchoconstriction - Inflammation - Increased mucus production
Positive Inotropic Medications
- Increase strength of heart muscle contraction, increase stroke volume, increase cardiac output - Cardiac glycosides (digoxin) - Beta agonists (dobutamine) - Phosphodiesterase inhibitors (milrinone) - These are used because the heart can't pump enough blood to the body's tissues (ex: systolic HF)
Expectorants MOA
- Increases production of respiratory tract secretions - Thins secretions making it easier to clear secretions from airways - Stimulates secretions
Pneumonia
- Infection of lung tissue - Bacterial - Viral - Fungal
Rivaroxaban (Xarelto)
- MOA: inactivate factor Xa - Indications: prevention of stroke in clients with A-fib - Administration: PO only - Interactions: do not give with other anticoagulants, avoid grapefruit juice - Antidote: andexanet alfa (Andexxa) - Black Box Warning: premature discontinuation of Xarelto, increases risk of thrombotic events, spinal/epidural hematoma may occur with epidural catheter
Warfarin
- MOA: inhibit vitamin K, dependent clotting factors - Indications: long-term anticoagulation, prevent recurrent MI, TIA, thrombus formation, prevent CVA in patients with A-fib, prevent thrombotic events in patients with atrial heart valves - Administration: PO only - Monitoring: PT/INR - therapeutic range is 2-3.5 sec - Contraindications: allergy, pregnancy, thrombocytopenia, bleeding, hepatotoxicity, PUD - Interactions: capsicum pepper, garlic, ginger, Ginkgo, St. John's wort, amiodarone - increased bleeding risk, NSAIDs - Antidote: vitamin K - Consistent or decreased intake of foods high in vit K - NO aspirin, NSAIDs or alcohol
Niacin
- Medication: Niacin (vitamin B3) - Unknown MOA - Adverse effects: flushing ; patient to take at night or with a small dose of ibuprofen
Thrombolytics
- Medication: Tissue plasminogen activator tPA (alteplase) - MOA: Binds to fibrin, converts tissue plasminogen to plasmin which promotes lysis of fibrin clot - Dissolves clots that have already formed - Indications: AMI, ischemic CVA, PE, CVAD - Should be administered within 3 hours of onset of symptoms - Window of administration for AMI is 2-4 hours (goal is 60-90 minutes) - Window of administration for acute ischemic CVA is 3-4.5 hours
PCSK-9 Inhibitors
- Medication: alirocumab (praulent) - Monoclonal antibodies that inhibit protease PCSK-9 - Administration: SC via self-administration with a pen or syringe - Adverse effects: diarrhea, influenza, injection-site reaction, myalgia, cough, allergic reaction
Central Acting Alpha 2 Agonists
- Medication: clonidine
Bile-Acid Sequestrants
- Medication: colesevelam, cholestyramine - Binds to bile acids in the intestine and prevents them from being reabsorbed into the blood - Decreases LDL - Adverse effects: Constipation, take 1 hr before or 4-6 hrs after other meds, can be mixed in juice, water, or milk
Cholesterol Absorption Inhibitor
- Medication: ezetimibe (zetia) - Blocks absorption of cholesterol in the intestine - Lowers LDL, increases HDL - Adverse effects: hepatitis (liver inflammation) and myopathy
LOOP Diuretics
- Medication: furosemide
Fibrates - Fibric Acid Derivates
- Medication: gemfribrozil - Reduces the liver's production of LDL and speeds up the removal of TG from the blood - Decrease TG, increase HDL - Adverse Effects: hepatotoxicity and myopathy, abdominal pain, N/V/D, gallstones
Thiazide Diuretics
- Medication: hydrochlorothiazide
Decongestants
- Medication: pseudoephedrine, phenylephrine, ephedrine
Potassium-Sparing Diuretics
- Medication: spironolactone
Anitplatelet Drugs
- Medications: aspirin, clopidogrel, plasurgel, ticagrelor
Vasodilators
- Medications: hydralazine HC: PO, IV - Sodium nitroprusside: IV infusion - CCU patients
HMG-CoA Reductase Inhibitors -Statins
- Medications: pravastatin, simvastatin, atorvastatin
Beta Blockers Nursing Care
- Monitor BP and HR - Use cautiously in patients with asthma & COPD - Take with food - Do not crush or chew SR products
ACE Inhibitors Nursing Care
- Monitor BP for OH - Monitor electrolytes & renal function - Discontinue if pregnancy is suspected
ARBs Nursing Care
- Monitor BP for OH - Monitor electrolytes and renal function - Discontinue if pregnancy is suspected
Antihistamines Nursing Care
- Monitor cardio-pulmonary and neuro status - Take at night to decrease daytime sedation - Avoid activities that require alertness - NO alcohol or other CNS depressants - Hydration, hard candy for dry mouth, prevent constipation - Anticholinergic properties allow to dry the secretions out
Coagulation Modifying Drugs General Nursing Care
- Monitor for bleeding: hypotension, tachycardia, bleeding gums, epistaxis, hematuria, hematemesis, blood in stool - Bleeding precautions: use soft toothbrush, use electric razor, report bleeding in gums, vomit, urine, or stool
Antitussives Nursing Care
- Monitor vitals (cardiopulmonary and neuro status) - Have patient change position slowly - Avoid activities that require alertness* - Hydration* and fiber (w/ codeine) - No alcohol* - Should not be used in productive cough*
CCBs Nursing Care
- NO GRAPEFRUIT JUICE (decreases metabolism of CCBs) - Verapamil: Steven-Johnsons Syndrome (watch for rash)
Antiplatelets Nursing Care
- No monitoring needed - Bleeding precautions - Fall precautions - Take med with food - MUST BE D/C BEFORE SURGERY
Leukotriene Antagonists Nursing Care
- Not indicated for acute exacerbation of asthma or COPD - Assess respiratory status
Anticholinergics Nursing Care
- Not used to treat acute episode of wheezing * - Rinse mouth after inhalation - Wait 5 minutes between inhalations - Sip fluids or suck on hard candies for dry mouth *
ARBs Adverse Effects
- OH - Dizziness - Lightheadedness - Hyperkalemia - URI
Anticholinergics Indications
- Only approved for COPD
A patient has received tissue plasminogen activator (tPA) for an acute myocardial infarction. Which finding is the nurse concerned about? A. Edema B. Fever C. Bleeding D. Reperfusion
C
Corticosteroids Adverse Effects
- Oral: mouth irritation, oral candidiasis (ICS)* - Resp: URI (upper respiratory infection) - GI: N/V, gastritis, PUD* - Endocrine: hyperglycemia* - Neuro: insomnia - M/S: bone loss*, myopathy - Other: risk for infection* - Fluticasone is contraindicated in milk allergy*
ACE inhibitors MOA
- Prevents conversion of angiotensin I to angiotensin II by blocking ACE
Digoxin MOA
- Promotes movement of calcium from ECF to ICF strengthening myocardial contraction - Slows contractions through SA and AV nodes and provides antiarrhythmic effect
Statins MOA
- Reduce cholesterol synthesis in liver - Reduce inflammation, platelet aggregation, and clot formation
Hemostasis
- Refers to the process of controlling bleeding or to stop bleeding - 3 steps: vasoconstriction, platelet plug, formation of fibrin clot
Xanthines MOA
- Relaxes bronchial smooth muscle resulting in bronchodilation - Decreases inflammatory mediators
Nitrates MOA
- Relaxes vascular smooth muscle - Causes general vasodilation - Decreases preload, venous return, cardiac O2 demand
Mucolytics Adverse Effects
- Resp: aspiration, bronchospasm - CV: tachycardia, hypotension - Neuro: drowsiness, dizziness - GI/Liver: hepatotoxicity
Beta 2-Agonist Adverse Effects
- Resp: paradoxical bronchospasm - CV: causes transient tachycardia/palpitations*, chest pain, hypertension - Neuro: tremors
Antihistamines Adverse Effects
- Resp: respiratory depression - Neuro: sedation*, drowsiness*, headache, tinnitus, dizziness, pupil dilation, blurry vision* - CV: tachycardia - GI: N/V, constipation - Oral: Dry mouth - GU: urinary retention*
Antitussives Adverse Effects
- Resp: respiratory depression* - CV: dizziness, lightheadedness - Neuro: drowsiness*, sedation* - GI: N/V, constipation
Bronchitis Medications
- SABA - Steroids - Antibiotics - Cough suppressant
Pneumonia Medications
- SABA - Steroids - Antibiotics - Cough suppressant
COP Medications
- SABA - Steroids - Leukotriene inhibitors - Antibiotics - Cough suppressants
Alpha 1 Receptor Antagonists Adverse Effects
- Serious: hypotension, first dose syncope - give at bedtime - Dizziness, headache - Contraindications: allergy, sildenafil (viagra)
Xanthines Nursing Care
- Serum theophylline blood levels MUST be monitored - Therapeutic level: 10-20 - Monitor cardio-respiratory status - Patients receiving IV theophylline are placed on cardiac monitor - Do not chew or crush SR preparations - Avoid caffeine - Take w/ food
Alpha 1 Receptor Antagonists Indications
- Severe HF (used w/ cardiac glycosides & diuretics) - Symptoms of BPH (increases urinary flow)
Asthma Medications
- Short acting beta agonist (SABA) - Steroids - Leukotriene inhibitors
Decongestants MOA
- Stimulate alpha-adrenergic receptors, resulting in decreased inflammation of nasal passages
Leukotriene Antagonists MOA
- Suppress effects of leukotrienes - Anti-inflammatory
Thiazide Diuretics Nursing Care
- Take medication in morning - Change positions slowly
Potassium-Sparing Diuretics Nursing Care
- Take medication in morning - Change position slowly - Limit foods high in K - Avoid salt substitutes
LOOP Diuretics Nursing Care
- Take medication in morning to avoid nocturia - Change positions slowly
Sinoatrial (SA) Node
- The heart's pacemaker - Located in the RA - Fires at a rate of 60-100
Patient teaching - rescue vs controller inhaler
- Use 15-20 min before exercise (EIA - exercise induced asthma - carry inhaler w/ you) - When patient has to use rescue & controller inhaler: use rescue inhaler 1st, wait at least 5 minutes, then use steroid inhaler)
Asthma S/S
- Wheezing - Cough - Chest tightness - Sputum production
Bronchitis S/S
- Wheezing - Cough - Fever * - Sputum production
COPD S/S
- Wheezing - Cough - Sputum production - SOB - Dyspnea on exertion - Hypoxia - Hypercapnia
Thiazide Diuretics MOA
- Works in the kidney in the DISTAL convoluted tubule - Blocks reabsorption of Na, Cl, and water causing diuresis
LOOP Diuretics MOA
- Works in the kidney on the LOOP of Henle - Blocks reabsorption of Na, Cl, and water causing diuresis
Antitussives MOA
- Works on CNS to increase cough threshold resulting in cough suppressant
A client with HTN develops a persistent cough. The nurse suspects the client is taking _____1_____. The nurse anticipates the HCP will discontinue the ______2______ and prescribe ______3________.
1. Lisinopril/ACE 2. Lisinopril/ACE 3. Losartan/ARB
A nurse is teaching a client with angina how to take NTG, Prioritize the nurse's instructions: "When you have chest pain": A. Take NTG #2 tab SL B. Wait 5 minutes C. Take NTG #1 tab SL D. Stop activity and rest E. Call 911
1. Stop activity and rest 2. Take NTG #1 tab SL 3. Wait 5 minutes 4. Take NTG #2 tab SL 5. Call 911
A nurse is teaching a patient how to apply a nitroglycerin patch. Which statement indicates the patient understands? A. "I will apply the patch to skin with no hair" B. "I will rotate the sites every week" C. "I will apply the new patch over the old patch" D. "I will clean my skin with alcohol before applying patch"
A. "I will apply the patch to skin with no hair"
A nurse is preparing to administer warfarin to a client with a mechanical valve replacement. The client's INR is 2.7. Which action should the nurse implement? A. Administer the medication as ordered B. Prepare to administer vitamin K C. Hold the medication and notify the HCP D. Assess the client for abnormal bleeding
Administer the medication as ordered - INR is in normal range
A client with HF is prescribed enalapril. The nurse should monitor the patient for which adverse effect(s)? Select all that apply. A. Hyperkalemia B. Cough C. Angioedema D. Hypokalemia E. Hypotension
Angioedema, cough, hyperkalemia
P wave
Atria depolarization
The client diagnosed with CAD is instructed to take 81 mg of aspirin. Which statement best describes the scientific rationale for prescribing this medication? A. This medication will help thin the client's blood B. Daily aspirin will decrease inflammation C. This medication will prevent platelet aggregation D. Baby aspirin will not cause gastric distress
Baby aspirin will not cause gastric distress
Which meal is appropriate for a client prescribed furosemide? A. Bacon and eggs B. Turkey and potato chips C. Baked chicken and spinach D. Canned soup and crackers
Baked chicken and spinach
Thrombolytics Adverse Effects
Bleeding
Clinical manifestations of digoxin toxicity include: SATA A. Blurred vision B. Dyspnea C. Anorexia D. Tachycardia E. Bradycardia
Blurred vision, anorexia, bradycardia
A client with a history of MI is prescribed metoprolol. Which assessment data should make the nurse question administering this medication? A. Blood pressure 110/70 B. Blood pressure 150/90 C. Apical pulse 52 D. Apical pulse 100
C. Apical pulse 52
A client diagnosed with HF is admitted to the telemetry unit. Which medication(s) should the nurse anticipate the HCP prescribing? SATA A. Captopril B. Metoprolol C. Furosemide D. Clonidine E. Procainamide
Captopril, metoprolol, furosemide
Antitussives Indications
Cough suppressant
A nurse is administering a calcium channel blocker to a client. Which assessment data should the nurse obtain before giving the medication? A. serum calcium level B. pulse oximetry C. current ECG D. blood pressure
D. Blood pressure
Which statement is true regarding dabigatran? A. Dabigatran does not require monitoring B. Dabigatran is a thrombolytic C. Dabigatran is administered subcutaneously D. Dabigatran does not have an antidote
Dabigatran does not require monitoring
Beta blockers should be used cautiously in patients that have a diagnosis of: ____________ and ____________ Asthma Heart failure Diabetes Hypertension
Diabetes and asthma
Vasodilators MOA
Directly relax arteriolar and/or venous smooth muscle
Hyperlipidemia
Elevated cholesterol - can cause blockage in arteries
A nurse is preparing to hang the next bag of heparin to a client diagnosed with a DVT. The client's current laboratory values are: PT 12.7 INR 1.7 PTT 62. Which intervention should the nurse take? A. Hang the IV bag at the same rate B. Order a STAT PT/INR/PTT C. Notify the HCP D. Assess the client for abnormal bleeding
Hang the IV bag at the same rate - PTT is 62 which is in the normal range (60-80)
Before administering digoxin to client, the nurse checks:
K level, digoxin level, apical HR for a full minute
Purkinje Fibers
Located in the ventricles beneath the endocardium
Mucolytics
Medication: acetylcysteine
Antitussives
Medication: dextromethorphan, codeine
Expectorants
Medication: guaifenesin
Xanthines
Medication: theophylline, aminophylline
Antihistamines
Medications: - Diphenhydramine (1st gen) - Cetirizine (2nd gen) - Fexofenadine (2nd gen) - Loratadine (2nd gen)
A nurse is providing care for a patient with HF who is prescribed furosemide. Nursing care includes: SATA A. Monitor for hearing loss B. Monitor calcium level C. Take at bedtime D. Monitor potassium level E. Monitor intake and output
Monitor for hearing loss, monitor potassium level, monitor intake and output
A nurse is caring for a patient with a deep venous thrombosis who is receiving heparin therapy intravenously. Which lab value should the nurse monitor? A. Partial thromboplastin time (PTT) B. Prothrombin time (PT) C. International ratio (INR) D. Troponin level
PTT
A nurse is preparing to administer warfarin. The client's current laboratory values are: PT 38 INR 5.9 PTT 39. Which intervention should the nurse take? A. Discontinue the IV bag immediately B. Prepare to administer phytonadione (vitamin K) C. Notify the HCP to increase the dose D. Administer the medication as ordered
Prepare to administer vitamin K - INR is too high
Beta 2-Agonist MOA
Relaxes smooth muscle in airways allowing increased airflow - bronchodilation
Mucolytics MOA
Thins thick mucus
Expectorants Indications
Upper respiratory infection
QRS wave
Ventricular depolarization
T wave
Ventricular repolarization
