Pharm Exam 2

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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


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