pharmacology exam 2 part 3
The nurse is preparing to administer an oral dose of digoxin. The apical pulse rate is 64. What nursing action is most appropriate?
Give the medication
The nurse has just administered the initial dose of Captopril (Capoten) to a newly admitted patient with hypertension. What is the priority nursing intervention over the next several hours?
Monitor blood pressure. (First-dose hypotension is a serious potential adverse effect of ACE inhibitors)
The nurse is administering IV lidocaine to a patient with a ventricular dysrhythmia. What the priority nursing intervention to prevent a potential complication with this drug?
Monitor the electrocardiogram (EKG)
The nurse is caring for a patient receiving amiodarone. Which body system should the nurse assess for serious side effects of this medication?
Respiratory
The nurse is caring for a patient receiving hydralazine. The healthcare provider prescribes propranolol. The nurse knows that a drug such a propranolol is often combined with hydralazine for what purpose?
To protect against reflex tachycardia (Bbs slow down HR)
Which hemodynamic system serves as a reservoir for circulating blood?
Veins
Which medication is most likely to cause the side effect of constipation?
Verapamil
Which condition do the natriuretic peptides serve to protect the cardiovascular system?
Volume overload (work by reducing blood volume and promoting the dilation of arterioles and veins)
A sign and symptom of digoxin toxicity is:
visual changes (yellow halos) bradycardia (below 60 bpm) GI disturbance
What intervention is used to prevent nitrate tolerance?
give a small amount of topical Nitroglycerin and remove for 10-12 hours/day
Patients may experience 'first dose hypotension" with captopril (Capoten), so the strategy is to ...
give at night
The nurse is caring for a patient who takes spironolactone and quinapril for treatment of heart failure. What finding indicates a potential interaction between these two drugs?
Hyperkalemia
The nurse is teaching a patient prescribed captopril [Capoten] for the treatment of hypertension. Which instructions should the nurse include?
-Avoid potassium salt substitutes. -A persistent dry cough may occur. -Report difficulty in breathing immediately.
Which are the main types of drugs used to prevent or relieve anginal pain?
-Beta blockers -Nitrates -Calcium Channel Blockers
A patient with angina pectoris has been prescribed nifedipine. Which possible adverse effects should the nurse expect with this medication?
-Edema of ankles and feet -Overgrowth of gum tissue
What electrolyte disturbance can happen with captopril (Capoten)?
Hyperkalemia
A nurse is teaching a group of nursing students about antidysrhythmic medications. Which statement by the student indicates understanding of the teaching?
"Antidysrhythmia drugs can cause new dysrhythmias or worsen existing ones. "
A patient with angina is being discharged with a prescription for nitroglycerine sublingual tablets. Which instructions should the nurse include?
"Store the tablets in the original container and tightly close it after use"
The nurse provides discharge instructions to a patient prescribed verapamil SR 120 mg PO daily for HTN. Which statement indicates an understanding of the medication?
-"I must make sure I swallow the pill whole". -"I will avoid drinking grapefruit juice" -"If I notice any swelling in my legs I will call my provider"
Stage 1 HTN:
130/90 mmHg or higher
The nurse is caring for a patient with bipolar disorder treated with lithium [Eskalith]. The patient has a new prescription for captopril [Capoten] for hypertension. The combination of these two drugs makes which assessment particularly important?
Lithium level (ACE inhibitors, such as captopril, can cause lithium accumulation)
Ace Inhibitors may cause:
a dry hacking cough.
The diuretics work by causing:
blockage of NA and water reabsorption
Beta Blockers can cause the following AEs:
bradycardia, heart bock, hypotension, fatigue, and fluid retension /worsening of HF.
Lidocaine toxicity is dose related and an EARLY symptoms is:
confusion
Arterial pressure: the renin-angiotensin-aldosterone system
constriction and volume
The nurse is caring for a patient prescribed quinidine for a supraventricular dysrhythmia. What is a common AE of this drug?
diarrhea
Blood pressure is the culmination of:
Cardiac output and peripheral resistance
Common adverse effect of verapamil (Calan) is:
Constipation (Common Callan is Constipated)
What should the nurse include in the discharge teaching for a patient prescribed amiodarone?
-Take the medication on an empty stomach -Wear sunblock and protective clothing when you are outdoors -Check your pulse daily and report excessive slowing to your healthcare provider immediately -Immediately notify your healthcare provider of shortness of breath, cough, or chest pain
What are the primary regulatory systems of arterial pressure?
-Autonomic nervous system -Renin-angiotensin-aldosterone system -Renal system
Which statements accurately reflect Starling's law as applied to a healthy heart?
-The right and left ventricles pump the same amount of blood. -Cardiac output is equal to the volume of blood delivered by the veins. -When venous return increases, cardiac output increases.
Nitroglycerin is used to treat: Selected Answer: Correct a and b
-acute angina -prevent chronic recurrent angina
The nurse understands that patients receiving nitroglycerine are at risk for which adverse effects?
-headache -dizziness -tachycardia
What is the mechanism of action of nitroglycerin (a nitrate)?
-it relaxes the smooth muscle -dilates the veins and the arterioles -decreases preload
three mechanisms that help ensure venous return:
-negative pressure in the right atrium -constriction of veins -combination of venous valves and contraction of skeletal muscles.
Stage 2 HTN:
140/100 mmHg
Stage 3 HTN:
180 mmHg or higher -or-diastolic blood pressure is 110 mmHg or higher.
What is the normal range for Potassium?
3.5-5 mg/L
The renin-angiotensin-aldosterone system plays an important role in maintaining blood pressure. Which compound in this system is most powerful at raising the blood pressure?
Angiotensin II
What should as astute nurse teach when his or her patient first starts verapamil (Non-dihydropyridine)?
Bowel regimen (common AE=constipation)
A patient is prescribed Captopril (Capoten) 25 mg by mouth twice a day for hypertension. For which therapeutic effect will the nurse monitor?
Decrease in blood pressure (The therapeutic effect of ACE inhibitors is to reduce blood pressure in patients with hypertension)
Quinidine's most common adverse effect is:
Diarrhea (yr QUINA get DIarrhea)
Antidote for digoxin toxicity is....
Digibind!
Cardiac output = Volume of blood ejected at each heartbeat × ____.
Heart rate (The amount of blood ejected with each heartbeat is known as the stroke volume. To determine the cardiac output, multiply the stroke volume by the number of beats per minute.)
ACEIs and eplerenone (Inspra) could be given together in HF. Which AE is a priority monitor for when these drugs are combined?
Hyperkalemia
The nurse is caring for a patient prescribed aliskiren [Tekturna]. How does this medication lower blood pressure?
It inhibits the conversion of angiotensinogen into angiotensin I. (Aliskiren is the first direct renin inhibitor on the market. It binds with renin and thus inhibits the conversion of angiotensinogen to angiotensin I. )
What is a positive ADVERSE Effect of thiazide diuretic therapy?
It promotes diuresis
A patient is admitted to the hospital with a diagnosis of hypertension. The nurse understands that which medication works by preventing angiotensin II from binding with its receptor sites?
Lorsartan (Cozaar®) (ARBs prevent the binding of angiotensin II at its receptor sites.)
The drug of choice in vasospastic angina is:
Nifedipine (Adalat)
The nurse is caring for a patient with renal artery stenosis who has been prescribed Captopril (Capoten). Which laboratory result indicates an adverse effect of this drug?
Serum creatinine level of 2.3 mg/dL (Patients with bilateral renal artery stenosis are at increased risk for renal insufficiency and failure with angiotensin-converting enzyme (ACE) inhibitors, such as benazepril.)
ACE inhibitors should be used in all patients that are stage _________ heart failure
Stage B (or higher)
ACEIs and eplerenone (Inspra) could be given together in HF. Which AE is a priority monitor for when these drugs are combined?
hyperkalemia
Eplerenone (Inspra, aldosterone antagonist) cause what electrolyte disturbance?
hyperkalemia
Arterial pressure: renal system
long-term volume control
The signs and symptoms of hypokalemia include which of the following:
muscle weakness feeling of "irregular heart beat" muscle cramps
Problems that exist with untreated HTN include:
myocardial sclerosing dementia brain damage
In giving SL nitroglycerin, the proper procedure is to:
one tablet every 5 minutes with a maximum of 3
Many antidysrhythmic drugs affect the action potential by:
prolonging the effective refractory period
Arterial pressure: autonomic nervous system
provides short-term tone and control
A life threatening adverse effect of amiodarone (Cordarone) is:
pulmonary toxicity
