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nrb 132 exam 1 second study set
cardiac medications, parteneral health, etc
Terms in this set (50)
what is the goal of antihypertensive medication?
lower BP and prevent end-organ damage
a nurse takes a patient's BP before administering HTN medication and it measured 98/60. should the nurse administer the medication?
no since it was under 100 systolic it is not needed
name the 3 different types of diuretics
1. hydrochlorothiazide (thiazide type)
2. furosemide (loop, more potent shorter action)
3. spironolactone (potassium-sparing)
what is the action of diuretics?
-decrease blood and fluid volume, decreasing cardiac output and renal blood flow
-blocks sodium, water, and chloride from renal reabsorption, lowering BP
-increases secretions of sodium, chloride, magnesium, calcium and potassium (SCCPM)
what are nursing considerations for all antihypertensive medications?
-always monitor BP and pulse and postural changes like in orthostatic hypotension, before and after administration
-monitor renal function and side effects
what are some nursing implications for diuretics?
-monitor for signs of
(I and O/weight) and
. encourage potassium rich foods if not on K+sparing
monitor lab values
for electrolytes like K+, glucose levels (hyperglycemia in loop or thiazide), CBC
administer in morning
to prevent nocturia
also remember sulfa allergy & sunblock
what are some common beta blockers?
what are the actions of beta blockers?
-decrease BP, pulse by blocking beta-adrenergic stimulation (chemicals that make the heart beat)
essentially makes heart beat less blood less forcefully so BP decreases
-reduces risk of angina and MI
what are some nursing implications for beta blockers?
monitor BP (orthostatic) and pulse. do not administer lower than 60
cannot be stopped abruptly
-monitor for side effects like fatigue, weakness, impotence,
, arrhythmia, CHF, PE, GI issues
use cautiously in patients with COPD/asthma, CHF or hepatic disease (can make it worse, SOB symptoms)
-monitor glucose for hypoglycemia
what are the two types of calcium channel blockers? list examples for each.
1. nondihydropyridines: diltiazem (Cardizem), verapamil (Calan, Isoptin)
2. dihydropyridines (ends in pine): amlodipine (Norvasc), felodipine (Plendil), nifedipine (Procardia)
what is the role of calcium in the heart?
used for smooth muscle spasms, blockers help block calcium from binding thus lessening the force of the heart muscle and decreasing BP
what are the actions of calcium channel blockers?
-inhibits calcium influx which causes
increases oxygenation to the heart
(prevent chest pain)
slows heart rate
and decreases strength of contraction, decreasing workload
inhibits coronary artery spasm
what are some of the nursing implications of calcium channel blockers?
-monitor BP, pulse and liver function
esophageal reflux, GI distress, bradycardia
, also dizziness, edema, headache
avoid grapefruit juice
encourage regular dental care
-do not stop abruptly
-risk for liver, heart, kidney failure
what are ace inhibitors?
angiotensin-converting enzyme inhibitors
what are some examples of ace inhibitors?
what are the actions of ace inhibitors?
-inhibits conversion of angiotensin I to angiotensin II (vasoconstrictor)
-reduces peripheral resistance, vasoconstriction so lower BP and reduces Na and H2O retention by inhibiting aldosterone
what are some of the nursing considerations for ace inhibitors?
-monitor BP, can cause severe hypotension (potent drug)
change positions slowly
to prevent falls
monitor for hyperkalemia, taste disturbances, dry/persistent cough, angioedema
, decreased renal function, agranulocytosis
-not for pregnant pts or renal disease, NSAIDs reduce function
-increase lipids, lower WBC
what are some examples of angiotensin II receptor blockers (ARB's)?
losar*tan* (Cozaar), valsar
*tan* (Cozaar), valsar*tan* (Diovan)
how do ARBs work?
-blocks angiotensin II (vasoconstrictor) receptors
-reduces peripheral resistance so blood can flow more freely, decrease BP
what are some nursing considerations for ARBs?
-monitor BP and
- hypotension and dizziness
-monitor renal function, CBC changes
-monitor electrolyte values, can cause
-assess for angioedema, side effects, dyspnea
what are some examples of vasodilators?
-sodium nitroprusside (Nitropress)
-Corlopam (fenoldopam mesylate)
what are the actions of vasodilators?
-relax smooth muscle in blood vessels, dilating arteries and improving blood flow to ischemic regions
cause peripheral vasodilation
and decreases peripheral resistance (elevates cardiac output)
rapidly lowers BP
in HTN crisis
what are some nursing considerations for vasodilators?
monitor BP, peripheral and apical pulse
-monitor for side effects like
headache, dizziness, flushing, tachycardia
, hypotension, edema
-do not use with viagra
what are some examples of alpha 1 blockers?
what are some of the actions of alpha 1 blockers?
-relax muscles and open small vessels
-keeping norepinephrine from tightening blood vessel walls
-similar to vasodilator, improve urine flow in men with prostate issues and decrease BP
what are some nursing considerations for alpha 1 blockers?
if not given with beta blocker and diuretic
-monitor BP, pulse
-monitor side effects like
drowsiness, fatigue, vomiting, diarrhea, urinary frequency, and cardiovascular collapse
what are some central alpha 2 agonists?
what are the actions of central alpha 2 agonists?
lower HR and reduce BP
heart doesn't pump as hard
-prevents brain from speeding up pulse and constricting blood vessels (inhibits norepinephrine) by stimulating alpha adrenergic receptors
what are some nursing considerations for alpha 2 agonists?
-monitor for drowsiness, dizziness, CMS, fatigue, constipation, dry mouth
-not for pts with liver disease or CAD
-methyldopa good for pregnant pts, prostate disease, renal failure
-reserpine not good for depression, psychosis, obesity, peptic ulcer
what are two types of lipid lowering agents?
1. statins (HMG-CoA reductase inhibitor
2. omega 3 ethyl esters
what are some examples of statins?
simvastatin (Zocor) or atorvastatin (Lipitor)
what are some of the actions of statins?
-blocks cholesterol production in liver
-decrease LDL, TC, triglycerides
-also used for ACS and stroke
what are some nursing considerations for statins?
monitor for increased liver enzymes, CK levels and cholesterol
-report to HCP (breakdown of muscle tissues into blood)
avoid grapefruit juice
-check to see if need to give at bedtime/ with food or not
-side effects of memory loss/confusion
what are some examples of omega 3 ethyl esters?
-fish oil capsules
-found in food
what are the actions of omega 3 ethyl esters?
decrease triglyceride levels by inhibiting production in the liver, reduce inflammation
what are some nursing considerations for omega 3 ethyl esters?
-GI distress, taste perversion, rash, back pain
what are some examples of anti-platelet medications?
what is the action of antiplatelet medications?
prevent platelet aggregation thus reducing thrombolytic events that impede bloodflow, reduce MI related to CAD
what are some nursing considerations for antiplatelet medications?
monitor for bleeding
thrombocytopenia, anaphylaxis. others include GI distress, headache, rash
-do not give if pt is bleeding or has bleeding disorders
-bleeding precautions on pts on these meds
what are some nursing considerations for the antiplatelet medication aspirin?
give with meals
prolong bleeding time
must report blood in stool or urine, and stop before surgery
-may cause ringing in ears
what are some examples of anticoagulants?
-enoxaparin (Lovenox), dalteparin (Fragmin)
Subq injections or IV
what are the actions of anticoagulants?
-prevents clots/thrombus from forming
-deactivates thrombin, preventing conversion of fibrinogen to fibrin
what are some nursing considerations for anticoagulants?
-monitor for bleeding, use precautions
-protamine sulfate is antidote for OD
-monitor aPTT, platelets, Hgb, Hct
what are the most common syringe sizes?
, some in 2-2.5
-TB syringe is 1mL
what size are subcutaneous needles usually?
24-26 mm gauge, 3/8-5/8inch needle
what size are intramuscular needles usually?
20-22mm gauge, 1-1.5-2inch needle
what are symptoms of mild anxiety and how is it treated?
-sensation something is off
-sensory stimulation increases
-attention to learn, solve problems
can be considered healthy and motivate someone
what are symptoms of moderate anxiety and how it is treated?
-sensation that something is definitely wrong
-nervousness/agitation, narrowed perception
-can still process info but need to be redirected
redirect and refocus patient
, relate feelings to anxiety, use problem solving techniques, oral prns possibly
what are symptoms of severe anxiety and how is it treated?
-vital signs increase
-restlessness, irritability, anger, loud speech
use kind, firm direction. decrease stimuli give IM medication. stay with patient to comfort, take deep breaths. lower to mild/moderate
what are symptoms of panic level anxiety and how is it treated?
-fight, flight or freeze
-focused on defense
-incoherent, out of control, loss of reality
guide firmly, reduce stimulus, IM medication, restraints
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