Cardio and Renal Flashcards
(74 cards)
HDL
helps rid your body of excess cholesterol so it’s less likely to end up in your arteries, does so by taking fat from your blood to your liver
LDL
“bad cholesterol” because it takes cholesterol to your arteries, where it can collect in your artery walls
good triglyceride level
below 150 mg/dl
good LDL level
below 100 mg/dl
good cholesterol level
less than 200 mg/dl
good HDL level
above 60 mg/dl
medications to treat high cholesterol
-Statins (HMG-CoA inhibitors)
-Bile Acid Resin
-Nicotinic Acid (Niacin)
-Fibric Acid Agents
-Cholesterol Absorption
Inhibitors
what’s HMG-CoA reductase?
the critical enzyme in the biosynthesis (production) of cholesterol
atorvastatin
*statin
*MOA: inhibits HMG-CoA reductase/lowers cholesterol
Adverse: HA, fatigue, muscle/joint pain (rhabdo) and heartburn
**watch for rhabdo, liver function
*take in PM & NOT w/ grapefruit juice
what’s Rhabdomyolysis?
when damaged muscle tissue releases its proteins and electrolytes into the blood
**These substances can damage the heart and kidneys
**watch for complaints of muscle aches/pains
nursing interventions for statins
*Monitor for joint and muscle pain.
*Monitor liver function labs (ALT and AST).
*Monitor client alcohol consumption
*Monitor cholesterol and triglyceride levels.
*Monitor client dietary compliance.
*Do not administer with grapefruit juice
1 choice to treat high cholesterol
statins
bile acids: prototype, etc
*cholestyramine (Questran)
*MOA: bind with bile acids, increasing cholesterol excretion in stool
*Use: lower cholesterol
*Adverse: GI tract, (bloating and constipation), can bind other drugs increasing potential for drug–drug interactions
nursing implications of bile acids
*GI side effects (bloating and constipation)
*Take an hour before or 4 hours after other meds because of absorption
*bile acids need to be mixed with a LOT of water (60-180 ml) so not for someone on a fluid restriction/unable to drink
nicotinic acid, prototype etc
*niacin (B3)
*for those allergic to, or unable to tolerate, statins
*Need high doses, 2-3 g/day
*Decreases VLDL & LDL, increases HDL
*Adverse: Flushing/hot flashes, GI upset. *Interventions: ASA 30 minutes prior to prevent flushing
fibric acids/fibrates prototype, etc
*gemfibrozil (Lopid)
*MOA: unknown
*Use: high cholesterol
*Adverse: GI distress, watch for bleeding with patients on anticoagulants, flu-like sx
nursing implications of fibric acids/fibrates
*Take with food to prevent GI distress
*Increases risk of bleeding if used with Coumadin.
*Avoid concurrent use with statins (increased risk of rhabdo)
General Cholesterol Medication Information
-Should be discontinued during pregnancy.
-Take medication in PM
-Monitor liver and renal function.
-Low fat, high fiber diet.
-Side Effects: Muscle aches, hepatotoxicity, myopathy, rhabdomyolysis, peripheral neuropathy
kidneys secrete what?
*Renin - B/P regulation
*Erythropoietin - stimulate RBC production
*Calcitriol - active form of vitamin D for bone homeostasis
diuretics decrease the preload or the afterload?
preload
how to diagnose renal failure
*Urinalysis
*Serum creatinine
*Diagnostic imaging
Renal biopsy
**Glomerular filtration rate (GFR)
What’s GFR?
*glomerular filtration rate
*Best marker for estimating renal function
*Measure volume of filtrate passing through Bowman’s capsule per minute
furosemide (Lasix)
*loop diuretic for hypertension
*-ide
*MOA: block reabsorption of Na & Cl in loop of Henle
*K+ WASTING
*Adverse: electrolyte imbalances, dehydration and hypotension.
monitor K+, B/P, HR and kidney function
**Can cause transient deafness pushed fast
hydrochlorothiazide
*thiazide and thiazide-like diuretics
*–thiazide
*K+ WASTING
*Use: hypertension
*Less effective than loop diuretics
*Not effective w/ severe renal failure
*Adverse: electrolyte imbalances (loss of K+ & Na+) so WATCH LEVELS
