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Flashcards in Exam 3 Deck (76)
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1
Q

What are the primary antihypertensive agents? (5)

A
  1. Diuretics
  2. Beta Blockers
  3. Ca2+ channel blockers
  4. ACE Inhibitors
  5. Angiotensin II blockers (ARBS)
2
Q

What should assess before administering Atenolol or Metoprolol?

A

Assess HR and BP

3
Q

Sam is due for his Atenolol, but you checked his BP and HR and both are low. What is your nursing action?

A

Hold the atenolol

4
Q

Sean is a new admit and has a prescription for Lasix, what is the best way to know the medication is working properly?

A
  1. Check his weight daily

2. Measure his input and output

5
Q

What is the purpose of digoxin?

A

to treat HF by increasing contractility

6
Q

When should you hold the prescription of digoxin?

A

if serum digoxin is higher than 1.8 ng/ml

7
Q

While giving digoxin what is your concern?

A

digoxin toxicity

8
Q

What are the signs and symptoms of digoxin toxicity?

A
  1. N/V
  2. Fatigue
  3. Anorexia
  4. Visual disturbance like seeing halos or blurring
9
Q

What is the drug of choice for HTN?

A

hydrochlorothiazide

10
Q

What kind of drug is hydrochlorothiazide?

A

thizade diuretic

11
Q

What is your pt. teaching for thiazide?

A

since potassium levels decrease, advise patient to increase potassium-rich foods (shellfish, bananas, avocado, spinach)

12
Q

When is the best time for a patient to take their diuretic?

A

daily in the morning

13
Q

What does ACE inhibitor stand for?

A

it is angiotension-converting enzyme inhibitor

14
Q

What is the MOA for ACE inhibitors?

A

prevents the conversion of Angiotensin I to Angiotension II, this lowers peripheral resistance and a decrease in fluid volume

15
Q

What are ACE inhibitors such lisinopril, catopril, used for?

A

to decrease BP, and reduce blood volume

16
Q

If taking lisinopril, should I encourage an increased in potassium-rich foods as part of my teaching?

A

No, decrease potassium because hyperkalemia is an adverse effect

17
Q

If an elderly patients have HTN why are they given combination pills?

A

older people do not like taking taking a lot of pills

18
Q

What is an example of a combination drug for HTN?

A

tenoritic= diuretic + B blocker

19
Q

What is my concern with tenoritic?

A

it causes hypotension

20
Q

If an older patient is taking tenoritic, what is your major concern? What is your nursing intervention?

A

my major concern is the pt is at risk for falls. I intervene by dangling feet prior to ambulation and having the pt get up slowly

21
Q

What is Angina?

A

acute chest pain due to insufficient O2 to myocardium

22
Q

What group of meds are given to treat angina?

A

Nitrates

23
Q

What is the prototype for Nitrates?

A

nitroglycerin

24
Q

What is the MOA for nitrates?

A

relax both arterial and venous smooth muscle; dilate coronary arteries.
** Decrease venous return which promotes dilation**

25
Q

If Sara, has a nitroglycerin patch, how do I prevent tolerance?

A

remove the patch for 6-8 hours

26
Q

If Sara is taking nitroglycerin and develops a headache which i s a common adverse effect, what can type of analgesic can I administer?

A

acetaminophen (Tylenol)

27
Q

If Sean is taking nitrogylcerin and now wants to Viagra, do we recommend the physician he gets Viagra?

A

No, nitrates and viagra can not be used concurrently

28
Q

What type of tachycardia do nitrates cause?

A

reflex tachycardia

29
Q

Do nitrates cause bradycardia?

A

no

30
Q

What is the MOA of statins?

A

interfere with the synthesis of cholesterol

31
Q

If Lee is taking Lipitor during what SI/Sx should he call the MD?

A

when his skin begins to turn yellow (jaundice) liver failure

32
Q

During pt teaching you teach Lee to report rhabdomyolysis, he ask you to what it is?

A

muscle or joint pain as result from lipitor

33
Q

Kevin is beginning to take amlodipine, what is your pt teaching?

A

he is taking a calcium channel blocker so he can not drink grapefruit juice

34
Q

What are the reasons a patient is taking an ACE inhibitor?

A
  1. HTN
  2. reduce diabetic neuropathy
  3. HF
  4. after an MI to reduce a re occurrence
  5. angina
35
Q

Do ACE inhibitors fix dysrhythmias?

A

no

36
Q

If Kevin’s Cr levels are below 6 should I give him an lisinopril?

A

no

37
Q

What is another name for vitamin B3?

A

Niacin

38
Q

Why would a patient be given Niacin?

A

decreases VLDL & LDL levels (antihyperlipidemia)

39
Q

What are some side effects of taking Niacin?

A
  1. flushing
  2. hot flashes
  3. nausea
  4. xs gas
  5. diarrhea
    More seriously
  6. hepatotoxicity
  7. gout
40
Q

If patient is experiencing flushing from taking Niacin, what can be given?

A

pt can take aspirin 30 mins prior

41
Q

What are the side effects of Lasix?

A
  1. hyperurcemia
  2. hypoklaemia
  3. hyperglycemia
  4. dehydration
    - dry mouth
    - thirst
    - weight loss
    - headache
  5. hypotension
  6. dizziness
  7. fainting
42
Q

What is the MOA of Beta blockers?

A

decrease HR and contractility

43
Q

What type of pts is a beta blocker contraindicated?

A

asthma pt.

44
Q

What type of diuretic is Lasix?

A

loop

45
Q

What is the MOA of Lasix?

A

acts on the loop of Henle preventing the reabsorption of Na+ and Cl-

46
Q

Why are pts given diuretics?

A
  1. HF
  2. HTN
  3. edema
  4. pulmonary edema
  5. increase urine flow
47
Q

When is the best time for a pt to take their statin?

A

take in the evening or at night

48
Q

What type of drugs can be given with statins?

A

bile acid-binding resins (Sequestrants)

49
Q

What is the MOA for sequestrants?

A

bind with bile acids to increase excretion of cholesterol in stool

50
Q

What is the prototype drug for bile-acid resins?

A

Questran

51
Q

What is the adverse effect of Questran?

A

GI problems (constipation and bloating)

52
Q

Which 2 diseases are the most responsible for kidney failure?

A

diabetes and HTN

53
Q

What is the antidote for heparin?

A

protamine sulfate

54
Q

What is histamine?

A

chemical mediator of inflammatory response; responsible for allergy SX

55
Q

What type of med is given for allergic rhinitis?

A

decongestants (relievers) and antihistamine (preventers)

56
Q

What is the prototype drug for Antihistamines?

A

Benadryl

57
Q

What are some side effects of Benadryl?

A

drowsiness, anticholinergic

58
Q

What is your pt teaching for benadryl?

A

avoid ETHOL

no operating heavy machinery (ie driving)

59
Q

What is a common type of decongestant?

A

Sudafed

60
Q

If my pt has hypertension and I want to give him a decongestant, can I give him Sudafed?

A

NO

61
Q

If all meds for asthma are not working for my pt, what is my last resort?

A

theophylline

62
Q

Why is Theophylliine not typically prescribed?

A

narrow margin of safety (5-20 mcg/ml serum)

63
Q

What is your favorite thing that is incorporated with Theophylline?

A

caffeine

64
Q

What is type of med that inhibits coughing?

A

Antitussives

65
Q

What do some antitussives consist of?

A

some consist of narcotics

66
Q

If an antitussive has a narcotic, what do we know will be a side effect?

A

constipation

67
Q

What is the MOA of antitussive?

A

blocks the cough reflex in the medulla

68
Q

If Susan is using an MDI inhaler and you hear whistling is that okay?

A

No, there should be no whistling sound. they could mean she does not have her lips fully around the inhaler

69
Q

When a pt with asthma is using an inhaler, how do we know it is effective?

A

lung sounds are clear

70
Q

What type of med is used to dissolve clots?

A

thrombolytics

71
Q

What does it mean when a drug is positive inotropic? negative?

A

if positive they increase heart contractility and if negative they decrease heart contractility

72
Q

What does it mean when a drug is positive chronotropic? negative?

A

if they are positive that means it increases heart rate and if negative they decrease the heart rate

73
Q

Is digoxin negative or positive inotrope? chronotrope?

A

positive for inotropic drug and negative for chronotropic

74
Q

What is an example for a negative inotrope drug? `

A

metroprolol

75
Q

What is a positive chronotropic drug?

A

dopamine

76
Q

How do we know digoxin is working on a pt?

A

the pt become active