Week 7 Flashcards
1
Q
Pulmonary edema clinical manifestations
A
short of breath
pink frothy sputum
crackles
2
Q
Diuretic medication increase the production of ________
A
urine
3
Q
Diuretic Meds:
A
- bumetanide
- Furosemide
- Hydrochlorothiazide
- Spironolactone
- Mannitol
4
Q
Clients should take their diuretic before ______ to prevent nocturia
A
2 PM
5
Q
Bumetanide and furosemide are ________ diuretics
A
loop (work in the loop of henle)
6
Q
Bumetanide & furosemide are great for treating _________ and ________
A
edema
heart failure
(sometimes for hypertension)
7
Q
bumetanide and furosemide cause the excretion of too much _______
A
potassium
8
Q
Hypokalemia signs
A
Weakness fatigue
muscle cramps
dysrhythmias
nausea and vomiting
9
Q
Normal potassium range _______
A
3.5 to 5
10
Q
Patients can counteract hypokalemia by eating __________ foods
A
potassium rich
11
Q
furosemide can cause _______ loss
A
hearing (ototoxicity)
12
Q
Hydrochlorothiazide is a __________ treatment for hypertension
A
First line
13
Q
True or false?
HCTZ is safe, effective and inexpensive
A
True
14
Q
HCTZ cause the kidneys to excrete too much ________
A
potassium
15
Q
Spironolactone is a potassium _______ diuretic
A
sparing
16
Q
Clients taking spironolactone should avoid _________ foods. It causes ________
A
- potassium rich
- hyperkalemia
17
Q
Mannitol is administered ________
A
intravenously
18
Q
Mannitol causes the blood to become _________
A
hypertonic
19
Q
Mannitol is used to treat ________ edema
A
cerebral
20
Q
Key problems with mannitol:
1.
2.
A
- It leaks out of regular capillaries causing edema
- It crystallizes at room temp. (Store in warmer, use IV filter, and foley catheter to monitor urinary output)
21
Q
Beta-blocker meds
A
Cardioselective agents
1. Atenolol
2. Metoprolol
Nonselective Agents
1. Carvedilol
2. Labetalol
3. Propranolol
22
Q
Atenolol and Metoprolol block ________ receptors
A
beta 1
23
Q
Carvedilol, labetalol, and propranolol block ______, ______, ________ receptors
A
alpha 1
beta 1
beta 2
24
Q
Propranolol blocks _______ and _____ receptors
A
beta 1
beta 2
25
Beta blockers are prescribed for ______, _________, ________ and _________ following a heart attack
hypertension
angina pectoris
atrial fibrillation
cardioprotection
26
Alpha receptors are located in the _______ and veins
arteries
27
Alpha receptors cause ________
vasoconstriction
28
Blocking alpha receptors cause _________
vasodilation (decreased blood pressure)
29
Beta 1 receptors are located in the _______
heart
30
Blocking beta 1 receptors decreases _______, _______ and _________
heart rate,
strength of contractions,
blood pressure
31
Beta 2 receptors are located in the _______
lungs
32
Blocking beta 2 receptors can cause _____________
bronchoconstriction (not good effect)
33
If beta blocker worked to well it would cause _________ and __________
bradycardia and hypotension
34
Hold beta block and notify prescriber if patient's heart rate is less than _____ and SBP is less than ______
50, 100
35
Beta blocker cause 2 issues for diabetics.
1. Beta 2 receptors are blocked which inhibits the ________ response.
2. Its harder to recognize when they become _____________
1. blood glucose response (fight or flight response)
2. hypoglycemic
36
Bronchoconstriction is a contradiction for ________- and ______ patients
COPD, asthma (they should avoid nonselective beta blockers)
37
Depression and erectile dysfunction is caused by ___________
beta blockers
38
ACE inhibitor meds:
1.
2.
3.
1. enalapril
2. lisinopril
3. Ramipril
39
the liver produces a substance called ____________
angiotensinogen
40
an enzyme called ______ cleaves part of the molecule and leaves ___________
renin,
angiotensin-I
41
ACE enzyme cut off another part of the molecule and leaves us with ___________
angiotensin-II
42
Angiotensin-II causes:
1.
2.
3.
1. vascular smooth muscle to contract
2. release of aldosterone
3. harmful changes in the heart muscle
43
ACE inhibitors block the enzyme that converts _________ into its active form
angiotensin-I
44
ACE inhibitors cause _______, _______, ________
vasodilation,
production of more urine,
lower blood pressure
45
ACE inhibitors four major effects:
1. hypotension
2. hyperkalemia (aldosterone is blocked which increases potassium)
3. Persistent dry cough (#1 reason for discontinuation)
4. Angioedema (less than 1% develop, looks like wheals and edema, african descent has highest risk)
46
Angiostensin II receptor Blockers (ARBs) meds:
1.
2.
3.
1. losartan
2. Olmesartan
3. Valsartan
47
ARBs block _________ in blood vessels and adrenal glands
angiostensin-II
48
ARBs cause ________ and increases ____________ of sodium and water
vasodilation,
renal excretion
49
ARBs cause ____________ and __________
hypotension and angioedema
50
Calcium Channel Blockers (CCBs) meds
Dihydropyridines
1.
2.
Nondihydropyridines
1.
2.
1. Amlodipine
2. Nifedipine
1. Diltiazem
2. Verapamil
51
Clients must avoid __________ juice when taking CCBs
grapefruit
52
CCBS are prescribed
for ___________, _________, __________ (nondihydropyridines only)
hypertension, chest pain, (atrial fibrillation*)
53
CCBs block calcium channels in arteries causing _________ and _________ blood pressure
vasodilation, decreased
54
Nondihydropyridines CCBs cause a decreased _________
heart rate
55
CCBs HYC:
1.
2.
3.
1. Vasodilation (hypotension and swelling)
2. Bradycardia (diltiazem and verapamil)
3. Constipation (verapamil)
56
If the left side of the heart fails, blood backs up into the _______
lungs
57
Clients with right sided heart failure develop _______
edema
58
Signs of right sided heart failure:
1.
2.
3.
1. jugular vein distension
2. weight gain
3. cardiogenic shock
59
when the heart is not able to pump sufficient amounts of blood and oxygen to the brain is _________
cardiogenic shock
60
Digoxin is prescribed for __________ and __________
1. heart failure
2. cardiac dysthymia (atrial fibrillation)
61
Digoxin MOA
1.
2.
1. vagal nerve stimulation
2. sodium potassium ATPase inhibition
62
The vagus nerve releases ________ and slows the ________
acetylcholine
heart rate
63
Digoxin stimulates the vagus nerve which ______ the release of acetylcholine
increase (helps atrial fibrillation)
64
Digoxin inhibits _______ and increases calcium which causes the heart to ________ with more force
1.sodium, potassium ATPase
2. contract
(helps with heart failure)
65
Low potassium can cause digoxin _________
toxicity
66
high potassium levels decrease digoxin effects and lead to treatment ________
failure
67
Digoxin has a ________ therapeutic range
narrow
68
blood level before the next dose is in a ________
trough
69
Did you check your dig because you have to means
1. heart failure between 0.5 and 1.0
2. atrial fibrillation between 1.0 and 2.0
70
Digoxin toxicity signs :
VAND
vomiting, anorexia, nausea, diarrhea
71
As digoxin toxicity worsens, patients report blurred or ______ vision
yellow
72
Most feared outcome of digoxin toxicity is ______________
Signs: dizziness, fatigue, syncope, death
bradydysrhythmias
73
If heart rate is less than _____ or change in rhythm, withhold digoxin
60
74
Digoxin toxicity antidote is ________
digoxin immune fab (binds digoxin floating in the bloodstream)
75
_________ is a side effect of the digoxin antidote
hypokalemia
76
Adrenergic Agonists meds
1.
2.
3.
4
1. epinephrine
2. Dopamine
3. Dobutamine
4. Norepinephrine
77
_________ is the treatment for severe allergic reactions, cardiac arrest, and upper airway restriction
Epinephrine
78
Dopamine is administered to clients with extremely low __________.
Low doses help _______ blood flow to the kidneys
blood pressure
increase
79
Short term medication treatment of heart failure is _________
Dobutamine
80
____________ is a treatment for severe hypotension
Norepinephrine
81
adrenergic agonist meds activate the same adrenaline receptors as __________ meds
blood pressure
82
______________ causes vasoconstriction and pupil dilation
alpha 1 activation
83
___________ causes the heart to beat faster and stronger
beta 1 activation
84
____________ causes the airways to open up (bronchodilation)
beta 2 activation
85
At high dose, dopamine ________ blood flow
restrict
86
Adrenergic meds HYC:
1. Cardiac complication symtoms?
2. necrosis route and issues
1. tachycardia, hypertensive crisis, and heart attack
2. give meds through a central line. Cause so much vasoconstriction that fingers, toes, and nose lose blood flow and die (necrose)
