NUR211 Final Exam Study Guide Final Exam Study Guide
Vasodialator and loop diuretics- use for hyper tension, orthostatic hypotension, watch for dizziness Digoxin discharge teaching, what must a client know how to do?• Patient must know how to take their pulse (hold if less than 60 or more than 100) • Therapeutic range is 0.5-2.0 • Treat heart failure and heart rhythm problems • If you miss a dose, do not doubt dose. Skip the dose if the next dose is due in less than 12 hours.If the next dose is due in more than 12 hours, take the dose as soon as remembered.• Maintain adequate hydration *Symptoms of toxicity • Antacids delay absorption • It is best to take digoxin without food. Peak concentration is reduced if taken with food. Meals containing increased fiber or foods high in pectin may decrease absorption.• Maintain adequate potassium in diet • VBAK- Visual, bradycardia, ABD distress, potassium • Toxicity- hallow, bradycardia, GI upset.
How to monitor and interpret labs for potassium wasting diuretics. Normal potassium ranges. Nursing interventions, potassium rich foods
• Normal range: 3.5-5.0
• Causes dysrhythmias with too much or too little • Loop diuretics or thiazide also need to monitor weight and report any gain (greater than 2 lbs in 48 hours or 5 lbs in a week)- pertains to all diuretics • Only prescribe Loop diuretics if HCTZ (hydrochlorothiazide- potassium wasting diuretic) treatment fails • Thiazide diuretic- (HCTZ) only used in patient who have normal renal function • Potassium wasting mean you lose more potassium • Sweet potato, avocado, squash, spinach • Assess response to treatment and prevent adverse events: electrolyte imbalance and decline in renal function • Potassium low offer- foods like bananas, avocado, squash, and notify physician.
Actions of ACE inhibitors, think about chronotropic, inotropic etc.
• “Pril” medications- prevent angiotensin • ACE inhibitors block angiotensin to cause diuresis by blocking aldosterone production • Reduce cardiac work, helps with circulation • Vasodilator- opens blood vessels so heart doesn’t have to work hard to push blood through system • Decreases calcium level • Chronotropic effects changes the heart rate • inotropic effects can be applies to the effect of a transmitter substance or hormone on its target 1 / 2
• Chronotropic: conduction speed
• Inotropic: strength of conduction
What meds should not be given with grapefruit juice
• Statins • Calcium channel blockers- can cause toxicity and arrhythmias Calcium channel blockers- edema raises feet up.Client teaching with use of nitro and other vasodilators- should they continue to perform a task causing pain?
• Teach patient to lie or sit before taking this medication • Nitro can be take X3 with 5 minutes in between each dose but patient cannot restart strenuous activity after taking it- they need to rest • Sublingual=tingle • Dark, room temp area
How do calcium channel blockers work in the heart, the rest of the body?
• Decrease BP by opening blood vessels, relieves and prevents chest pain • Vasodilators • Relax & widen blood vessels with the heart to prevent chest pain
Nifedipine
Maintenance
Open arteries going to the heart
When to hold beta blockers- what do they impact? HR, BP
• Heartrate is below 60 • Blood pressure is less than 100 systolic • Change positions slowly
Minipress (Prozasin) teaching- alpha blocker/ treats high blood pressure& urinary retention
• Don’t stop take drug • May cause dizziness or fainting • Avoid driving • Avoid becoming overheated or standing for long periods of time • Avoid getting up too fast • Can affect eyes fi getting cataract surgery • Lowers BP will need to be checked often • Store at room temperature • Propranolol, BP meds, diuretics interact with minipress
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