Diuretics
What are the primary classifications of diuretics and an example of each?
Loop Diuretics: Furosemide & Bumetanide
Thiazide diuretics: Hydrochlorothiazide
Potassium sparing-Diuretics: Spironolactone & Eplerenone
Osmotic Diuretics: Mannitol & Glycerin
Name 2 types of Organic Nitrates?
- Nitroglycerin
- Isosorbide Mononitrate
- Isosorbide Dinitrate
What are some common side effects of Ace inhibitors?
Cough
Hypotension
Hyperkalemia
What are Beta Blockers used for? And How is it administered ?
Use: Angina (MI prevention), Hypertension, Heart Failure, Dysrhythmias and Glaucoma
Routes: PO, IV push or infusion, eye drops
- Regular or Sustained
Release
How does a calcium channel blocker work in the body?
decrease calcium in smooth muscle, decrease in the force of myocardial contraction = decrease cardiac workload
What are three nursing considerations for diuretics?
- Assess BP prior to administration
- Administer in am
- Monitor weight, I & O
- Monitor electrolytes
- Administer IV doses slowly (over 1-2 minutes)
- Monitor blood glucose levels
What do you want to teach a patient on Organic Nitrates?
- Avoid Alcohol
- Change positions gradually (severe hypotension)
-Headache will diminish with time
What are nursing considerations for a patient on an Ace Inhibitors?
- Monitor BP carefully, especially at first dose
Monitor potassium levels
- If pregnant, ACE inhibitors MUST stop
- Monitor for angioedema s/sx
What are 3 signs & symptoms of a Beta Blocker?
- Bradycardia
- Fatigue
- Impotence/Decreased
libido
- Depression
- Nightmares
What food do you want a person on calcium Channel blocker to avoid? And why?
*Teach pt to avoid grapefruit products of any kind !
Will increase risk of drug toxicity
What would you teach a patient that are on diuretics?
- Take early in the day
-Eat Foods high in potassium (oranges, bananas, spinach)
- potassium supplement
- Signs of abnormal electrolytes
- Monitor weight
- labs checked regularly
- Do not use salt substitutes if on potassium-sparing diuretics
What are the Nursing Considerations of Organic Nitrates ?
- Assess BP prior to administration (Hold if SBP is greater than 100)
- pt. sit/ lie down (1st
time)
- gloves for paste
- Assess skin and rotate sites for paste/ patch
- Apply to hairless area
What is Angioedema & how do you treat it?
A non-inflammatory swelling of skin, mucous membrane, and other organs (Does my voice sound funny)
This a life threatening. Should be treated with epinephrine (SQ)
What do you want to teach patients on Beta Blockers?
- Self pulse monitor
- Report worsening shortness of breath/ cough, depression, fatigue
- Do NOT abruptly stop or double dose
- Teach diabetic pts to rely on other signs of hypoglycemia rather than tachycardia
What type of patients must be monitored while on calcium channel blocker? And what would you assess?
*pts. w/ history of heart failure must be closely monitored.* (Assess: lungs, symptoms of SOB, weight)
Which Diuretics can cause ototoxicity if given rapid IV push?
Loop Diuretics
What are at least 3 signs & symptoms of Organic Nitrates?
-Headache
- Orthostatic Hypotension
- Flushing
- Dizziness
- Reflex Tachycardia
What are ace inhibitors good for? And how are they administered ?
- Use: hypertension, MI, and heart failure, diabetics (to prevent nephropathy)
- Route: PO
True or False? You need to taper a person off of a beta blocker medication
True
What are Calcium channel blockers used for? And how are they administered ?
Use: angina (both stable and variant) hypertension and dysrhythmias
(MC) routes: PO and IV push or infusion
May be regular or sustained release
What is the action of a Diuretics?
- Block the reabsorption of sodium, chloride and water.
As a result, there is a decrease in fluid volume and increase in urine flow (decrease in BP)
What are the actions of an Organic Nitrates?
Acts directly on vascular smooth muscle to promote vasodilation
In therapeutic doses, mostly venous dilation w/ some arteriole dilation
- Dilation of coronary arteries causes increase in O2 supply & increase O2 to collateral vessels
Name 3 types of Ace inhibitors?
Lisinopril
Benazepril
Captopril
Quinpril
Enalapril
A non-selective Beta Blockers Should NOT be used in patients that have? and Why?
Asthma because of Bronchoconstriction
- Hypotension
- Peripheral Edema
- Dizziness
- Bradycardia (especially if on other cardiac meds)
- Constipation (big problem for elderly)
- Gingival hyperplasia