Hypertension
What medications fall in the calcium channel blocker class? What side effects should we monitor for?
Medications include amlodipine and diltiazem; side effects include hypotension, headache, dizziness, and edema; caution should be used in patients who have heart failure
what is an expected side effect you should educate patients on when taking a SABA?
tachycardia, palpitations, and feeling jittery- these are expected side effects that occur due to the mechanism of action of the drug, and are not concerning.
How do loop diuretics work and what are the primary side effects to monitor for?
Loop diuretics like Furosemide (Lasix), work by causing the excretion of fluid and electrolytes through the urine; side effects include electrolyte imbalances, dehydration, and hypotension
What is the mechanism of action of carbidopa-levodopa? What side effects do we monitor for?
It increases the amount of dopamine in the bloodstream to reduce symptoms of Parkinson's disease; side effects include orthostatic hypotension, nausea, vomiting, and dyskinesias (movement disorders)
What are important patient teaching points for oral iron supplementation?
Should be taken on an empty stomach if tolerated; better absorbed if taken with vitamin C; should not be taken with calcium; can cause nausea and constipation- the patient may need to take stool softeners
What medications are in the ACE inhibitor class? What side effects should we monitor for?
Lisinopril (end in -pril); we should monitor for ACE cough- not dangerous but can be annoying for patients; should also monitor for angioedema- swelling of tongue of mouth- this is an emergency; other side effects include hypotension and hyperkalemia
Steroids help reduce the inflammation in the airway; inhaled steroids can lead to oral thrush, so patients should be educated to rinse their mouth out after use; oral steroids can lead to hyperglycemia, electrolyte imbalances, weight gain, and increased infection risk
What are the nursing priorities for a patient taking a diuretic?
Obtain daily weight first thing in the morning, strict intake and output, monitor vital signs for hypotension, monitor electrolytes for abnormalities
What blood tests would you anticipate being ordered for a patient taking phenytoin for seizures?
Serum levels of the medication, to ensure that the patient is not above the therapeutic range
What patient education would you include for a patient who is taking an anticoagulant medication?
They should monitor for bleeding risk, use soft-bristled toothbrush, use an electric razor, not take NSAIDs or aspirin unless approved by their doctor
What medications are in the ARB class? What side effects should we monitor for?
Losartan (medications ending in -artan). Side effects include hypotension, dizziness, hyperkalemia
what is the mechanism of action of anticholinergics (muscarinic antagonists) like ipratropium in COPD?
they work to inhibit the action of acetylcholine, which causes bronchodilation and reduces secretions, improving the excess mucus production that occurs with COPD
How do thiazide diuretics work and what side effects should we monitor for?
Thiazide diuretics like hydrochlorathiazide work by causing the excretion of electrolytes and water through the urine to reduce fluid and edema; side effects include electrolyte imbalances and dehydration
What patients should not be prescribed triptans and why?
Patients with hypertension, angina, MI, CAD history; triptans cause vasoconstriction which can worsen these pre-existing conditions
What type of treatment would you anticipate for a patient with pernicious anemia?
Pernicious anemia is a type of vitamin B12 deficiency anemia that occurs due to a lack of intrinsic factor (protein in the stomach that helps with vitamin B12 absorption). Patients with pernicious anemia require supplementation with IM vitamin B12 since the oral form will not be absorbed
Why are diuretics used for hypertension treatment?
Because they increase the absorption of water and electrolytes through the urine, they reduce the fluid volume in the body, which therefore reduces the blood pressure since there is less blood to pump
which medication class would you expect a patient to use when having an acute asthma or COPD exacerbation?
short acting beta agonists like albuterol; these are used for acute exacerbations and work quickly to relax the smooth muscles in the airway to improve breathing
What is different about potassium sparing diuretics when compared to other types of diuretics?
Why should patients taken carbidopa-levodopa make sure to take this medication at exact specified times?
Because otherwise the medication may wear off, causing their symptoms of Parkinson's disease to worsen
What types of medications would you anticipate being administered to a patient hospitalized with sickle cell crisis?
Pain medications- IV narcotics as well as NSAIDs, will typically be on a PCA pump due to high dosages of medications required to adequately treat their pain.
What medications are in the beta blocker class? What should we monitor for?
Metoprolol (end in -olol). Side effects include hypotension, bradycardia, dizziness, fatigue; patients should have their blood pressure and heart rate checked prior to administration
SABA is used as a rescue medication for an acute exacerbation; LABA are used as a daily control medication and should be taken whether or not the patient has any respiratory symptoms
Why are diuretics used in heart failure?
They help reduce the symptoms of fluid overload by increasing the excretion of water and electrolytes; by doing so they reduce the workload of the heart and make it easier to pump efficiently
What are three major side effects to be aware of for patients taking valproic acid for seizures?
How does warfarin differ from the Factor Xa inhibitors?
Warfarin requires monitoring of INR levels to determine if the medication is therapeutic; the factor Xa inhibitors such as apixaban, do not require any routine monitoring. Warfarin is also affecting by oral intake of foods with vitamin K