HTN
Primary vs. Secondary Hypertension
1' modifiable lifestyle cause
2' caused by disease process
Stable vs. Unstable Angina
S -familiar,exertion, stress,emotion,relief
U -new,rest,worsening,unrelieved
Ventilation vs. Oxygenation
V - high/low RR, wheezes, crackles, sputum, shallow/laboured breathing
O - low SpO2, cyanosis, drowsiness, confusion
Antihypertensives
Amlodipine: edema, grapefruit juice. Ramipril: dry cough, elevated BUN, elevated K+. Metoprolol: low energy, fainting, hyperglycemia, ED.
Client Teaching
Client demonstrates readiness to learn.
Keep daily log of BP, ensure BP machine is accurate.
Chest Pain
Sit or lay down, call for help!
Orthopneic Position
Sit up, support arms, lean forward.
Diuretics
Furosemide/Thiazide: potassium shedding, low K+. Spironolactone: potassium sparing, high K+.
Nursing Process / DMF
Assessment, priorities, plan, intervention, evaluation.
Coming to know, salience, clinical impression, healing initiative, reflection.
Orthostatic Hypotension
Change positions slowly, report felling dizzy or lightheaded.
Oxygen for Myocardial Infarction
MI = ischemia
Reduce ischemia, oxygenate myocardium.
Pink Puffers & Blue Bloaters
P - short fast breaths,polycythemia
B - pursed lip breathing,cyanosis
Bronchodilators
Salbutamol: fast acting, tachycardia, shaking. Ipatropium: anticholinergic, nebulize with air. Theophylline: narrow therapeutic index, anxiety, tachycardia, nausea, avoid caffeine.
Goal of Care
SMART goals: Specific, Measurable, Achievable, Realistic, Timed.
Beta Receptors
BP & HR
Nitroglycerin
Administer sublingual/spray q5min x3 doses
Respiratory Distress
Oxygen therapy. Monitor SpO2 & vital signs. Chest X-ray. Arterial Blood Gas (ABG) test.
Steroids
Prednisone: taper dose, hyperglycemia.
Budesonide: immunosuppression, nebulize with air.
Nursing Action Statement
Includes: action word, clear direction, frequency, duration.
Potassium
Normal range 3.5-5.0 mmol/L
Diuretics can cause: hypokalemia (Lasix/HCTZ), hyperkalemia (Aldactone/Ramipril)
Aspirin
Low dose 81mg/day, reduces platelet aggregation
Respiratory Infections
Increasing WBC = infection worsening
Decreasing WBC = infection resolving
Stool Softeners
Docusate: prevention of constipation, straining, Valsalva effect, bradycardia, vasovagal syncope.
Barriers to Discharge
Poor sleep, weakness, fatigue, cognitive impairment.