Diuretics
Which diuretic(s) cause hypokalemia and what should the patient be taught?
Furosemide and Hydrochlorothiazide
Teach the patient to eat a diet with a lot of K+
What is an adverse affect caused by ACE-I that may result in a patient needing to be switched to an ARB?
Cough
Which parts of cardiac output do vasodilators affect?
Decrease preload and decrease afterload
What should the nurse assess before giving Digoxin?
Apical pulse, monitor for signs of dysrhythmias, and ensure the patient has a dietary intake of high-potassium foods.
What are the therapeutic uses of anticoagulants antiplatelets, and thrombolytics?
Antiplatelets: used for clot prophylaxis, prevent platelets from clumping together
Anticoagulants: prevent new clots and growth of existing clots, block fibrin (used to form a clot)
Thrombolytics: clot busters, dissolve clots, used for an ischemic stroke
What drug is a contraindication with diuretics due to its reliance on K+?
Digoxin
What action do ARBs have on cardiac output? What drug has a similar action?
Afterload, so do ACE-Is
Which medication can be given with a vasodilator to prevent reflex tachycardia? Which adverse effect is normal, and will go away with time?
beta blocker
flushing and headache - teach it is normal, and to not stop meds
What lab values should be assessed before administering amiodarone?
Liver (AST/ALT) & Thyroid (T3, T4, TSH)
Which drug is monitored using PTT and which drug is monitored using PT/INR?
PTT (46-70): Heparin
PT/INR (2-3): Warfarin
What outcomes should be assessed to know if the diuretics are working?
Decreased weight, decreased BP, decreased edema, improved breathing
What are the names of the 3 calcium channel blockers?
diltiazem, verapamil, nifedipine
A patient requires nitroprusside in the hospital during an emergency situation, which lab should be drawn and how should BP be monitored?
Continuous BP monitoring with arterial (ART) line
Why is Finasteride contraindicated in pregnant women, and what precautions should be taken if they need to handle the medication?
Finasteride is contraindicated in pregnant women because it can be harmful to the developing male fetus. Pregnant women should avoid handling broken or crushed tablets to prevent any potential exposure to the medication.
Why are patients on both heparin and warfarin at the same time?
Heparin works faster than warfarin. Give together so heparin can take effect until the Warfarin becomes therapeutic and starts to take effect.
If a patient is on a potassium wasting diuretic and they need K+ replacement, what are nursing considerations with this?
Never give K+ IV push, give it slowly over 1 hour
Which CCB(s) help with atrial fib and atrial flutter?
Diltiazem or verapamil
What are uses for beta blockers? What other drug do they have the same end result as?
HTN, angina, HF, MI, dysrhythmias
Same end result as CCB
What can happen with long-term use of Procainamide?
Long-term use of Procainamide can lead to lupus or blood dyscrasias.
What are some nursing considerations for opioid use?
Vital signs, teaching caution if medication has acetaminophen in it, constipation (fluids, fiber, walking, and stool softeners), dizziness, taking the prescribed dose at the prescribed time, and pain assessment.
What are symptoms of hypokalemia vs hyperkalemia?
hypo: muscle weakness, cramping, leg discomfort, heart rhythm changes
hyper: more deadly than hypo, heart rhythm changes, severe cardiac events
What electrolyte level should be considered with ACE-I and ARBs, and is this level high or low? What is something we teach these patients not to eat?
Potassium levels, they are high
Can cause hyperkalemia, so we teach the patients to not use salt substitutes (high in K+)
Nitroglycerin teaching: sublingual for acute angina attack vs patch teaching for long term use (think: minimize tolerance)
Sublingual: give 1x, wait 5 minutes, if does not resolve, call 911 and take second dose
Patch: to avoid tolerance, put a patch on only during the day and take off at night to avoid tolerance build up - must be off for at least 8 hours daily
Which drug can cause rhabdomyolysis and what lab value do you monitor for muscle injury?
statins can cause rhabdomyolysis (atorvastatin, simvastatin) & monitor Creatinine Kinase (CK) because it indicates muscle breakdown
A patient is experiencing abdominal cramps, hot flashes, sweating, muscle spasms, runny eyes, and irritability. What medication should the nurse give?
Naloxone (opioid antagonist) because those were symptoms of withdrawal.