Anticoagulants
The nurse is caring for a postoperative patient. The nurse will anticipate administering which medication to this patient to help prevent thrombus formation caused by slow venous blood flow?
A.Alteplase (Activase)
B.Aspirin
C.Clopidogrel (Plavix)
D.Low molecular-weight heparin
D.Low molecular-weight heparin
Medication class of Lisinopril?
ACE (angiotensin-converting enzyme) Inhibitor that blocks the conversion of angiotensin 1 into angiotensin 2 to lower blood pressure.
How does this class of meds work, and what for?
Increases the force of the heart's contractions to improve functioning for patients with heart failure and AFIB.
What are Antilipemic Medications?
Medications to treat high cholesterol levels and prevent coronary events.
What do Thiazide and Loop diuretics do, and for what?
Increase urine output to reduce edema and/or hypertension.
Action?
Prevent clot formation by stopping them from forming
The nurse is preparing to administer an angiotensin-converting enzyme (ACE) inhibitor to a patient who has hypertension. The nurse notes peripheral edema and swelling of the patient's lips. The patient has a blood pressure of 160/80 mm Hg and a heart rate of 76 beats per minute. What is the nurse's next action?
A.Administer the dose and observe carefully for hypotension.
B.Hold the dose and notify the provider of a hypersensitivity reaction.
C.Notify the provider and request an order for a diuretic medication.
D.Request an order for serum electrolytes and renal function tests.
B.Hold the dose and notify the provider of a hypersensitivity reaction.
**Angioedema
A high-yield medication we discussed?
Digoxin
A patient has been taking lovastatin for several months to treat hyperlipidemia. The patient reports muscle weakness and tenderness. The nurse will take which action?
A.Ask the provider about switching to simvastatin.
B.Contact the provider to report these symptoms.
C.Give PRN ibuprofen to combat these effects.
D.Tell the patient their symptoms with subside once the medication is stopped.
B.Contact the provider to report these symptoms.
**Myopathy can lead to rhabdomyolysis medical emergency.
The most common side/adverse effects of Thiazide and Loop Diuretics?
Hypokalemia, Hyponatremia, Hypovolemia, Ototoxicity.
Lab Work?
Partial thromboplastin time (PTT) and Activated partial thromboplastin time (aPTT)
Treatment option for severe angioedema?
Epinephrine
The nurse is preparing to administer digoxin to a patient who has heart failure. The patient reports nausea, vomiting, and a headache. The nurse notes a respiratory rate of 18 breaths per minute, a heart rate of 58 beats per minute, and a blood pressure of 120/78 mm Hg. What will the nurse do next?
A.Administer the next dose as ordered since these are mild side effects.
B.Hold the dose and notify the provider of possible digoxin toxicity.
C.Reassure the patient that these are common, self-limiting side effects.
D.Request an order for an antiemetic and an analgesic medication.
B.Hold the dose and notify the provider of possible digoxin toxicity.
**Nausea, vomiting, and headache are common signs of digoxin toxicity, as is a heart rate of less than 60 beats per minute and yellow/green/white halos with double or blurred vision.
Dietary education that must be provided with statins?
Avoid grapefruit juice.
Foods high in potassium?
Bananas, dried fruits, nuts, oranges, leafy greens, legumes, potatoes, sweet potatoes, tomatoes, fish, etc.
A patient has been receiving intravenous heparin. When laboratory tests are drawn, the nurse has difficulty stopping bleeding at the puncture site. The patient has bloody stools and is reporting abdominal pain. The nurse notes elevated partial thromboplastin time (PTT) and activated partial thromboplastin time (aPTT). Which action will the nurse perform?
A.Ask for an order for oral warfarin (Coumadin).
B.Obtain an order for protamine sulfate.
C.Request an order for vitamin K.
D.Obtain an order to switch to subcutaneous heparin.
B.Obtain an order for protamine sulfate. This is the ANTIDOTE!
A unique side effect of Lisinopril (and other ACE Inhibitors)?
Persistent, non-productive cough. May switch to an ARB medication.
Baselines to monitor?
Digoxin level, Potassium levels, Heartrate
A nurse is caring for a client who has chronic renal disease and is receiving therapy with epoetin alfa. Which of the following laboratory results should the nurse review for an indication of a therapeutic effect of the medication?
A.The leukocyte count
B.The platelet count
C.The hematocrit (Hct) level
D.The erythrocyte sedimentation (ESR) rate
C.The hematocrit (Hct) level
**For RBC production and increased RBC, HGB, HCT levels
Describe one primary clinical use for mannitol.
Reducing intracranial or intraocular pressure by inducing osmotic diuresis.
A nurse is teaching a client who has angina with severe hypertension about nitroglycerin sublingual tablets. Which of the following statements should the nurse include in the teaching?
A."Place one tablet under your tongue every 5 minutes for 30 minutes to relieve chest pain.”
B."Nitroglycerin decreases chest pain by dissolving blood clots that are occluding the arteries.”
C."You can store the bottle of tablets in your bathroom medicine cabinet.”
D."Nitroglycerin dilates cardiac blood vessels to deliver more oxygen to the heart."
D."Nitroglycerin dilates cardiac blood vessels to deliver more oxygen to the heart."
A nurse is assessing a client who is receiving a continuous IV infusion of dopamine. Which of the following findings should the nurse recognize as a therapeutic effect?
A.Increased pulse
B.Increased urine output
C.Decreased blood pressure
D.Decreased dysrhythmias
B.Increased urine output
**Increased renal perfusion for the treatment of shock and heart failure