Keep the Beat!
A client is anxious before cardiac surgery and has a blood pressure of 168/94 mm Hg with a heart rate of 108 bpm. The provider orders Inderal (propranolol) IV to help control heart rate and blood pressure. Explain how this medication works to lower blood pressure and heart rate.
Propranolol (Inderal) blocks beta-adrenergic receptors in the heart, reducing the effects of epinephrine and norepinephrine. This slows the heart rate, decreases contractility, and lowers blood pressure by reducing cardiac workload.
A client being treated for a urinary tract infection develops new-onset ankle pain, and the nurse suspects a possible adverse effect of this drug. This fluoroquinolone antibiotic is used for urinary and respiratory infections, but can cause tendon rupture and photosensitivity.
Ciprofloxacin (Cipro)
This stool softener helps prevent straining without stimulating the bowel.
Docusate sodium (Colace)
One of these medications is used as an emergency treatment to stabilize cardiac membranes in severe hyperkalemia or hypocalcemia, while the other works by lowering serum calcium levels and inhibiting bone resorption. What are these two medications, and how do their indications and mechanisms differ?
An older adult with heart failure has fatigue, shortness of breath, and an irregular apical pulse. The nurse prepares to administer Lanoxin (digoxin). Explain how this medication works to improve cardiac output and slow the heart rate.
Digoxin increases the force of myocardial contraction (positive inotrope) and slows electrical conduction through the AV node, allowing more efficient filling and improved cardiac output. It also lowers heart rate by increasing vagal tone.
This sulfa drug is used to treat urinary and respiratory infections and should be taken with plenty of water.
Trimethoprim-sulfamethoxazole (Bactrim)
This antiemetic blocks serotonin receptors to prevent nausea and vomiting.
Ondansetron (Zofran)
What education should the nurse provide to a patient receiving insulin?
Verify insulin type, dose, route, and timing before administration to prevent medication errors
Use the correct syringe or pen designed for insulin (units)
Clear insulin should be clear and colorless
Cloudy insulin should be gently rolled, not shaken
Administer rapid‑ or short‑acting insulin in relation to meals as prescribed to avoid hypoglycemia
A client with heart failure is prescribed Aldactone (spironolactone) along with furosemide (Lasix). Describe the differences in how Aldactone and furosemide work, including their effects on potassium levels.
Furosemide (Lasix) is a loop diuretic that works in the loop of Henle to block sodium and water reabsorption. Causes potassium loss (hypokalemia risk). Provides rapid and strong diuresis to reduce fluid overload in heart failure.
Aldactone (spironolactone) is a potassium-sparing diuretic that works in the distal tubule by blocking aldosterone. Retains potassium and promotes mild fluid loss. Helps counteract potassium loss caused by furosemide while still reducing fluid volume.
What key patient education points should the nurse include to ensure safe and effective use of Acetaminophen (Tylenol).
What education points should the nurse provide to promote safe and effective use of Pantoprazole (Protonix)?
This form of a cardiac medication is placed under the tongue, may be repeated every 5 minutes for up to three doses.
Nitroglycerin
One of these medications prevents platelet aggregation and is commonly prescribed after stent placement or for stroke prevention, while the other is a low‑molecular‑weight heparin used for DVT/PE prevention and treatment.
What are the clinical indications for epinephrine use?
This osmotic laxative helps reduce ammonia levels in hepatic encephalopathy.
Lactulose (Chronulac)
This medication works by promoting the synthesis of clotting factors in the liver, helping blood clot more effectively and reversing the effects of certain anticoagulants.
vitamin K
This medication is given as a rapid IV push followed by a saline flush, may cause a brief feeling of chest tightness or a sense of impending doom, and is used to treat a stable narrow‑complex supraventricular tachycardia (SVT).
Adenosine
One of these diuretics blocks aldosterone and spares potassium, while the other increases sodium and water excretion but may cause potassium loss. What are these two medications, and how do their electrolyte effects differ?
This resin exchanges sodium for potassium to treat hyperkalemia.
Sodium polystyrene sulfonate (Kayexalate)
This medication is commonly prescribed to reduce inflammation and suppress the immune response in conditions such as asthma exacerbations, allergic reactions, autoimmune disorders, and inflammatory conditions.
Deltasone (prednisone)