PN - Nursing Care of Patient with Hypertension Wk 4

Calculate Drips

100

Order: 1,000 mL of Normal Saline (NS) to infuse over 8 hours. Tubing: Macrodrip tubing with a drop factor of 15 gtts/mL. Calculate the drip factor in gtt/min and round to the nearest whole number.

What is 31 gtts/min?

Calculation: 

1. Convert hours to minutes:
   • 8 hours × 60 minutes/hour = 480 minutes
2. Plug the values into the formula:
   

   Drip Rate=1000 mL/480 min×15 gtts/mL

3. Solve the equation:
   

   Drip Rate = 2.0833 × 15gtts/mL

   Drip Rate≈31.25 gtts/min = 31 gtts/mL
   
   
   
   

200

Order: 1,000 mL of 0.9% Sodium Chloride (Normal Saline) to be infused over 10 hours. Tubing: IV administration set with a drop factor of 15 gtts/mL. Calculate the drip factor in gtt/mL and round to the nearest whole number.

What is 25 gtts/min?

Calculation: 

1. Convert hours to minutes:
   • 10 hours × 60 minutes/hour = 600 minutes
2. Plug the values into the formula:
   

   Drip Rate=1000 mL/600 min×15 gtts/mL

3. Solve the equation:
   

   Drip Rate = 1.666 × 15 gtts/mL

   Drip Rate = 25 gtts/mL

300

Order: 250 mL dose of a medication to be infused over 2 hours. Tubing: IV secondary line with a drop factor of 15 gtts/mL. Calculate the drip factor in gtt/mL and round to the nearest whole number.

What is 31 gtts/min?

Calculation: 

1. Convert hours to minutes:
   • 2 hours × 60 minutes/hour = 120 minutes
2. Plug the values into the formula:
   

   Drip Rate=250 mL/120 min×15 gtts/mL

3. Solve the equation:
   

   Drip Rate = 2.0833 × 15 gtts/mL

   Drip Rate = 31.25 gtts/mL = 31 gtts/mL

400

Order: 500 mL of 0.9% Sodium Chloride (Normal Saline) to infuse over 6 hours. Tubing: IV tubing has a drop factor of 20 gtts/mL. Calculate the drip factor in gtt/mL, round to the nearest whole number.

What is 28 gtts/min?

Calculation: 

1. Convert hours to minutes:
   • 6 hours × 60 minutes/hour = 360 minutes
2. Plug the values into the formula:
   

   Drip Rate=500 mL/360 min×20 gtts/mL

3. Solve the equation:
   

   Drip Rate = 1.388 × 20 gtts/mL

   Drip Rate = 27.77 gtts/mL = 28 gtts/mL

500

Order: 250 mL of Vancomycin to be administered over 2 hours. Tubing: IV administration set with a drop factor of 30 gtts/mL. Calculate the drip factor in gtt/mL, round to the nearest whole number.

What is 63 gtts/min?

Calculation: 

1. Convert hours to minutes:
   • 2 hours × 60 minutes/hour = 120 minutes
2. Plug the values into the formula:
   

   Drip Rate=250 mL/120 min×30 gtts/mL

3. Solve the equation:
   

   Drip Rate = 2.083 × 30 gtts/mL

   Drip Rate = 62.5 gtts/mL = 63 gtts/mL

Calculate PO

100

A physician orders metoprolol tartrate 25 mg by mouth (PO) daily. The pharmacy dispenses 50 mg tablets. Calculate the number of tablets to administer. 

What is 0.5 mg tablet?

1. Identify the variables:
   • Desired Dose (D): 25 mg
   • Dose on Hand (H): 50 mg
   • Quantity (Q): 1 tablet
2. Set up the equation:
   (25 mg/50 mg)×1 tablet = X
3. Solve for X:
   

   0.5×1 tablet = 0.5 tablets 

   
   

200

A patient is ordered lisinopril 5 mg PO daily. The medication is available in a bottle of liquid oral solution with a concentration of 2.5 mg/5 mL. Calculate the amount in mLs to administer.

What is 10 mLs?

• Identify the variables:
  • Desired Dose (D): 5 mg
  • Dose on Hand (H): 2.5 mg
  • Quantity (Q): 5 mL
• Set up the equation:
  (5 mg/2.5 mg)×5 mL =  X mL
• Solve for X: 
  2×5 mL=10 mL

300

A physician orders fenofibrate 134 mg by mouth (PO) daily. The pharmacy dispenses 67 mg tablets. Calculate the number of tablets to administer.

What is two (2) tablets?

Calculation: 

1. Identify variables:
   • Desired Dose (D): 134 mg
   • Dose on Hand (H): 67 mg
   • Quantity (Q): 1 tablet
2. Plug into the formula:
   

   Tablets to Administer = 134 mg/67 mg × 1 tablet

3. Solve:
   

   Tablets to Administer = 2 tablets 

400

A patient is ordered clonidine 0.1 mg PO twice daily. The medication is available in a bottle of liquid oral solution with a concentration of 0.2 mg/10 mL. Calculate the amount in mLs you will administer.

What is 5 mL?

Calculation: 

1. Identify variables:
   • Desired Dose (D): 0.1 mg
   • Dose on Hand (H): 0.2 mg
   • Quantity (Q): 10 mL
2. Plug into the formula:
   

   mL to Administer =0.1 mg/0.2 mg × 10 mL 

3. Solve:
   

   mL to Administer = 0.5×10 mL = 5 mL

500

A patient is ordered ezetimibe (Zeita) 5 mg PO daily. The medication is available in a bottle of liquid oral solution with a concentration of 10 mg/5 mL. Calculate the amount in mLs you will administer.

What is 2.5 mL?

Calculation: 

1. Identify variables:
   • Desired Dose (D): 5 mg
   • Dose on Hand (H): 10 mg
   • Quantity (Q): 5 mL
2. Plug into the formula:
   

   mL to Administer = 5 mg/10 mg×5 mL

3. Solve:
   

   mL to Administer = 0.5×5 mL = 2.5 mL

HTN Patho

100

This is the measure of pressure exerted by blood on the walls of the blood vessels.

What is blood pressure?

200

This determines blood pressure.

What is cardiac output?

300

This is the amount of blood that the heart pumps each minute.

What is cardiac output?

400

This refers to the ability of blood vessels to stretch.

What is peripheral vascular resistance?

500

This also means the thickness of the blood.

What is viscosity?

Lipid Control

100

Name this condition that is considered to be a major contributor to the development of heart disease.

What is atherosclerosis?

200

Name the two lipids in our bloodstream.

What are cholesterol and triglycerides?

300

Name this condition when serum cholesterol levels are above 240 mg/dL and triglyceride levels are above 150 mg/dL.

What is hyperlipidemia?

400

Name this is the organ in the body that metabolizes and execretes high-density lipoproteins.

What is the liver?

500

Name this serum level that elevates with diets saturated in fat and cholesterol.

What are low-density lipoproteins (LDLs)?

Care for Me

100

List the nursing diagnosis related to the complexity of treatment, costs, and side effects of medications, lack of symptoms, and need to alter long-term lifestyle habits.

What is ineffective health self-management?

200

Name this nursing diagnosis that requires the patient to verbalize understanding of their hypertension and treatment regimen.

What is readiness for enhanced health literacy?

300

List three of the seven home health medication hints to help with patient teaching.

What are: 1. medication compliance (count pills), 2. note medication refills on calendar, 3. communicate with HCP/pharmacist if meds too expensive for pt, 4. reinforce BP teaching (monitoring/recording), 5. reinforce HR teaching, 6. reinforce medications even when pt has no symptoms and report side effects, 7. reinforce pt who is travel to refill meds ahead of time?

400

Name the appropriate nursing diagnosis for a patient with the following blood pressure readings: 90/59, 88/56, and 86/55.

What is risk for unstable blood pressure?

500

Name the acronym that teaches an effective way to lower BP, and what each letter represents.

What is lifestyle?

L - limit salt, caffeine, and alcohol

I - include daily potassium and calcium

F - Fight fat and cholesterol

E - exercise regularly

S - stay on your BP regimen

T - try to quit smoking

Y - your medications are to be taken daily

L - lose weight

E - end-stage complications will be avoided!

The Pressure & The Plaque

100

According to Ford and Roach, this category of drugs, including atorvastatin, is the first-line treatment for hyperlipidemia and is best administered at bedtime because cholesterol is primarily synthesized during the night.

What are HMG-CoA Reductase Inhibitors (or Statins)?

200

This class of antihypertensives is known for causing a persistent dry cough. If this occurs, the nurse should expect the provider to switch the patient to an ARB.

What are ACE Inhibitors (Angiotensin-Converting Enzyme Inhibitors)?

300

Patients taking Niacin (Vitamin B3) for high cholesterol often experience intense skin flushing. Ford and Roach suggest teaching the patient to take this common over-the-counter medication 30 minutes before reduce this effect.

What is Aspirin (or NSAIDs)?

400

Before administering this "cardioprotective" antihypertensive class (suffix -lol), the nurse must assess the patient’s apical pulse; the drug should be withheld if the heart rate is below 60 bpm.

What are Beta-Adrenergic Blocking Agents (Beta Blockers)?

500

Ford and Roach highlight that these specific drugs, such as cholestyramine, can lead to a deficiency in fat-soluble vitamins (A, D, E, and K), requiring the nurse to monitor for signs of easy bruising or bleeding.

What are Bile Acid Resins (or Sequestrants)?