Drug Classes
This class of drug is used for cardiac issues and sometimes neuro issues. It is a beta-receptor antagonist. Some common side effects are bradycardia, hypotension, fatigue, and insomnia.
End in -olol.
Beta Blockers
Patho: chronic inflammatory lung disease, often caused by smoking or other inhaled irritants
Sx/Sx: difficulty breathing, SOB, excess mucus production, wheezing
Tx: inhaled bronchodilator and corticosteroids
Chronic Obstructive Pulmonary Disease (COPD)
2 types: emphysema (destruction of alveolar walls) and chronic bronchitis (inflammation and narrowing of bronchial tubes)
Magnetic Resonance Imaging (MRI)
Ms. Martha is admitted to the hospital for a heart failure exacerbation. During your shift, Ms. Martha expresses to you that she is not dealing with her declining health very well and asks for you to sit with her for a little bit and consult Spiritual Care. What would be a proper nursing diagnosis for Ms. Martha?
Ineffective coping related to declining health as evidenced by tearfulness and need to spiritual support.
Potassium
3.5-5.2 mmol/L
This class of drug is used to lower blood pressure. They can also help with arrhythmias, such as atrial fibrillation. They block calcium from entering the bloodstream, allowing the heart and blood vessels to relax.
Common ending is -dipine
Calcium Channel Blockers
Patho: short period of symptoms similar to a stroke; also called a 'mini-stroke'
Sx/Sx: unilateral numbness (face, arm, leg); slurred speech or difficulty speaking; loss of vision or blurred vision; dizziness or loss or balance/coordination
Tx: imaging, antiplatelets, anticoags, Statins
Transient Ischemic Attack (TIA)
Computed Tomography (CT) Scan
Billie Ruben is admitted to end stage liver disease secondary to alcoholic liver cirrhosis. Billie has been so ill she has not been able to get out of bed for months. Upon assessment, you find a stage 4 pressure injury to Billie's coccyx. What is your nursing diagnosis?
Impaired skin integrity related to impaired mobility as evidenced by stage 4 coccyx injury.
Sodium
135-145 mEq/L
This class of drug is often referred to as a 'water pill'. It help excrete excess fluid from the body for patients in heart or liver failure. Common side effects are acute kidney injury, frequent urination, hyponatremia, and hyperkalemia.
Often end in -mide
Loop Diuretics
Patho: damage to the kidneys; kidneys no longer filter out toxins and waste like they should; 5 stages
Sx/Sx: N/V, loss of appetite, urinating less, mental decline, peripheral edema, HTN, muscle cramps
Tx: ACE-inhibitors, ARBs, diuretics, hemodialysis, peritoneal dialysis
Chronic Kidney Disease (CKD)
This scan is an ultrasound image of the heart to look at the function and size of the heart muscle and heart valves. It can be used to diagnosis heart failure and valvular issues.
Echocardiogram (Echo)
Bart is a 54 y.o. male with heart failure. After a right heart cath (RHC), Bart is admitted to the ICU with fluid volume overload and an elevated cardiac index. Bart's echocardiogram reveals an EF of only 15%. Bart's lower extremities are cool and dry. What is a proper nursing diagnosis for Bart?
Impaired tissue perfusion related to decreased cardiac output as evidenced by advanced heart failure with EF of 15%.
Troponin
This class of drug is used to treat high blood pressure. It works by dilating blood vessels by blocking angiotensin 2 in the kidneys. This is safe for use in patients with chronic kidney disease and heart failure. Common side effects are dizziness, hypotension, and edema.
Often end in -sartan
Angiotensin II Receptor Blockers
Patho: autoimmune disease where the immune system attacks the platelets
Sx/Sx: easy bruising, petechiae, purpura, bleeding mucus membranes, hematochezia/melena, hematemesis, heavy menstrual flow
Tx: steroids, immunoglobulins, monoclonal antibodies, drugs that increase Plt counts
Immune Thrombocytopenic Purpura (ITP)
This test is used to look at the structure of blood vessels. This test uses contrast dye to highlight the blood vessels and show if there are any blockages. This test is commonly performed on the heart (coronary) or legs (peripheral).
Angiography
Tonya is a 36 y/o female in to deliver her 4th child. All scans have been normal and no complications with prior deliveries. Tonya had an uncomplicated labor. However, after delivery Tonya experiences a postpartum hemorrhage. What is an appropriate nursing diagnosis for Tonya?
Fluid volume deficit related to bleeding after birth as evidenced by changes in mental status and hypotension.
D. dimer
<0.5 mg/L
This class of drug is used in severe heart failure. These medications either increase or decrease cardiac contractility (can be either positive or negative). Can help relieve HTN, chest pain, SOB. Side effects can be arrhythmias, hypotension or hypertension, headache, nervousness, and blurry vision.
No common ending.
Hint: they are use a LOT in the ICU's
Inotropes
Patho: progressive nervous system disorder; disease causes muscle neurons to gradually atrophy; about 10% of cases have genetic link
Sx/Sx: weakness, trouble walking, tripping/falling, slurred speech/trouble swallowing, muscle cramps/twitching, dementia, breathing problems
Tx: Meds- edaravone, riluzole, Sodium phenylbutyrate-taurursodiol
Supportive cares- physical/occupational/speech therapies, nutritional support, breathing cares (tracheostomy)
Amyotrophic Lateral Sclerosis (ALS)
Also called Lou Gehrig's Disease
This test uses a pharmacological agent to increase the heart's workload in order to evaluate if there are any narrowed/blocked arteries or if the patient has any cardiac damage from a heart attack. Often times, this test is done before a cardiac angiogram to see where the blockages are.
Myocardial Perfusion PET stress test (MPI PET or chemical stress test)
Tucker is in a motor vehicle accident (MVA) and is an unrestrained driver. Tucker hits his head on the airbag and has LOC. Upon arrival to the ED, Tucker is repeating himself and unaware of where he is and what happened. After a few days, Tucker is diagnosed with a TBI from the MVA. Tucker is still experiencing some amnesia and is occasionally combative/impulsive. What is a good nursing diagnosis for Tucker?
Hemoglobin
13-17 g/dL (men)
12-15 g/dL (women)