Beta Blockers
What is the expected therapeutic action of beta-blockers like Metoprolol?
Decrease heart rate, contractility, renin release, and peripheral vascular resistance.
What is the therapeutic use of Doxazosin and what does it treat?
Hypertension and benign prostatic hyperplasia, treats BPH
What is the action of ACE inhibitors?
Blocks the conversion of angiotensin I to angiotensin II
What vital sign should be held if it is below a threshold when administering Nifedipine?
Hold if systolic BP is less than 90 mmHg.
What is the mechanism of action of Digoxin?
Positive inotrope and negative chronotrope; increases calcium availability in cardiac cells
Name two conditions beta-blockers are used to treat.
Hypertension and heart failure.
What is the main precaution for the first dose of Doxazosin?
Administer at night due to a high risk of orthostatic hypotension.
What is a common side effect of Nifedipine?
Peripheral edema or bradycardia
What is a sign of Digoxin toxicity?
Visual disturbances, nausea, bradycardia, anorexia, headache
Stopping Metoprolol abruptly has what effect
Rebound hypertension
Which drug interaction increases the risk of hypotension with Doxazosin?
Alcohol
What interaction increases the effects of Nifedipine?
Grapefruit juice
Why should Nitroglycerine not be combined with phosphodiesterase inhibitors?
Risk of severe hypotension
What patient education is essential for Metoprolol administration?
Do not stop abruptly; monitor HR and BP.
What education should you provide to a patient taking Doxazosin?
Rise slowly to prevent dizziness or syncope.
A nurse is caring for a client who has a new prescription for captopril for hypertension. The nurse should monitor the client for which of the following as an adverse effect of this medication?
1. Hypokalemia
2. Hypernatremia
3. Neutropenia
4. Bradycardia
3. Neutropenia
The nurse should analyze the findings and determine that the priority hypothesis is that the client is at risk for developing neutropenia which can be a serious adverse effect for clients taking an ACE inhibitor. Monitor the client’s CBC and teach the client to report indications of infection to the provider.
A nurse is teaching a client who has a new prescription for verapamil to control hypertension. Which of the following instructions should the nurse include?
1. Increase fiber intake
2. Drink grapefruit juice daily for Vit. C
3. Decrease calcium in diet
4. Withhold food 1 hr after med is taken
1. Increase fiber intake
Increasing dietary fiber intake can help prevent constipation, an adverse effect of verapamil.
A nurse is caring for a client who has a new prescription for digoxin and takes multiple other medications. The nurse should identify that concurrent use of which of the following medications increases the client’s risk for developing digoxin toxicity?
1. Phenytoin
2. Verapamil
3. Warfarin
4. Aluminum Hydroxide
2.
Verapamil, a calcium-channel blocker, can increase digoxin levels. If these medications are given concurrently, the digoxin dosage may need to be decreased, and the nurse should monitor digoxin levels carefully.
What is a major contraindication for beta-blockers?
Second-degree heart block or greater.
Name one complication related to alpha-blockers.
Reflex tachycardia
A nurse is reviewing laboratory results of electrolytes for four clients who take digoxin. Which of the following electrolyte values increases a client’s risk for digoxin toxicity?
1. Calcium 9.2
2. Calcium 10.3
3. Potassium 3.4
4. Potassium 4.8
3. Potassium 3.4
The nurse should analyze the cues from the client’s laboratory results and determine that a potassium level of 3.4 mEq/L is below the expected reference range and increases a client’s risk for developing digoxin toxicity. Low potassium can cause fatal dysrhythmias, especially in older clients who take digoxin.