You lower my blood pressure with just a look!
What are three safety considerations with any cardiac medication?
1. Monitor BP and HR before adminsitering
2. Daily weights
3. Slow position changes
During the administration of milrinone, the patient’s blood pressure decreases from 170/96 mmHg to 96/60 mmHg. What is the first nursing intervention that should be performed?
Reduce or stop the infusion!
A patient with Congestive Heart Failure is just prescribed Furosemide (Lasix) for the first time. What education topics should you inform them of?
1. low sodium, high potassium diet
2. fluid restriction
3. daily weights
Your patient on Heparin is hemorrhaging and, based on aPTT values, she needs to reverse the effects of the medication, what agent will you administer?
Protamine Sulfate
A patient with pernicious anemia walks into your clinic for her medication. What route will you prepare to administer the Cyanocobalamin (Vitamin B12)?
Intramuscular Injection
An 56-year old African American patient presents to their primary care doctor for recurrent blood pressures of 170/92 mmHg. What medication class do you anticipate being prescribed for first-line
treatment of hypertension?
Calcium Channel Blockers
Jolene, a 76 year-old patient with Congestive Heart Failure, asks why the doctors do not want to give her the same medication her husband is taking, Nifedipine. What, as her nurse, would you educate her on?
It can cause increased pulmonary edema and worsen CHF symptoms.
When administering Dopamine, we know that 10 mcg/kg/min is prescribed to:
Increase HR, BP, and contractility
A client is being discharged from the hospital with Warfarin (Coumadin) to be taken at home. Which food should the client be instructed to avoid?
Green, leafy vegetables (Spinach)
A patient with Chronic Kidney Disease presents with a Hgb <10 and complaints of fatigue, pallor, headaches, and dyspnea. What medication (or medication class) do you anticipate to be administering to this patient?
Epoetin Alfta (Epogen) or Darbepoetin Alfa (Aranesp) or Erythropoiesis-Stimulating Agents
A patient with hypertension is presenting to the clinic with continued complaints of headaches,
dizziness, nausesa, and blurred vision. Their home blood pressure log states that the last few
readings have been 156/94 and the patient notes increased urine output. On assessment, you see JVD and 2+ pitting edema of the extremities. They say that they are compliant with taking their
Lisinopril (Prinivil). What do you expect to be added to the treatment regimen?
Hydrocholorthiazide (HCTZ)
A patient presents to the emergency room with atrial fibrillation. A physician prescribes 125 mcg of Digoxin (Lanoxin) via IV. The patient develops sudden dizziness, nausea, vomiting, loss of
appetite, vision changes, and abdominal discomfort. What will the nurse do?
Administer Digibind
What are the different indications of use for Atropine and Epinephrine?
Atropine = Bradycardia
Epinephrine = Asystole
Gary, a 72-year-old patient, is on a Heparin Sodium drip while admitted in the hospital. Knowing such information, name three patient education topics that should be provided?
1. Use a soft-bristled toothbrush
2. Shave with an electric razor
3. Report any severe brusing
A patient is in Neutropenic precautions as a result of their chemotherapy treatments causing neutropenia. Knowing this, what medication (or medicaiton class) do you anticipate administering in order to elevate the neutrophil counts?
Filgrastim/Neupogen or Pegfilgrastim/Neulasta (Granulocyte-Stimulating Colony Factors)
Rick, an 82-year-old patient, has hypertension, coronary artery disease, and is in the beginning stages of heart failure. His physician wants to start him on a Beta-Adrenergic Blocker to decrease his heart rate, myocardial contractions, cardiac output, and renin release from the kidneys. When looking at Rick’s chart, the physician sees he has a history of COPD and Asthma. What medication would you anticipate being prescribed?
Metoprolol (Lopressor) or other CARDIO-selective beta-blockers
A patient with a history of dysrhythmias presents with blurry vision, crackles in the lungs, decreased breath sounds, blue-gray skin, and a yellow-tinge to the sclera. What medication are they most likely taking?
Amiodarone (Cordarone) or Potassium Channel Blockers
A client is being treated for septic shock with an adrenergic agonist (Vasopressor). Which nursing diagnosis will the nurse prioritize during initial treatment?
Ineffective tissue perfusion
A patient arrives at the ER with tinnitus, confusion, and dizziness. Later, they develop more severe symptoms of hemorrhage, kidney failure, and seizures. What medication have they overdosed on?
Aspirin
Your patient is on Ferrous Sulfate for iron supplementation. Give two education topics that are important to provide the patient?
1. Causes dark/green stools
2. Milk/calcium decreases absorption, orange juice is better!
Joe, transported to the emergency department via ambulance, has a blood pressure of 210/106 mmHg. What is the indicated medication to give to quickly decrease arterial blood pressure?
Hydralazine (Apresoline)
A patient is being prescribed Flecainide (Tambocor) for their atrial fibrillation. You check their recent medical history and notice which of the following recent conditions would be a concern?
Recent Myocardial Infarction
Your patient asks what the difference is between Fludrocortis (Florinef) and Midodrine (Orvaten) as they are considering one of the two for their hypotension. What will you tell them?
1. Fudrocortis (Florinef) works on distal tubules of kidney to enhance reabsorption of electrolytes and water
2. Midodrine (Orvaten) works on the alpha-1 adrenergic receptor to increase SVR
3. Fall risk and safety is important to consider for both
Tina, a patient of yours, is discussing the need for medications for her intermittent claudication due to peripheral artery disease. She describes it as a pain in the leg that is bothersome. Knowing that Cilostazol (Pletal) can be prescribed for her condition, what aspect of her medical history would prevent this from being administered?
Heart Failure
Folic acid deficiency can occur from what two phenomenons?
1. Poor dietary intake of folate
2. Alcoholism