Dosage Calculation
Order:
Lidocaine 2 grams in 500ml of LR to run at 2mg/min
What will you set your pump at? (Nearest whole number)
30 mL/hr
What are some of the warning signs to educate patient on about
Adverse Drug Reactions for Gemfibrozil include: Gastrointestinal manifestations include nausea, abdominal pain, jaundice and diarrhea, which may indicate gall bladder disease.
Muscle pain or joint pain indicates myopathy
What is the intended use of Vasopressin (or what is the most common clinical picture we use Vasopressin for)
Treats vasodilatory or hemorrhagic shock that is unresponsive to IV fluids or other vasopressors
What are the lab goals for effective medication regime in the management of hyperlipidemia?
Decreased LDL (lower the bad cholesterol))
Increase HDL (raise the good cholesterol)
Decrease Triglycerides (elevated triglycerides raises heart disease risk)
How can epinephrine be given (what routes)
Subcutaneous injection, IM and IV
Order
300mL of NS to run over 30 minutes
What will you set your pump at ( round to the whole number)
600 mL
What is Alirocumab and how it is given?
Alirocumab is a PCSK9 Inhibitor
Used to decrease LDL levels
Comes in a prefilled syringe, warm to room temperature and educate it is given SQ every 2 weeks.
What is Sacubitril/Valsartan? What is it used for?
A combination of Angiotensin Receptor Blocker/Neprilysin Inhibitor (ARNi)
It is used to treat hypertension and heart failure
What is the best time to take statins?
Statins should be taken in the evening with or without food
What is Magnesium Sulfate used for in the cardiac setting?
What is the antidote?
Life threatening ventricular arrhythmia, typically torsade's de points.
Calcium Gluconate is the antidote
Order:
Heparin 25,000 units in 250ml of D5W to run at 8 units/kg per hour ( round to the tenth)
Weight=72 kg
What will you set your pump at?
5.76 mL
Round to 5.8 mL
What is atropine used for?
What assessments should be prioritized prior to administration?
Atropine is used for symptomatic bradycardia
Nursing should prioritize the assessment of the patient's heart rate and blood pressure
What is Inclisiran? What is it used for?
Inclisiran is a Short-interfering RNA medication
Used to reduce LDL Cholesterol and triglycerides
When is the best time to gemfibrozil?
Usually taken twice daily, 30 minutes before breakfast and evening meals (before meals).
What are the signs of hyperkalemia?
Heart palpitations, EKG changes, numbness and tingling (paresthesia) and diarrhea
Order
Magnesium Sulfate 1.5 grams in 500ml of NS to run at 30 mg/hr
What will you set your pump at? Round to the nearest whole number
10 mL/hr
(no rounding needed)
What are keys to effective patch application is a client who has a new prescription for a transdermal nitroglycerin patch?
Apply patch to a clean, dry hairless area. Be sure to rotate sites. N
Nursing should look to ensure old patches are removed before new ones are applied
What is Ivabradine? What is it used for?
Ivabradine is a hyperpolarizatoin-Activated Cyclic Nucleotide-Gated (HCN) blocer
Treats stable symptomatic heart failure with an EF of 35% or less and are in NSR with a resting heart rate of 70 bpm
A patient has been taking atorvastatin and had gemfibrozil added for better lipid control. If a patient complains of muscle pain what lab order will the nurse expect to be monitoring?
The nurse expects an order for the patient to come and have a CK (creatinine kinase) checked
Myopathy or pain in the muscles, can progress to rhabdomyolysis which causes a breakdown of muscle protein (can ultimately cause kidney damage)
What are signs of hypokalemia?
Muscle twitching, cramps and weakness, fatigue, constipation
Order
Heparin 25,000 Units in 250 ml of NS to run at 8 units per kg per hour (round to the nearest tenth)
Weight=48 Kg
Answer =3.8 mL
What is one significant risk of Nitroprusside therapy?
Cyanide Poisoning
Be sure to administer for no longer that 3 days and at a rate of 5mcg/kg/min or less.
What is Bempedoic Acid and What is it used for?
Adenosine Triphosphate-Citrate Lyase Inhibitor
Used to decrease LDL levels. Adjunct therapy with a cholesterol lowering diet and a statin
What patient teaching should be included if colesevelam is prescribed for hyperlipidemia?
Medication should be mixed with 8 ounces of water or juice
Clients should report severe abdominal pain, nausea or vomiting (pancreatitis), bleeding mucous membranes, dark tarry stools, hematuria, and ecchymosis (bruising) to their provider. They should also avoid taking other medications 4 hours prior to taking colesevelam (should take alone).
What labs can the nurse expect to monitor for a patient taking Bempedoic Acid?
The nurse can expect to monitor LDL cholesterol levels (for effectiveness) as well as liver and kidney functions, CBC, uric acid and CK