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Pharmacology Exam #2 > Blood Pressure Agents > Flashcards

Blood Pressure Agents Flashcards

1
Q

What are some risks related to hypertension?

A

Coronary Artery Disease
* hypertrophy/thickening of the heart muscle
* Increased pressure generated by the muscle contraction
* Increased workload on the heart

If HTN remains untreated:
* CAD and Cardiac Death
* Stroke
* Renal Failure
* Loss of vision

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2
Q

Normal Blood Pressure

A

<120mmHg AND <80mmHg

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3
Q

Elevated Blood Pressure Reading

A

120-129 mmHg AND <80mmHg

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4
Q

Hypertension Stage 1 Reading

A

130-139mmHg OR 80-89mmHg

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5
Q

Hypertension Stage 2 Reading

A

greater than/equal to 140mmHg OR
greater than/equal to 90mmHg

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6
Q

Modifiable Risk Factors for Hypertension

A
  • Stress
  • Cigarette Smoking
  • Alcohol Use
  • Obesity
  • Decreased physical activity
  • High Salt Diet
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7
Q

Non-modifiable Risk Factors for Hypertension

A
  • Chronic Kidney Disease
  • Increased Age
  • Diabetes*
  • Sleep Apnea*
  • Genetic predisposition

*possibly modifiable

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8
Q

Lifespan considerations for Blood Pressure Agents
In Children

A
  • More likely to be secondary HTN
  • Use drug therapy with caution
  • Lifestyle changes first: weight loss, increased activity
  • Monitor BP closely
  • With diuretics: monitor electrolytes and glucose closely
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9
Q

Lifespan considerations for Blood Pressure Agents
In Adults

A
  • Lifestyle modifications first: weight loss, alcohol use, smoking, stress, activity
  • Safety precautions: watch for dehydration from meds; chronic dehydration can also cause HTN
  • Caution with pregnancy: Labetalol is first choice in pregnancy if needed. ACEI/ARB/Renin inhibitors are contraindicated in pregnancy.
  • Drugs can enter breastmilk; choose alternative method of feeding
  • Adverse effects should be reported immediately
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10
Q

Lifespan considerations for Blood Pressure Agents
In Older Adults

A
  • More susceptible to toxic effects: Reduced doses; close monitoring
  • Safety precautions: do not crush, cut, or chew ER or SR medications (will cause toxic dose)
  • Fall risk r/t hypotension/orthostatic hypotension
  • Monitor closely for dehydration
  • In institutional settings, BP should be taken immediately before administering medication
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11
Q

Stepped Care Management of Hypertension

no need to memorize… just know the general idea

A

Step 1: Lifestyle modifications
Step 2: Drug therapy added
Step 3: Change in drug class or combination therapy
Step 4: Second or third agent or diuretic added if not already being used

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12
Q

Antihypertensive Agents
all of the drug classes

A

Drugs affecting the RAS
* ACE (Angiotensin Converting Enzyme) inhibitors
* Angiotensin II Receptor Blockers (ARBs)
* Renin Inhibitors

Calcium Channel Blockers
Vasodilators
Diuretics

Sympathetic Nervous System Blockers
* Beta Blockers: selective/non-selective
* Alpha Adrenergic Blockers: nonselective/Alpha 1 blockers
* Alpha AND Beta Blockers (aka Nonselective Adrenergic Blocking Agents)
* Alpha 2 Agonist

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13
Q

ACE Inhibitors
Mechanism of Action

Drugs affecting the RAS

A
  • Blocks ACE from converting angiotensin I to angiotensin II in the RAAS
  • This in turn blocks adosterone, leading to vasodilation, sodium and water excretion, and small increase in potassium

⬇️ decreased peripheral resistance (vasodilation)
⬇️ fluid volume (sodium/water loss)
⬇️ cardiac workload

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14
Q

ACE Inhibitor
Indications

Drugs affecting the RAS

A
  • HTN
  • Congestive Heart Failure
  • Left Ventricular dysfunction
  • Diabetic nephropathy prevention
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15
Q

ACE Inhibitor
Drug Names

Drugs affecting the RAS

A

“-pril”
Benazepril
Captopril
Enalapril
Lisinopril
Ramipril

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16
Q

ACE Inhibitor
Contraindications

Drugs affecting the RAS

A

Absolute:
* Allergy
* Pregnancy (Black Box warning)

Relative:
* Impaired renal function (makes it worse)

Caution:
* Acute/unstable CHF

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17
Q

ACE Inhibitor
Drug Interactions

Drugs affecting the RAS

A
  • Allopurinol (increases the risk of blood dyscrasias)
  • Other RAAS drugs
  • NSAIDs (decrease the effect of ACEIs)
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18
Q

ACE Inhibitor
Adverse Effects

Drugs affecting the RAS

A

Related to vasodilation & alterations in blood flow:
* Hypotension
* Renal insufficiency
* Dizziness
* Fatigue

Other:
* Pancytopenia (depressed bone marrow)
* GI irritation
* Rash
* Hyperkalemia
* Dry, constant cough
* Reflex tachycardia

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19
Q

ACE Inhibitor
Specific assessments

Drugs affecting the RAS

A

Labs:
CBC: before and during treatment because of bone marrow depression

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20
Q

ACE Inhibitor
Specific Implementation

Drugs affecting the RAS

A
  • Patient teaching regarding cough
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21
Q

Angiotensin II Receptor Blockers: ARBs
Mechanism of Action

Drugs affecting the RAS

A
  • Angiotensin II Receptor Antagonist
  • Blocks angiotensin II from binding with the receptors on the vascular smooth muscle AND in the adrenal cortex
    Prevents vasoconstriction
    Prevents release of aldosterone
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22
Q

Angiotensin II Receptor Blockers: ARBs
Indications

Drugs affecting the RAS

A
  • HTN
  • CHF
  • Diabetic nephropathy prevention
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23
Q

Angiotensin II Receptor Blockers: ARBs
Drug Names

Drugs affecting the RAS

A

“-sartan”
Candesartan
Irbesartan
Losartan
Olmesartan
Telmisartan
Valsartan

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24
Q

Angiotensin II Receptor Blockers: ARBs
Contraindications

Drugs affecting the RAS

A

Absolute:
* Allergy
* Pregnancy (Black Box warning)

Cautions:
* Hepatic dysfunction
* Renal dysfunction
* Hypovolemia

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25
**Angiotensin II Receptor Blockers: ARBs** Adverse Effects ## Footnote **Drugs affecting the RAS**
* 🧠 **CNS**: Headache, dizziness, syncope, weakness * 💓 **CV**: hypotension * 💩 **GI**: N&V, abdominal pain, diarrhea * **Skin**: Rash * Hyperkalemia * Renal damage
26
**Angiotensin II Receptor Blockers: ARBs** Drug Interactions ## Footnote **Drugs affecting the RAS**
* NSAIDs *(dec. effect of ARBs)* * Other RAAS drugs
27
**Angiotensin II Receptor Blockers: ARBs** Specific Assessment ## Footnote **Drugs affecting the RAS**
**History:** * Liver impairment **Labs:** * Liver function tests
28
**Renin Inhibitor: Aliskiren** Mechanism of Action ## Footnote **Drugs affecting the RAS**
* **Inhibits renin release from kidney** * Which leads to inhibition of the RAAS ⬇️ decreased aldosterone ⬇️ decreased sodium reabsorption ⬇️ decreased Blood pressure
29
**Renin Inhibitor: Aliskiren** Indication ## Footnote **Drugs affecting the RAS**
Hypertension
30
**Renin Inhibitor** Drug Name ## Footnote **Drugs affecting the RAS**
**Aliskiren**
31
**Renin Inhibitor: Aliskiren** Contraindications ## Footnote **Drugs affecting the RAS**
**Absolute:** * Allergy * Pregnancy *(Black Box Warning)*
32
**Renin Inhibitor: Aliskiren** Adverse Effects ## Footnote **Drugs affecting the RAS**
* Hyperkalemia * 💩 Diarrhea
33
**Renin Inhibitor: Aliskiren** Drug Interactions ## Footnote **Drugs affecting the RAS**
* Other drugs that affect the RAAS *(increase in adverse effects)*
34
**Drugs affecting the RAAS** Assessment
**History:** * Allergy * Pregnancy * Impaired kidney function, salt/volume depletion, heart failure **Physical:** * Baseline: cardiac, respiratory, abdominal, skin * Vitals and weight *(fluid volume)* **Labs:** * Renal function tests * Electrolytes * Pregnancy test
35
**Drugs affecting the RAAS** Nursing Diagnoses/Conclusions
* Altered tissue perfusion *(r/t changes in cardiac output)* * Altered skin integrity *(r/t dermatologic effects)* * Impaired comfort *(r/t adverse effects)* * Electrolyte imbalance risk *(r/t action of drug)* * Knowledge deficit
36
**Drugs affecting the RAAS** Implementation/Patient Teaching
* Encourage lifestyle changes * Use of barrier contraceptives * Comfort and safety measures * Monitor pt. carefully in any situation that might result in fluid loss *(vomiting, diarrhea, dehydration)* * Teach patients to watch for warning signs
37
**Calcium Channel Blockers** Mechanism of Action
* **Inhibits the movement of calcium ions** across the cell membranes in **cardiac and arterial muscle** * Leads to a *depressed impulse* and *slower conduction, decreased myocardial contractility*, and *relaxed dilated arteries*
38
**Calcium Channel Blockers** Indications
* Hypertension * Angina * Arrhythmias
39
**Calcium Channel Blockers** Drug Names
**"-dipine"** Amlodipine Felodipine Nifedipine **Diltiazem** **Verapamil**
40
**Calcium Channel Blockers** Contraindications
**Absolute:** * Allergy **Relative:** * Renal or hepatic dysfunction * Heart block or sick sinus syndrome (low heart rate) **Caution:** * Congestive Heart Failure * Systolic dysfunction * Low ejection fraction
41
**Calcium Channel Blockers** Adverse Effects
* 🧠 **CNS**: dizziness, fatigue * 💓 **CV**: hypotension, peripheral edema, heart block, bradycardia * 🤢 **GI**: Nausea * 🔴 **Skin**: Flusing, Rash
42
**Calcium Channel Blockers** Drug Interactions
**Drug:** * Diltiazem: Cyclosporine **Food:** * Grapefruit Juice
43
**Calcium Channel Blockers** Assessment
**History:** * Allergy * Contraindications: heart block, sick sinus syndrome, heart failure; liver and kidney impairment **Physical:** * Skin, respiratory, cardiac, neuro, abdominal * Vitals, pain * ECG **Labs:** * Liver and renal function tests
44
**Calcium Channel Blockers** Nursing Diagnoses/Conclusions
* Altered cardiac output risk *(r/t hypotension)* * Injury risk *(r/t CNS & CV effects)* * Altered tissue perfusion *(r/t changes in cardiac output)* * Knowledge deficit
45
**Calcium Channel Blockers** Implementation/Patient Teaching
* Monitor BP, cardiac rhythm, and cardiac output * Stay hydrated * small, frequent meals for GI effects * Change positions slowly to avoid orthostatic hypotension * Teach about drug interactions
46
**Vasodilators** Mechanism of Action
*** Acts **directly** on **vascular smooth muscle** ➡️ muscle relaxation leading to *vasodilation*, and decreased BP. * *Decreased peripheral resistance* * *Increased cardiac output*
47
**Vasodilators** Indications
**Emergency Use** * Severe hypertension * Refractory hypertension *(spikes for no apparent cause after being treated)* * Hypertensive emergencies * Malignant hypertension *(HTN caused organ damage)*
48
**Vasodilators** Drug Names
**Hydralazine** **Minoxidil** **Nitroprusside** **Nitroglycerin**
49
**Vasodilators** Contraindications
**Absolute:** * Allergy **Cautions:** * Conditions exacerbated by decreased BP: peripheral vascular disease, CAD, CHF, Cerebral insufficiency, tachycardia
50
**Vasodilators** Drug Interactions
Based on the individual drug - look up in drug guide
51
**Vasodilators** Adverse Effects
* 🧠 **CNS**: dizziness, headache, anxiety * 💓 **CV**: Refractive tachycardia * 🤢 **GI**: Nausea & Vomiting * **Skin**: abnormal hair growth * **Nitroprusside:** Cyanide toxicity *(pink, cherry-red skin, headache, dizziness, dyspnea, vomiting, shortness of breath)*
52
**Vasodilators** Assessment
**History:** * Allergy * CV dysfunction **Physical:** * skin, cardiac, respiratory, abdominal * vitals, weight * ECG **Labs:** * Renal and hepatic function
53
**Vasodilators** Nursing Diagnoses/Conclusions
* Altered tissue perfusion * Altered skin integrity * Impaired comfort * Knowledge deficit
54
**Vasodilators** Implementation/Patient Teaching
* Encourage lifestyle changes * Monitor BP closely * Monitor for any drop in fluid volume * Small frequent meals for GI upset * Safety precautions for falls
55
**Diuretics** Mechanism of Action
* Increase the excretion of sodium and water from the kidney ➡️ decreased blood pressure
56
Commonly used **Diuretics** for hypertension
**Thiazide and thiazide-like** * Chlorothiazide * Chlorothalidone * Hydrochlorothiazide **Potassium Sparing Diuretics** * Spironolactone * Triamterene
57
**Beta Blockers** Mechanism of Action ## Footnote **Sympathetic Nervous System Blockers**
* **Blocks beta receptors in the heart** * ⬇️ Decreases **heart rate** and cardiac muscle contraction * Vasodilates ➡️ increased blood flow to kidneys ➡️ decrease in release of renin *(stopping the RAAS)*
58
**Beta Blockers** Indications ## Footnote **Sympathetic Nervous System Blockers**
* HTN * Angina * tachyarrhythmias * migraine headache * MI * glaucoma * heart failure * hyperthyroidism
59
**Beta Blockers** Drug Names ## Footnote **Sympathetic Nervous System Blockers**
**"-olol"** **Selective:** *(blocks ONLY beta receptors in the heart)* * Atenolol * Metoprolol **Non-selective:** *(blocks ALL beta receptors: more adverse effects)* * Propanolol
60
**Beta Blockers** Contraindications ## Footnote **Sympathetic Nervous System Blockers**
**Absolute:** * Allergy **Relative:** * Acute/unstable heart failure, bradycardia, heart block *(because it lowers the heartrate)* * Bronchospasm, COPD, asthma *(because it can cause bronchospasm)* **Caution:** * Renal or hepatic dysfunction * Diabetes *(blocks normal signs and symptoms of altered blood glucose)*
61
**Beta Blockers** Adverse Effects ## Footnote **Sympathetic Nervous System Blockers**
* 🧠 **CNS**: Headache, fatigue, dizziness, depression, sleep issues, disorientation, memory loss * 💓 **CV**: bradycardia, hypotension, orthostatic hypotension * 💩 **GI**: N&V, diarrhea, pain, colitis * **GU**: decreased libido, impotence * Alterations in glucose levels
62
**Beta Blockers** Drug Interactions ## Footnote **Sympathetic Nervous System Blockers**
* Clonidine: increased hypertensive effect - if taken together and need to discontinue them - stop Beta Blocker first, then Clonidine several days later to allow body to readjust * NSAIDs * Insulin/hypoglycemic agents
63
**Beta Blockers** Specific Assessment ## Footnote **Sympathetic Nervous System Blockers**
**History:** * Lung disease? * Diabetes? **Physical:** * Take apical pulse prior to administering, **hold if below 60 bpm** * Do not abruptly stop medication, taper over 1-2 weeks * Patients with diabetes should monitor blood glucose closely
64
**Alpha-adrenergic Blockers (Non-Selective): Phentolamine** Mechanism of Action ## Footnote **Sympathetic Nervous System Blockers**
* **Blocks alpha 1 receptors**: vasodilation resulting in decreased BP * **Blocks alpha 2 receptors:** prevents norepinephrine feedback loop resulting in increase in reflex tachycardia
65
**Alpha-adrenergic Blockers (Non-Selective): Phentolamine** Indications ## Footnote **Sympathetic Nervous System Blockers**
* Diagnose and manage episodes of pheochromocytoma *(fairly rare)* *(Also an antidote for MAOIs)*
65
**Alpha-adrenergic Blockers (Non-Selective)** Drug Name ## Footnote **Sympathetic Nervous System Blockers**
**Phentolamine** *(administered IM or IV only)*
65
**Alpha-adrenergic Blockers (Non-Selective): Phentolamine** Contraindications ## Footnote **Sympathetic Nervous System Blockers**
**Absolute:** * Allergy **Relative:** * CAD, MI --> made worse
66
**Alpha-adrenergic Blockers (Non-Selective): Phentolamine** Drug Interactions ## Footnote **Sympathetic Nervous System Blockers**
**Alcohol** *(increases vasodilation)*
67
**Alpha-adrenergic Blockers (Non-Selective): Phentolamine** Adverse Effects ## Footnote **Sympathetic Nervous System Blockers**
**Many due to being Non-Selective** 💓 **CV** * Hypotension * Angina; MI * Arrhythmia * Increased reflex tachycardia * Flushing *(from vasodilation)* 🧠 **CNS** * Cerebral Vascular Accident * Headache * Dizziness * Weakness
68
**Alpha 1 Blockers** Mechanism of Action ## Footnote **Sympathetic Nervous System Blockers**
* **Blocks Alpha 1 receptor sites** * *Decreases vascular tone* resulting in *vasodilation* ➡️decreases Blood Pressure
69
**Alpha 1 Blockers** Indications ## Footnote **Sympathetic Nervous System Blockers**
Hypertension
70
**Alpha 1 Blockers** Drug Names ## Footnote **Sympathetic Nervous System Blockers**
**"-azosin"** Doxazosin Prazosin Terazosin
71
**Alpha 1 Blockers** Contraindications ## Footnote **Sympathetic Nervous System Blockers**
**Absolute:** * Allergy **Cautions:** * Heart failure * Renal failure or hepatic impairment
72
**Alpha 1 Blockers** Adverse Effects ## Footnote **Sympathetic Nervous System Blockers**
* 🧠 **CNS**: Headache, dizziness, fatigue * 💓 **CV**: arrhytmias, heart failure, hypotension, angina * **GU**: priapism *(r/t inc. vasodilation)* * **Skin**: flushing *(r/t inc. vasodilation)* **(NO reflex tachycardia because they do NOT block Alpha 2 receptors)**
73
**Alpha 1 Blockers** Drug Interactions ## Footnote **Sympathetic Nervous System Blockers**
* Drugs used for erectile dysfunction *(could have dangerously low blood pressure)*
74
**Alpha and Beta Blockers** ***(AKA: Nonselective Adrenergic Blocking Agents)*** Mechanism of Action ## Footnote **Sympathetic Nervous System Blockers**
**Blocks norepinephrine** at **ALL** alpha and beta receptors in the sympathetic nervous system * Decreases Blood Pressure AND heartrate * Increased renal perfusion ➡️ decreased renin released *(stops the RAAS)*
75
**Alpha and Beta Blockers** ***(AKA: Nonselective Adrenergic Blocking Agents)*** Indications ## Footnote **Sympathetic Nervous System Blockers**
Hypertension
76
**Alpha and Beta Blockers** ***(AKA: Nonselective Adrenergic Blocking Agents)*** Drug Names ## Footnote **Sympathetic Nervous System Blockers**
**Carvedilol** **Labetalol**
77
**Alpha and Beta Blockers** ***(AKA: Nonselective Adrenergic Blocking Agents)*** Contraindications ## Footnote **Sympathetic Nervous System Blockers**
**Absolute:** * Allergy **Relative:** * Heart Block * bradycardia * Liver disease **Caution:** * Lung disease/bronchospasm * Diabetes
78
**Alpha and Beta Blockers** ***(AKA: Nonselective Adrenergic Blocking Agents)*** Adverse Effects ## Footnote **Sympathetic Nervous System Blockers**
* 🧠 **CNS**: fatigue, dizziness * 💓 **CV**: CVA, heart failure, arrhythmias * 🫁 **Respiratory** * 💩 **GI**: N, V, D, abdominal pain * **GU**: impotence, decreased libido * **Skin**: Rash * **Liver failure** **NO reflex tachycardia**
79
**Alpha and Beta Blockers** ***(AKA: Nonselective Adrenergic Blocking Agents)*** Drug Interactions ## Footnote **Sympathetic Nervous System Blockers**
* Antidiabetic Agents: can lead to hypoglycemia
80
**Alpha 2 AGONIST: Clonidine** Mechanism of Action ## Footnote **Sympathetic Nervous System Blockers**
* **Stimulates** the **Alpha 2 receptors** in the **CNS** and *inhibits* the *CV centers* ➡️ decrease in sympathetic outflow from the CNS resulting in a drop in Blood Pressure
80
**Alpha 2 AGONIST: Clonidine** Contraindications ## Footnote **Sympathetic Nervous System Blockers**
**Absolute:** * Allergy **Relative:** * Narrow angle glaucoma * Severe HTN * Hypotension * Bradycardia **Cautions:** * CV disease * Diabetes * Hyperthyroidism * Renal/hepatic impairment
80
**Alpha 2 AGONIST: Clonidine** Indications ## Footnote **Sympathetic Nervous System Blockers**
**Hypertension** *(Oral and transdermal formulations)*
81
**Alpha 2 AGONIST: Clonidine** Adverse Effects ## Footnote **Sympathetic Nervous System Blockers**
* 🧠 **CNS**: Bad dreams, drowsiness, headache, fatigue * 💓 **CV**: hypotension, bradycardia * 🟡 **GU**: decrease in urinary output
82
**Alpha 2 AGONIST** Drug Name ## Footnote **Sympathetic Nervous System Blockers**
**Clonidine**
83
**Alpha 2 AGONIST: Clonidine** Drug Interactions ## Footnote **Sympathetic Nervous System Blockers**
* **Beta Blockers**: *(Paradoxical hypertension)* * **Adrenergic Antagonists:** *(Cancels out effectiveness)* * **CNS depressants/alcohol**: *(increase in CNS effects)*
84
**Sympathetic Nervous System Blockers** Assessment
**History:** * Contraindications and cautions **Physical:** * CNS * cardiac/perfusion * respiratory * abdominal * urinary * vitals * ECG **Labs:** * electrolytes * renal and hepatic function tests * glucose
85
**Sympathetic Nervous System Blockers** Nursing Diagnoses/Conclusions
* Impaired comfort *(r/t adv. effects)* * Altered tissue perfusion *(r/t CV effects)* * Altered cardiac output *(r/t CV effects)* * Altered breathing pattern * Injury Risk *(r/t CV and CNS effects)* * Activity Intolerance *(r/t suppression of SNS)* * Altered Sensory Perception *(r/t CNS effects)* * Knowledge deficit
86
**Sympathetic Nervous System Blockers** Implementation/Patient Teaching
* Take apical pulse prior to administering, hold if under 60bpm * Prepare medication carefully * Monitor blood pressure * Do not abruptly stop medication * Encourage patient to make lifestyle changes * Change positions slowly * Patients with diabetes should monitor glucose closely * Do NOT crush ER formulations * Consult a healthcare provider before taking any OTC medication/herbal therapies * Emphasize importance of follow up appointments
87
**Antihypotensive Agents: Vasopressors** Mechanism of Action
* **Stimulate ALL adrenergic receptors** in the SNS * **HR** and **myocardial contractility** *increases* * Blood vessels **constrict** ➡️ **increased** blood pressure * Bronchi dilate and *rate/depth of breathing increase*
88
**Antihypotensive Agents: Vasopressors** Indications
* Hypotensive states: Shock, heart failure * Anaphylaxis * Bronchospasm/Acute Asthma *(Given via IV - acute emergency situations)*
89
**Antihypotensive Agents: Vasopressors** Drug Names
* Dobutamine * Dopamine * Epinephrine * Norepinephrine
90
**Antihypotensive Agents: Vasopressors** Contraindications
**Absolute:** * Allergy * Pheochromocytoma *(leads to too many catecholamines)* **Relative:** * Hypovolemia **Cautions:** * Tachycardia * Hypertension * Disease that limits blood flow
91
**Antihypotensive Agents: Vasopressors** Adverse Effects
🧠 **CNS** * Headache * Sweating * Anxiety 💓 **CV** * arrhythmias * HTN * changes in peripheral blood flow
92
**Antihypotensive Agents: Vasopressors** Drug Interactions
* Any drug or substance that increases BP or HR
93
**Antihypotensive Agents: Vasopressors** Assessment
**History:** * Contraindications/Cautions **Physical:** * Respiratory, cardiac/perfusion, abdominal, skin * Weight * Vitals **Labs:** * Kidney and liver function tests
94
**Antihypotensive Agents: Vasopressors** Nursing Diagnoses/Conclusions
* Altered tissue perfusion *(r/t changes in cardiac output)* * Altered sensory perception *(r/t CNS effects)* * Impaired comfort *(r/t adverse effects)* * Knowledge deficit
95
**Antihypotensive Agents: Vasopressors** Implementation/Patient Teaching
* Monitor BP and HR * Safety and comfort measures: nonslip socks, easy access to bathroom, small frequent meals, lighting * Thorough patient teaching

Pharmacology Exam #2 (14 decks)

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