Drugs affecting the cardiovascular & renal Flashcards
adverse effects of ace inhibitors
dry cough
headaches
fatigue
hypertensive emergency which drug is used to lower bp?
sodium nitroprusside
(vasodilator)
beta blockers adverse effects
edema and sob
side effects of alpha blockers include
orthostatic hypotension-change positions slowly
Linsopril if taken should only be abruptly stopped if what occurs
angiodema
Which antihypertensives are considered more effective in white patients than in African-American patients?
beta blockers and ace inhibitors
Which antihypertensives are considered more effective in African-American patients than in white patients?
calcium channel blockers
diuretics
need to avoid excessive exercise, hot climates, saunas, hot tubs, and hot environments. Heat may precipitate vasodilation and lead to worsening of
hypotension
primary hypertension
essential hypertension
THE MAJOR GROUPS OF ANTIHYPERTENSIVES ARE
DIURETICS
ALPHA BLOCKERS
CENTRALLY ACTING ALPHA BLOCKERS
BETA BLOCKERS
ACE INHIBITORS
VASODILATORS
CCBs (CALCIUM CHANNEL BLOCKERS)
ARBs (ANGIOTENSIN II RECEPTOR BLOCKERS)
Angiotensin receptor blockers rbcs
decrease in blood pressure
CALCIUM CHANNEL BLOCKERS (CCBs) MAY BE USED TO TREAT
ANGINA
DYSRRHYTHMIA’S
HYPERTENSION
AND HELP REDUCE BLOOD PRESSURE BY CAUSING SMOOTH MUSCLE RELAXATION AND DILATATION OF BLOOD VESSELS. ** IF CALCIUM IS NOT PRESENT, THEN THE SMOOTH MUSCLE OF THE BLOOD VESSELS CANNOT CONTRACT.**
WHEN GIVING ANTIHYPERTENSIVE DRUGS, THE NURSE WILL CONSIDER GIVING THE FIRST DOSE AT BEDTIME FOR WHICH CLASS OF DRUGS?
ALPHA BLOCKERS SUCH AS DOXAZOSIN
WHEN A PATIENT IS BEING TAUGHT ABOUT THE POTENTIAL ADVERSE EFFECTS OF AN ACE INHIBITOR, WHICH OF THESE EFFECTS SHOULD THE NURSE MENTION AS POSSIBLY OCCURRING WHEN THIS DRUG IS TAKEN TO TREAT HYPERTENSION.
DRY, NONPRODUCTIVE COUGH
FIRST HYPOTENSIVE EFFECT:
C-COUGH
A-ANGIO EDEMA
P-PROTEINURIA
T-TASTE CHANGES
O-ORTHROSTATIC HYPOTENSTION
P-PRURITUS
R-RENAL FAILURE/RASH
L-LIVER TOXICITY/LEUKOPENIA
contraindications for ace inhibitors
ACE INHIBITORS HAVE AN EFFECT ON POTASSIUM EXRETION WHICH WOULD CAUSE HYPERKALEMIA AND NSAIDS DECREASE ANTI-HTN EFFECT.
nitroglycerin common adverse effect
headache
forms of nitroglycerin
topical ointment
oral
continuous iv
sublingual spray
For a patient using transdermal nitroglycerin patches, the nurse knows that the prescriber will order which procedure for preventing tolerance?
Remove the patch at night for 8 hours, and then apply a new patch in
Patients who are taking beta blockers for angina need to be taught which information?
These drugs are for long term prevention of angina episodes
side effect of nitrates
tachycardia
Which of the following describes the rationale for the administration of nitroglycerin by the sublingual route?
The first pass effect is avoided
during his morning walk, a man begins to experience chest pain. he sits down and takes one nitroglycerin sublingual tablet. after 5 minutes, the chest pain is worsening. what action would be the priority in this situation
call 911
The nurse notes in the patient’s medication history that the patient is receiving a lidocaine infusion. Based on this finding, the nurse interprets that the patient has which disorder?
Ventricular dysrhythmias
The nurse is administering amiodarone (Cordarone) and should monitor for which potential adverse effect?
pulmonary toxcity
verapamil treats which condition
Recurrent paroxysmal supraventricular tachycardia
A patient is experiencing a rapid dysrhythmia, and the nurse is preparing to administer adensoine (Adenocard). Which is the correct administration technique for this drug
It should be given as a fast intravenous push
A patient with a rapid, irregular heart rhythm is being treated in the emergency department with adenosine. During administration of this drug, the nurse will be prepared to monitor the patient for which effect?
Tranasitory asystole
When assessing a patient who has been taking amiodarone for 6 months, the nurse monitors for which potential adverse effect?
Photophobia
he nurse is assessing a patient who has been taking quinidine and asks about adverse effects. An adverse effect associated with the use of this drug includes:
Tinnitus
A patient calls the family practice office to report that he has seen his pills in his stools when he has a bowel movements. How will the nurse respond?
“What you are seeing is the wax matrix that contained the medication, but the drug has been absorbed.”
The nurse is administering lidocaine and considers which condition, if present in the patient, a caution for the use of this drug?
Renal dysfunction
A patient is in the clinic for a follow-up visit. He has been taking amiodarone (Cordarone) for almost 1 year, and today he tells the nurse, “I am noticing some blue color around my face, neck, and upper arms. Is that normal?” Which is the nurse’s correct response?
This can happend with amiodarone. I will let your doctor know about it right away.”
As part of treatment for early heart failure, a patient is started on an angiotensin-converting enzyme (ACE) inhibitor. The nurse will monitor the patient’s laboratory work for which potential effect?
Hyperkalemia
Before giving oral digoxin (Lanoxin), the nurse discovers that the patient’s radial pulse is 52 beats/min. What will be the nurse’s next action?
Check the apical pulse for 1 minute
what can cause digoxin toxicity?
Low potassium levels increase the chance of digoxin toxicity.
-nausea vomiting
-bradycardia
-anorexia
-visual changes
A patient who has heart failure will be started on an oral ACE inhibitor. While monitoring the patient’s response to this drug therapy, which laboratory tests would be a priority?
potassium
bun
creatine
When teaching the patient about the signs and symptoms of cardiac glycoside toxicity, the nurse should alert the patient to watch for
Flickering lights or halos around lights
A patient is taking a beta blocker as part of the treatment plan for heart failure. The nurse knows that the purpose of the beta blocker for this patient is to
Prevent simulation of the heart by catecholamines
qrs complex
ventricular depolarization
p wave
atrial contraction, depolarization
t wave
ventricular repolarization, rest
beta blocker
negative inotropic, chronotropic, dromotropic
-mask symptoms of hypoglycemia in patients with Diabetes
-can exaberate chf
bronchoconstriction can lead to resp problems
ATENOLOL-used after MI
contraindicated heart block, bradycardia
METOPROLOL-
ESMOLOL-used for ventricular dysrhythmias
Hr less than 60
don’t give
Hemodialysis
(toxcity)
removal of captopril and lisinopril
Diltiazem
afib,svt,flutters
-action decrease contractility and conductivity and slow down hr
thiazide diuretic
hypertensive crisis
-nitroprusside
anti hypertensive
cardiac glycosides
no longer used as first line
digoxin is the prototype-narrow index high toxicity( 0.5-2)
Antidote digibind
+inotropic
+chronotropic
-dromotropic
lidocaine
treatment for vent dysrhythmias IV
amiodarone
prolong action potentials
difficult dysrhythmias
life threating
Afib
controlled less than 100
uncontrolled more than 100
-irregular rhythm
-p wave
qrs <0.12
Diltiazem
atrial flutter
pwave saw tooth
rate 250-350bpm
rhythm can be regular or irregular
Amiodarone
If taking beta blockers contact health provider if notice
weight gain 2-3 pounds in one day or 5 in a week
ventricular fib
rhythm is irregular
no p waves
qrs not detectable
epinephrine
ventricular tachycardia
regular rhythm
no p waves
qrs wide and bizarre. 0.12
metoprolol
amiodarone
Pregnant women with high blood pressure use
methyldopa
