Exam 2 Medications

Question 1

Captopril

Answer 1

ACE inhibitor- lower BP

Client education: can cause a dry cough (switch to ARB), monitor BP for 2 hours after the initial dose (hypotension), alert MD for signs of tongue swelling, rash, or decreased sense of taste

Nursing implications: MONITOR FOR HYPERKALEMIA, monitor for hypotension, monitor for angioedema

Question 2

Enalapril

Answer 2

ACE inhibitor- lower BP

Client education: can cause a dry cough (switch to ARB), monitor BP for 2 hours after the initial dose (hypotension), alert MD for signs of tongue swelling, rash, or decreased sense of taste

Nursing implications: MONITOR FOR HYPERKALEMIA, monitor for hypotension, monitor for angioedema

Question 3

Telmisartan

Answer 3

ARBs- lower BP

Client education: change positions slowly, monitor BP 2 hours after the initial dose (hypotension), alert MD of signs of muscle weakness or slow and irregular heartbeat

Nursing implications: MONITOR FOR HYPERKALEMIA, monitor for hypotension, monitor for muscle weakness

Question 4

Metoprolol

Answer 4

Beta Blocker- lowers HR & BP

Client education: change positions slowly, monitor BP before and after giving (hypotension), alert MD to signs of slow or irregular HR

Nursing implications: monitor for hypotension, monitor for slow/irregular HR

Question 5

Spirolactone

Answer 5

K+ sparing diuretic- manage edema, heart failure, and hypertension

Client education: Change positions slowly, watch out for foods high in potassium (green leafy vegetables, melons), alert MD of any muscle weakness or irregular HR

Nursing implications: monitor for hypotension, monitor for irregular HR

Question 6

Furosemide

Answer 6

Loop diuretic, potassium wasting- manage edema, heart failure, and hypertension

Client education: change positions slowly, ingest foods with potassium (green leafy vegetables, melons), alert MD of signs of muscle weakness or irregular HR

Nursing implications: monitor hypotension, irregular HR, may need patient to take potassium supplements

Question 7

Clopidogrel

Answer 7

Platelet aggregation inhibitor- reduced platelets sticking together

Client education: watch for signs of bleeding that do not stop, caution patients to avoid risks for falling

Nursing implications: no reversible agent/antidote, monitor for abnormal bleeding, monitor patient H&H

Question 8

Aspirin

Answer 8

NSAID- reduces platelets sticking together

Client education: watch for signs of bleeding that do not stop, alert MD of GI upset (GI bleed)

Nursing implications: do not take if allergic to ibuprofen, monitor for abnormal bleeding, can increase risk for intracranial bleed, s/s of mild toxicity (tinnitus, dizziness, lethargy, nausea, and vomiting)

Question 9

Enoxaparin

Answer 9

Low molecular weight heparin- blood thinner

Client education: watch for signs of bleeding that does not stop, alert MD to s/s of GI upset (GI bleed)

Nursing implications: PROTAMINE IS THE ANTIDOTE, monitor for abnormal bleeding, monitor for nausea, HA, confusion, injection site irritation or pain at site, dose adjustment is necessary for advanced age and renal insufficiency

Question 10

Fondaparinux

Answer 10

Activated factor Xa inhibitor- blood thinner

Client education: watch for signs of bleeding that does not stop, alert MD to signs of GI upset (GI bleed), liver enzymes will need to be monitored

Nursing implications: ANDEXANET ALFA IS AN ANTIDOTE, monitor for abnormal bleeding, before starting this drug the patient must receive screening for bleeding and coagulation profile and hepatic or renal impairment, routine coagulation testing is not necessary

Question 11

Rivaroxaban

Answer 11

Activated factor Xa inhibitor- blood thinner

Client education: watch for signs of bleeding that does not stop, alert MD to signs of GI upset (GI bleed), liver enzymes will need to be monitored

Nursing implications: ANDEXANET ALFA IS AN ANTIDOTE, monitor for abnormal bleeding, before starting this drug the patient must receive screening for bleeding and coagulation profile and hepatic or renal impairment, routine coagulation testing is not necessary

Question 12

Warfarin

Answer 12

Anticoagulant- reduce clotting factors

Client education: watch for signs of bleeding that does not stop, caution patient to avoid risks for falling

Nursing implications: monitor for PT/INR LEVELS AT LEAST THREE TIMES A WEEK to obtain therapeutic range of 2-3, monitor for abnormal bleeding

Question 13

Diltiazem

Answer 13

Calcium channel blocker, vasodilator- lower BP

Client education: change positions slowly, monitor BP before and after giving (hypotension), alert MD of muscle weakness or irregular HR

Nursing implications: monitor for hypotension, flushing, HA, peripheral edema, irregular HR, gingival hyperplasia

Question 14

Verapamil

Answer 14

Calcium channel blocker- lower BP

Client education: change positions slowly, monitor BP before and after giving, alert MD of muscle weakness or irregular HR

Nursing implications: monitor for hypotension, flushing, HA, peripheral edema, irregular HR, gingival hyperplasia

Don’t give with afib or sick sinus syndrome

Question 15

Digoxin

Answer 15

Cardiac glycoside- decreases the HR

Client education: change positions slowly, alert MD to signs of visual disturbances (yellowish/greenish tint, blurred vision), nausea and vomiting

Nursing implications: monitor for abnormal arrhythmias, THERAPEUTIC SERUM DIGOXIN 0.5-2 ng/dl, monitor calcium levels

Question 16

Statins

Answer 16

Hyperlipidema lowering agent

Client education: alert MD of prolonged muscle aches, joint aches, muscle tenderness (hold, reduce, or switch meds), if taking with warfarin clotting time can be prolonged, diet and exercise routine will aide in decreases levels

Nursing implications: monitor liver function and lipid panel at baseline then recheck in 6 weeks, Rhabdomyolysis reported with atorvastatin