HTN, CAD, diuretics Flashcards
HTN life style management
weight loss at least 10 pounds if overweight
smoking cessation
moderation of alcohol intake
reduction of salt intake
increase aerobic physical activity
HF left side signs and symptoms
pulmonary congestion
dyspnea, orthopnea, paroxysmal nocturnal
fluid retention, edema, swelling in ankles and feet
captopril
used for HTN, HF, decrease morbidity and mortality in CVS disorders
ACE - angioedema, cough (dry), elevated K+
persistent cough
acute hypotension
hyperkalemia
looking for the return of BP two target limits w/o adverse effects
take 1-2 hours after meals
may crush
check serum potassium
digoxin
produces positive intropic effect inc force of contraction
produces negative chronotropic effect slows HR
inc force of myocardial contractility inhibits Na, K and ATP Ca enters cells exchanges for Na
mild to moderate HF in adults and children
controlled vent response rate in adults w chrinic AF
headache, weakness, drowsiness, visual, GI upset
assess apical pulse
assess for PD goal of therapy is to eliminate PD in patient w afib slowing of HR and elimination of PD
administer w food or after meals
maintence dose administered for HF
serum blood draw prior to administration
dec absorption can result in toxicity - accumiliation that leads to N/V visual, atria or vent tachyarrthymias, vfib, SA, AV block
digoxin toxicity
anorexia, N/V, malaise, depression, yellow halo around objects
life - threatening heart rhythms
discontinue med
digifab - binding fragment derived from anti digoxin antibodies
monitor cardiac status, anaphylaxis
don’t give to patient if heart rate is below 60
nitroglycerin
converted to nitric oxide - relax smooth muscle in blood vessel walls to decrease in venous return and arterial blood pressure
reducing left vent workload and dec myocardial oxygen use
relieves angia pain
acute chest pain
severe headache, dizziness, bradycardia, syncope, hypotension and orthostatic hypotension
SL give three doses 5 min apart
furosemide
potassium wasting
inhibits sodium and chloride reabsorption in ascending loop of henle
produce significant diuresis
management of acute pulmonary edema, HF, hepatic and renal disease
dizziness, vertigo, parathesia, hypotension, rash, dehydration
IV injection over 1-2 min
monitor fluid and electrolytes daily, BP
spirnolactone
potassium sparring
blocks effect of aldosterone in renal tubules
blocks sodium - retaining effects of aldosterone
treatment of Hf, ascites, hypokalemia, primary/secondary hyperaldosteronism
dizziness, headache, abdominal cramping, diarrhea, deepening of voice, gyneomastia, menustral irregularities, testicular atrophy
same time each day, take w food
avoid foods high with potassium
assess for absence of edema, increases BP, measure weight, monitor electrolytes
mannitol
inc the thickness of filtrate so water can’t be absorbed
treatment of cerebral edema
manage oliguria, ARF, reduction of intracranial pressure before and after neurosurgery
blurred vision, nausea, vomiting, diarrhea, urinary retention
perform neuro assessment and LOC
