Meds Flashcards
Propranolol
Drug Class: Beta Blocker
Causes: hypotension, bradycardia, HF, fatigue, brochospasm
Nursing Action: Monitor BP/HR, breathing (due to bronchospasm), crackles, dyspnea, weight gain, edema. Check apical pulse before admin. Notify MD if pulse <50.
Amiodarone
Drug class: Potassium Channel Blocker
Causes: pulmonary toxicity, bradycardia, AV block, visual disturbances
Nursing Action: Obtain basline chest x-ray & monitor pulmonary function. Notify MD of dyspnea, cough, & chest pain. Monitor BP/EKG. Notify MD S&S of HF (dyspnea, cough, chest pain, JVD, crackles). AV block occurs - DC med and insert pacemaker. Educate pt. to notify MD of blurred vision, stay out of sunlight, signs of blindness. Monitor liver & thyroid function.
Toxicity symptom = productive cough
Verapamil
Drug Class: Calcium Channel Blocker
Causes: bradycardia, low BP, HF, AV block, constipation, edema
Nursing Action: Monitor EKG/BP. Treat severely low BP with IV fludis, trendelenberg position, IV calcium gluconate. Check apical pulse before admin. Notify MD if HR <50. Monitor chest pain, dyspnes, crackles, weight gain, edema.
Verapamil
A nurse is caring for a client who received IV verapamil to treat supraventricular tachycardia (SVT). The client’s pulse rate is now 98/min, and the blood pressure is 74/44 mm Hg. The nurse should expect a prescription for which of the following IV medications?
Calcium Gluconate
The nurse should plan to generate solutions to address the client’s hypotension which includes the administration of calcium gluconate, given slowly IV. The calcium counteracts vasodilation caused by verapamil
Adenosine
Drug class: Class V Antidysrhythmic
Causes: bradycardia, low BP, dyspnea, vasodilation
Nursing Action: Low BP = Monitor EKG, admin IV bolus.
TX of SVT
Digoxin
Drug Class: Cardiac Glycoside
Causes: low HR, low BP, cardiotoxicity, GI upset, fatigue, vision issues
Nursing Action: Monitor apical HR. Hold dose if HR <60. Monitor Digoxin level. Therapeutic level = 0.8-2.0 ng/mL. Monitor for S/S of toxicity: anorexia, N/V, visual disturbances, dysrhythmias. Monitor potassium level. LOW potassium increases risk for toxicity. Normal potassium level = 3.5-5.0 mEq/mL.
Digoxin
A nurse is assessing a client who is taking digoxin to treat heart failure. Which of the following findings is a manifestation of digoxin toxicity?
Report of anorexia
The nurse should analyze the cues from the client’s manifestations and determine that anorexia, blurred vision, stomach pain, and diarrhea are manifestations of digoxin toxicity.
Blood Transfusion
Process:
–> Explain the procedure to the client.
–> Assess vital signs and the client’s temperature prior to transfusion.
–> Remain with the client during the initial 15 to 30 min of the transfusion. Most severe reactions occur within this time frame.
–> Review laboratory values to ensure the client requires transfusion and to compare to post-transfusion values.
–> Verify the prescription for a specific blood product.
–> Obtain consent for procedure if required.
–> Obtain blood samples for compatibility determination, such as type and cross-match.
–> Assess for a history of blood-transfusion reactions.
–> Initiate large-bore IV access. An 18- or 20-gauge needle is standard for administering blood products.
–> Obtain blood products from the blood bank. Inspect the blood for discoloration, excessive bubbles, or cloudiness.
–> Prior to transfusion, two RNs (or an RN and a PN, depending on facility policy) must identify the correct blood product and client by looking at the hospital identification number (noted on the blood product) and the number identified on the client’s identification band to make sure the numbers match.
–> The nurse completing the blood product verification must be one of the nurses who administers the blood product.
–> Prime the blood administration set with 0.9% sodium chloride only. Never add medications to blood products. Y-tubing with a filter is used to transfuse blood.
–> Begin the transfusion, and use a blood warmer if indicated. Initiate the transfusion within 30 min of obtaining the blood product to reduce the risk of bacterial growth.
Blood Transfusion
A charge nurse is observing a newly licensed nurse on the unit who is preparing to administer a blood transfusion to an older adult client. Which of the following actions by the newly licensed nurse indicates an understanding of the procedure?
Obtains vital signs every 15 min throughout the procedure.
The nurse should plan to generate solutions to address the older adult’s increased risk of fluid overload which include checking the client’s vital signs every 15 min throughout the transfusion to allow for early detection of fluid overload or other transfusion reaction.
Proton-Pump Inhibitors (PPI’s)
Suppress gastric acid secretion by irreversibly inhibiting the enzyme that produces gastric acid, and inhibit basal and stimulated acid production.
Meds: Pantoprazole, esomeprazole, omeprazole, lansoprazole, and rabeprazole
–> Rabeprazole and pantoprazole are enteric-coated tablets and should not be crushed.
–>Do not to crush, chew, or break sustained-release capsules.
–> Take omeprazole and lansoprazole once a day prior to eating the main meal of the day.
–> Take rabeprazole after the morning meal.
–> Avoid alcohol and irritating medications (NSAIDs).
–> Complete the prescribed regimen, even when manifestations subside.
Epoetin Alfa (Erythropoietin)
A hematopoietic growth factor used to increase production of RBCs
Nursing Action:
–> Monitor for an increase in blood pressure.
–> Monitor Hgb and Hct twice per week.
–> Monitor for a cardiovascular event if Hgb increases too rapidly (greater than 1 g/dL in 2 weeks).
Client Education: Understand the importance of having Hgb and Hct evaluated on a twice-per-week basis until targeted levels are reached and then continue to have it checked monthly or after a dose adjustment.
Folic Acid needs which vitamin to convert from inactive to active?
Vitamin B-12
Also called cyanocobalamin
A nurse is teaching a client who has a new prescription for ferrous sulfate (Iron). Which of the following information should the nurse include in the teaching?
Foods high in vitamin C will promote absorption.
Epoetin Alfa (Erythropoietin) increases production of what?
Red blood cells (RBCs)
Folic Acid increases production of what?
Red blood cells (RBCs)
–> Folic acid is a water-soluble, B-complex vitamin.
–> Large doses of folic acid can mask vitamin B12 deficiency.
–> Large doses of folic acid will turn urine dark yellow.
