Perfusion Meds Flashcards
what is the action of ACE inhibitors?
Block conversion of angiotensin I to angiotensin II which causes vasodilation
ACE inhibitors prevent….
remodeling of the heart
why would a patient be given an ACE inhibitor?
–reduce afterload (HF)
What are some side effects of an ACE inhibitor?
- -Dry cough
- -Orthostatic hypotension
- hyperkalemia
- proteinuria
- taste disturbances (captopril)
How long should BP be monitored after administering an ACE inhibitor?
continually for the 1st 2 hours
what should temporarily be stopped prior to administration of an ACE inhibitor?
Diuretic for 2-3 days prior to help prevent Orthostatic hypotension
Since hyperkalemia is a risk for taking an ACE inhibitor, what should the nurse tell the patient to avoid?
salt substitutes
What meds should the nurse advise the patient to avoid when taking an ACE inhibitor?
NSAIDS
What does a loop diuretic end in and what should the patient notify the doctor of if they have the symptom?
- -ide
- -tinnitus (ototoxicity)
When a patient is taking a potassium sparing diuretic, what should the nurse advise the patient to avoid?
–potassium rich foods (bananas, oranges, dates)
What should the nurse consider when giving any kind of diuretic?
- -monitor weight daily
- -monitor electrolytes
- -obtain BP prior to administration
What is the antidote for heparin?
protamine sulfate
What is the antidote for warfarin?
Vit. K
What type of antiplatelet is commonly used after cardiac surgery?
Dipyridamole
what should be given with an antiplatelet to prevent GI bleed?
- -ranitidine (H2 agonist) or
- -Omeprazole (PPI)
what is dobutamine used for?
- -Increase CO, contractility
- -reduce PVR and PAWP
Why would a patient be given dobutamine?
- -CHF
- -Cardiogenic shock
- -Hemodynamically significant hypotension
What is the initial rate of dobutamine?
0.5 mg/kg/min IV
Why should dobutamine be titrated?
so HR does not increase >10% (can extend MI)
What are some side effects of dobutamine?
- -Angina
- -HTN
- -hypokalemia
- -Increased ventricular ectopy
- -allergic reaction
What is the mechanism of action of dopamine ?
Alpha and beta receptor stimulator
Why would a patient be given dopamine?
- -Cardiogenic shock
- -CHF
- -Increase BP when it is super low
What are some precautions when taking dopamine?
- -excessive vasoconstriction
- -tachycardia
- -arrhythmias
- -N/V
Dopamine should not be mixed with what type of solution?
alkaline solutions (becomes inactive)
What are some side effects of dopamine?
- -Angina
- -Aberrant conduction
- -azotemia
- -Widening QRS
- -hypo/hypertension
What drug class is epinephrine in?
alpha/beta adrenergic agonist
Why is epinephrine given?
- -Increases systemic Blood pressure and decreases diastolic blood pressure
- -improves blood flow during an arrest
when should epinephrine be given?
- -V-fib. or V-tach without a pulse
- -Asystole
- -PEA
- -Stokes Adams syndrome
- -bradycardia
What is the dosage for epinephrine?
1 mg IVP every 3-5 min.
where is nitroprusside normally used?
ICU
What is the mechanism of action of nitroprusside?
vasodilates- reduces afterload, lowers BP
why would a patient be given nitroprusside?
- -hypertensive crisis
- -CHF (esp. pulmonary edema)
what position should the patient be in when giving nitroprusside?
sitting/laying (if standing patient may fall)
What are some precautions with nitroprusside?
- -Monitor VS
- -Block from light
- -may cause CO2 retention
What should nitroprusside be mixed with?
D5W
What med should the nurse ask the patient if they take prior to giving nitroprusside?
ED meds like viagra
Prior to giving digoxin the nurse should assess…
apical pulse for full minute
What are signs of dig. toxicity?
- -visual changes (yellow/green halo)
- -loss of appetite
Is furosemide potassium sparing or potassium wasting?
Potassium wasting
