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unit two exam- nrn 170 > Perfusion Part One > Flashcards

Perfusion Part One Flashcards

1
Q

Very Nice Drugs

A

Verapamil,Nifedipine, Diltiazem

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2
Q

-pril

A

ACE inhibitors

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3
Q

-sartan

A

Angiotensin II. Receptor Blockers

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4
Q

-OLOL

A

Beta Blockers

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5
Q

RAAS

A

Renin Angiotensin Aldosterone System
1. Receptors recognize pressure change in vessels which stimulates kidneys to release renin into the bloodstream ( whenever BP is low)
2. Liver makes angiotensinogen which reacts with renin
3. This forms angiotensin I
4.Angiotensin 1 to Angiotensin II occurs in the lungs
5. Angiotensin II makes blood vessels small in diameter increasing BP (vasoconstrictor)
6. Angiotensin II to Angiotensin III releasing aldosterone
7. Aldosterone - BV increases and BP increases
Once optimal BP is reaches the kidneys will stop producing renin

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6
Q

Primary HTN

A

cause is unknown 90%

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7
Q

Secondary HTN

A

Cause/reason is known
10%

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8
Q

ANtihypertensive Drug Classifications

A

Ace inhibitors, ARBs, Beta Blockers, Ca Channel Blockers, Diuretics, Vasodilators

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9
Q

Antihypertensive Assess

A

Risk Factors (non modifiable and modifiable)
Check for High BP on multiple measurements

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10
Q

How many readings do you need to verify hypertension?

A

2

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11
Q

Antihypertensives Implement/Teach

A

Lifestyle change, take as prescribed, do not stop abruptly, proper BP taking technique, reduce coffee, ETOH, OTC meds

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12
Q

Antihypertensive Evaluate

A

BP WNL

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13
Q

Ace Inhibitors Use

A

HTN, heart failure

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14
Q

Ace Inhibitor Action

A

Prevents the conversion angiotensin I to II which prevents the release of aldosterone

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15
Q

Ace Inhibitor Adverse Effects

A

dry, nonproductive cough, which reverses when therapy is stopped, impotence, angioedema, Possible hyperkalemia~ ­K (> 5 meq/L) ­Mg, cardiac rhythm changes, cramping, diarrhea

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16
Q

What foods should you avoid when taking ace inhibitors?

A

Avoid high potassium items like bananas, zucchini, dried fruit, potatoes, spinach and salt substitutes

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17
Q

Arbs

A

Well tolerated, newer class
Do not cause a dry cough

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18
Q

Arbs Action

A

Allow angiotensin I to be converted to angiotensin II, but block the receptors that receive angiotensin II
Blocks vasoconstriction and release of aldosterone which lowers BP

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19
Q

ARBs drug examples

A

Losartan valsartan

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20
Q

Beta Blocker Use

A

HTN

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21
Q

Beta Blocker Action

A

Prevent/block beta receptors to accept epinephrine/nor- epinephrine

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22
Q

Beta Blocker Assess

A

• HTN,
•S/s of asthma, decreased HR, check for postural hypotension

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23
Q

Beta Blocker Implement/Teach

A

Check pulse, hold rate < 60, don’t stop abruptly

24
Q

Beta Blocker EValuate

A

BP HR

25
Q

Calcium Channel Blockers Use

A

HTN,angina,tachyarrhythmias

26
Q

Calcium Channel Blockers Drugs

A

Verapamil, Nifedipine, Dilitazem

27
Q

Calcium Channel Blockers Action

A

dilates peripheral arteries by relaxing vascular smooth muscle

28
Q

Ca Channel Blockers Teach

A

Do not drink grapefruit juice because it will increase the concentration of the calcium channel blockers

29
Q

Contraindications of Ca channel blockers

A

Hypersensitivity

30
Q

Alpha Adrenergic Receptor Blockers (Alpha Arbs)
Use

A

Mild to moderate HTN, increases urinary flow rates

31
Q

Alpha Adrenergic Receptor Blockers (Alpha Arbs)
Action

A

blocks alpha1 receptors in arterial smooth-muscle vasculature & decreases BP which is also found in the neck of the bladder

32
Q

Alpha Adrenergic Receptor Blockers (Alpha Arbs)
Major Adverse Effects

A

• orthostatic hypotension, tachycardia, fluid retention, dizziness

33
Q

Alpha Adrenergic Receptor Blockers
Assess/monitor

A

• BP & HR
•I&O
• Elimination pattern (Offer stool softener or antidiarrheal)

34
Q

Alpha arbs
Implement

A

• BP & HR
•I&O
• Elimination pattern (Offer stool softener or antidiarrheal)

35
Q

Alpha Arbs
Instruct

A

• To eat low sodium diet
• Rise slowly
• Be compliant with therapy
• Avoid OTC unless checking with MD

36
Q

Vasodilator Action

A

• Relaxes arteriolar smooth muscle causing vasodilatations, which decreases BP

37
Q

Vasodilators Use

A

Moderate to severe HTN & hypertensive crisis (requires immediate reduction )

38
Q

Hydralazine IV

A

Vasodilator

• Have a continuous BP monitor if available
• VS q 5 to 15 minutes with IV use
• Titrate IV dose to BP
• Do not leave pt unmonitored

39
Q

Hydralazine Side effects

A

Headache,dizziness, feelings of anxiety, edema, nausea, vomiting, tachycardia

40
Q

Arrhythmia

A

Change to the automaticity or conductivity of heart cells

41
Q

Class I Anti-arrhythmic Agents

A

Sodium Channel Blockers

42
Q

Class II Anti-arrhythmic Agents

A

Beta Blockers

43
Q

Class III Anti-arrhythmic Agents

A

Potassium Channel Blockers

44
Q

Adenosine

A

Used to treat Supra-ventricular tachycardia
Given IV push
Given very rapidly

45
Q

Class IV Anti-arrhythmic Agents

A

Calcium Channel Blockers

46
Q

Digoxin

A

Heart failure medication that can also be used to treat low heart rate

47
Q

Sodium Channel Blockers

A

Local anesthetic numbing agent for skin
Procainamide, quinidine,lidocaine
Blocks sodium channels from opening which causes decrease in HR

48
Q

Sodium Channel Blockers Use

A

Ventricular arrhythmias

49
Q

Sodium Channel Blockers Contraindications

A

Hypersensitivity, Brady, heart block, hypotension, HF

50
Q

Sodium Channel Blockers Contraindications

A

Hypersensitivity, Brady, heart block, hypotension, HF

51
Q

Sodium Channel Blockers Side Effects

A

dizziness, drowsiness, fatigue, vision changed, development of arrhythmias, hypotension, vasodilation

52
Q

Potassium Channel Blockers

A

Amiodarone, dofetilide, sotalol

53
Q

Potassium Channel Blockers Use

A

Ventricular fibrillation; pulseless Vtach

54
Q

Potassium Channel Blockers Contraindication

A

None if it is a life threatening situation

55
Q

Potassium Channel Blockers Side Effects

A

Weakness fatigue dizziness hypotension HF arrhythmias

56
Q

Amiodarone Side Effects

A

Fatal liver toxicity, pulmonary toxicity, vision changes, cardiac arrhythmias

57
Q

Nursing Interventions for anti arrhythmic agents

A

-monitor cardiac rhythm
-stabilize pt
Ventilation, o2, treat hypotension
Safety precautions

unit two exam- nrn 170 (4 decks)

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