VN 16 Study Guide Test 5- DONE Flashcards
1.What effects will ACE inhibitors have on the body? (class notes)
-decrease blood pressure
-hold onto potassium
-works on the kidneys & gets rid of water & sodium
2.What are nursing considerations (K,H,K) for a client on an ACE inhibitor? (class notes)
“-pril”
-USES:HTN, HF,MI
- hypotension=risk for falls/dizzy (keep call light in reach)
-monitor vital signs
-causes electrolyte imbalance:look at potassium lab (3.5-5.0)
-monitor renal values (bun & creatinine)
-monitor heart rate: EKG > tall t waves
-cause hyperkelemia
-angioedema:swelling of lips,tongue = respiratory compromise(difficulty breathing)
-watch food, dont add salt substitue(mrs.dash), low sodium diet, watch potassium high foods
-expected dry cough
-dont, suddenly stop taking medication (can cause rebound HTN) needs to be tappered
3.What effect do anti-platelets have for a client who has coronary artery disease?
Prevents from thrombos formation (forming blood clots)
4.What are nursing considerations (K,H,K) for a client on aspirin?(drug flashcard, previous study guide)
-treats mild-moderate pain
-reduces fever
-antiflammatory (RA, OA)
-prevent stroke
-decrease risk of MI
-risk for bleeding: dont give to pt w/bleeding tendencies,peptic ulcers,on anticoagulants,vitamin k deficiency or asthma
-do not give to children or adolescents w/viral infection
-stop taking 1 week before major surgery
-aspirin toxicity causes tinnitus
AE:heartburn,vomiting,anorexia,tachycardia,hypotension
-avoid garlic,ginger,ginko,feverfew,omega 3 oil,vitamin E
- ANTIDOTE: sodium bicorbonate(baking soda), activated charcoal
5.What are nursing considerations (K,H,K) for a client on clopidogrel? (class notes,ATI pg.187)
-Uses: Clot preventions
-Treats:acute coronary syndrome, MI, stroke, intermittent claudication(pain affecting the calf)
-monitor for signs of bleeding: GI bleeding, risk for hemorrhage, black tarry stools, emesis, bleeding gums, bruising
-Monitor labs(not weekly) platelet counts, HGB “less than 7, go to heaven”
-dont use w/other meds that enhance bleeding
-caution in clients w/bleeding tendencies,peptic ulcer, severe kidney & hepatic disorders
6.When is heparin used? (ATI pg.181/Ford pg.460)
-Prevent other blood clots from forming/ for conditions needing fast anticoagulant activity
-evolving stroke
-pulmonary embolism
-massive deep-vein thrombosis(DVT)
-angina/ MI
- What are nursing considerations (K,H,K) for heparin? (class notes, ATI pg.181, Ford pg.461)
ANTIDOTE protamine sulfate* (administer slowly IV, no faster than 20mg/min or 50mg in 10 min & doesnt exceed 100mg in 2hr period)
-risk for bleeding/hemorrhaging
-Do not take aspirin w/anticoagulants or 2 anticoagulants at the same time
-can cause low platelets
-Heparin usually given in the abdomen SUBQ , 2 inches from umbilicus (not the thigh), apply gentle pressue for 1-2 minsafter the injection, rotate & record injection sites
-Check the following labs weekly APTT (activated partial thromboplastin time) RANGE: 30-40PTT
Platelet count,HTC, HGB
-Heparin and warfarin can be given together at the same time once we reach therapeutic INR lab values, once therapeutic level is reached stop heparin.
-observe for increased heart rate, decreased BP, bruising, petechiae, hematomas, emesis & black tarry stools
-be aware heparin contains pork, keep in mind for jewish & muslim religions who prohibit use of pork.
-Avoid NSAIDS,antibiotics,aspirin,alcohol(alcohol based mouthwash)
-stop infusion if bleeding is seen( when heparin is given via IV)
8.What are nursing lab considerations for anti-coagulants? (class notes)
-APTT (activated partial thromboplastin time)
RANGE: 30-40PTT
-Platelet count
RANGE:150,000-400,000
<150 “iffy”
<50 “risky”
-INR (2-3 therapeutic level)
-HCT(hematocrit)
RANGE:42-52 men 37-57 women
-test for positive homan sign
9.What are nursing considerations (K,H,K) for a client on a beta-blocker? (class notes, ATI pg.158,159)
-suffix “-lol” or “-olol”
-TREATS Hypertension, HF,MI, tachydysrhythmias
-works to decrease workload of the heart
-lowers heart rate, then lowers the blood pressure
-Take vital signs, hold med if heart rate less than 60.
-monitor glucose levels
-Caution in patients w :
COPD, ASTHMA, DIABETIC patients
-contraindicated in clients w/AV block & sinus bradycardia
worry about the 4 B’s
-Bradycardia
-Bottom out BP (hypotensive, low BP)
-Bronchi Restriction
-Blood Sugars (can mask hypoglycemia symptoms like tachycardia)
-do not suddenly stop medication, taper dose(can cause rebound HTN)
- What are nursing considerations (K,H,K) for a client on a calcium-channel blocker?(class notes, ATI pg.155,156)
suffix “-dipine”
Very nice drugs = verapmil (IV/injections given slowly over 2-3 mins)
Nice= Nifedipine -dipine
Drugs= dialtiazem
-TREATS angina pectoris, HTN, cardiac dysrhythmias
-monitor heart rate (hold med if heart rate less than 60)
-monitor vitals, daily weight, edema
-lowers heart rate “calms the heart”
-lowers BP
-no grapefruit juice (can cause severe hypotension)
-can cause: orthostatic hypotension, constipation, peripheral edema, headache,flushing
-elevate legs & compression to reduce edema
-increase fluids, fiber, fruits
-taper does,do not suddenly stop medication (causes rebound HTN)
-ADVERSE EFFECT: reflex tachycardia (if BP decreases,heart beats faster in attempt to raise it)
11.What are nursing considerations (K,H,K) for a client on a vaso-dilator?
Ex: nytroglycerine (NTG), Nitroprusside, isosorbide
USE:(HTN CRISIS,ANTIANGINAL)
-decrease blood pressure FAST
Adverse effects:
-severe hypotension
-NITROPRUSSIDE can cause cyanide poisoning
Cyanide poisoning manifestations: drowsiness, weakness, delirium
-watch patients who are taking slidenafil (erectyle dysfunction meds)
-hot flushing of the face
-diziness & lightheadedness are alarming
-keep in original dark glass bottlein a dry cool place, dont chew or swallow the tablets
Expected Adverse affect
-Bad headache (HA)
Avoid long term use- Take patches off for at least 10 hrs. (Take it off at night)
12.What are nursing considerations (K,H,K) for a client on enoxaparin?(ATIpg.182,class notes)
-USE:prevention of blood clots usually after surgery
-Given SUBQ, Self administered, BID(twice a day), for 7-10 days,2 inches from umbilicus
-dont rub injection site for 1-2 mins after.
-risk of hemorrage
-monitor for bleeding (increased HR, bruising, black tarry stools, emasis)
-avoid aspirin
-check platelet counts
-no weekly labs
- Manifestations for hypokalemia (ATI pg.143)
“low & slow vitals” (hypotension, bradycardia)
-Fatigue
-nausea & vomiting
-weakness
-leg cramps
- Manifestations for hyperkalemia (ATI pg.146)
-weakness
-fatigue
-dyspnea
-cardiac dysrhythmias
Diarrhea
Tall t waves
Increased DTR
15.What are nursing considerations (K,H,K) for a client on a loop diuretic?(class notes, ATI pg.144)
suffix “-mide, -nide”
Ex: Furosomide,Bumetamide
distractor:isosorbide
-most powerful diuretics
-USE: HF, HTN, ASCITES (fluid in the abdomen)Edema
-hypokalemia > Signs & symptoms : “low/slow” bradycardia, fatigue, muscle twitching
-Increase potassium rich foods (bananas, strawberries, dark leafy veggies, raisins)
-Monitor potassium labs NORMAL RANGE: 3-5
-toxicity>Signs & symptoms: tinnitus, dizziness, hearing changes >Monitor symptoms
-hyperglycemia> signs & symptoms: high blood sugar on labs >Monitor blood sugars
-photosensitivity >Avoid sun, wear sunscreen
-increased urine output
-take MED in the AM
-monitor i&o’s
-monitor for significant weight loss.
-all diuretics risk for dehydration
-administer furosemide slowly (fast can cause ototoxicity)
