VN 22 Test 4 Flashcards
- Diuretic nutrition
Potassium Foods for potassium wasting
• Bananas
• Oranges
• Tomatoes
• Potatoes
• Spinach
Potassium sparing
•Avoid potassium
•restrict sodium
- Potassium wasting diuretic: Causes/AE and drug name
• Hypokalemia (see bradycardia, fatigue and muscle twitching)
• Toxicity (see tinnitus, dizzy )
• Hyperglycemia (risk for high blood sugar)
• Photosensitivity
Ex. Furosemide and bumetomide
- Potassium wasting diuretic: Nursing actions
• Increase potassium foods
• Monitor potassium lab 3.5-5.0
• Monitor Toxicity
• Monitor blood sugar
• Avoid the sun and wear sunscreen
• Take in the AM
• Monitor vital and output( monitor dark amber urine)
• Monitor weight
- Potassium Sparing diuretic: Causes/AE and drug name
• Hyperkalemia (see ECG: Tall T waves, dysrrhythmias, increase blood sugar, muscle cramps or numbness/ tingling in extremities)
• Gynecomastia (excess breast tissue in men)
• Menstrual problem
• Sexual dysfunction
Ex. Spironolactone
- Potassium Sparing diuretic: Nursing action
• Hook them up to 12 lead ECG
• Avoid potassium foods and sodium
- Categories of HTN
Normal: less than 120/less than 80
Elevated 120-129/less than 80
Stage 1: 130-139/80-89
Stage 2: greater than 140/ greater than 90
- Beta blocker: Causes
• Bradycardia (lowers the heart rate first)
• Bottom out BP (Hypotension; risk for falls)
• Bronchi restrictions (Avoid COPD and Asthmatic clients)
• Blood Sugar (Hypoglycemia; Avoid diabetic clients)
- Beta blocker: nursing action
• Monitor vitals before administering medication
- HTN nutrition
• Avoid smoking and drinking alcohol
• Low fat
• Low cholesterol
• Low sodium diet-2gram
• Fluid restriction
- lose weight if obese
- Risk for heart failure
• Uncontrolled hypertension
• MI/CAD/Cardiomyopathy/High LDL
• Heavy alcohol use
• Sedentary lifestyle
• Cocaine or other drugs
• Smoking
• Advanced age
- Complications of hypertension
• Stroke (CVA)
• Renal disease/failure
• Cardiac failure/MI/CAD
- Ace inhibitors: Causes
• Electrolyte imbalance (Hyperkalemia); Monitor electrolyte and EKG (Monitor Tall T waves); No salt or added potassium
• Angioedema (allergy reaction)
• Hypotension (risk for falls)
• Expected Adverse Effect: Dry cough (May switch if not control with ARBS)
- Ace inhibitors: nursing action
• Monitor Vital signs for hypotension
-monitor EKG
-Restrict potassium and sodium
- Rebound HTN if stop abruptly
-Monitor BUN and Creatinine
- Thiazide: Causes and drug name
• Hypokalemia (increase potassium)
• Chemically similar to Sulfonamides (ask for allergies)
• Hypotension (risk for falls)
Ex. Hydrochlorthaizide
- Thiazide: nursing action
• Increase potassium foods
• Monitor Labs Potassium
- Digoxin: Causes
• Toxicity (Sx: Nausea, vomiting, visual changes, and Anorexia)
• Diglband is the antidote
• Clients on loops diuretic or thiazides are at risk
• Older the client the higher the risk for toxicity
• Contraindication with St.John Wort
- Digoxin: Nursing Action
• Check Apical pulse (hold if less than 60)
• Check digoxin level (0.8-2.0)
- Manifestations of left side HF
• Hypoxemia
• Exertional dyspnea (first symptoms)
• Paroxysmal nocturnal dyspnea (Sleep with several pillows in bed or in a chair)*
• Orthopnea
• Pulse rapid or irregular
• Moist crackles
• BP elevated
• Cough with pink, frothy sputum
• Hemoptysis
• Urine output diminished
- Acute left sided heart failure
• Pulmonary edema
• Hypoxia
• Restlessness
• Confusion
- Manifestations of right sided HF
• Gradual unexplained weight
• Dependent pitting edema
• Ascites
• Hepatomagaly
• Jugular vein distention
• Peripheral edema
• Enlarged abdominal organs
• Fluid retention: Rings, shoes, or clothing become tight
- Accumulation of blood in abdominal organs manifestations
• Anorexia
• Nausea
• Flatulence
- Heart failure lab value
BNP: a good indicator for heart failure (it will be elevated) less than 100 is within normal limits
- Medical management for HF
• Reduce the hearts workload, improve cardiac output
- Interventions for HF
• Dietary modification
• Daily weight; 2-3 lbs
• Sudden swelling should be reported
• High Fowlers
• Gradual exercise; do not rush it
HTN management
Exercise
Weight loss
Reduce smoking and alcohol
Low sodium/fat