VN16 Test 5

Question 1

1. What effects will ACE inhibitors have on the body?

Answer 1

• -lowers bp
• -gets rid of water/sodium
• -keeps potassium with normal range (3.5-5)
• -doesn’t affect hr
• -non productive dry cough.

Check
-Ekg (tall T waves)
-No adding addition salt
-Monitor electrolyte
-Hypotensive (risk falls due to dizziness)
-Check vitals

Question 2

2. What are nursing considerations (K,H,K) for a client on an ACE inhibitor?

Answer 2

Electrolyte imbalance
Angioedema
Hyperkalemia
Change positions slowly
Alters taste
Increases lithium
Dry Cough (change to ARBS)

Question 3

3. What effect do anti-platelets have for a client who has coronary artery disease?

Answer 3

Prevent thrombus formation in the arterial system (prevent forming of blood clot)

Question 4

4. What are nursing considerations (K,H,K) for a client on aspirin?

Answer 4

Tinnitus
Nausea
Vomiting
Dehydration
Excitability
Hyperventilation leading to respiratory alkalosis
Do not give to children

Question 5

5. What are nursing considerations (K,H,K) for a client on clopidogrel?

Answer 5

• Increase bleeding (hemorrhage)
• Use cautiously with vit. K deficiency
• Monitor for salicylate poisoning (tinitus)
• Check labs:
o Platelets
o Hgb/hct <7 go to heaven (hgb lab)

Question 6

6. When is heparin used?

Answer 6

When a patient is at risk for clotting
When quick action is needed

Question 7

7. What are nursing considerations (K,H,K) for heparin?

Answer 7

• Hemorrhage (bleeding)
• Low platelets

Question 8

8. What are nursing lab considerations for anti-coagulants?

Answer 8

• Check INR
• If using heparin check
o PT
o INR
o aPPT

Question 9

9. What are nursing considerations (K,H,K) for a client on a beta-blocker?

Answer 9

Kill hurt know (4 B’s)
1. Brady cardia (less than 60)
2. Bottom out bp (hypotensive)
3. Bronchi restriction (watch out on copd, asthma pts)
4. Blood sugars- can mask hypoglycemia symptoms (watch out for DM)

Beta-blockers lower the heart rate first then the blood pressure

Question 10

10. What are nursing considerations (K,H,K) for a client on a calcium-channel blocker?

Answer 10

Kill hurt know
1. Reflex tachycardia
2. Grapefruit juice is a no no
3. Hold med if heart rate is <60
4. Bad HA are normal
5. Check VS for BP and HR

Question 11

11. What are nursing considerations (K,H,K) for a client on a vaso-dilator?

Answer 11

1. Severe hypotension (take bp to check)
2. Cyanide poisoning (only nitroprusside) (weakness, delirium, drowsy)
3. Watch your patients that are taking sildenafil

Question 12

12. What are nursing considerations (K,H,K) for a client on enoxaparin?

Answer 12

*Produce stable responses when administered at recommended dosages; bleeding less likely to occur
-Sq self administered for 7-10 days BID 2xday and sites are to be rotated
-Direct-acting oral anticoagulants (DAOCs)
*Direct thrombin inhibitors: dabigatrin
-Factor X inhibitors: rivaroxaban
-monitor hct, hgb, cbc and platelets
Antidote is protamide (protamine?) sulfate

Question 13

13. Know manifestations for hypokalemia

Answer 13

• Anorexia,
• nausea,
• vomiting,
• mental depression,
• confusion,
• delayed or impaired thought processes,
• drowsiness,
• abdominal distention,
• decreased bowel sounds,
• paralytic ileus,
• muscle weakness or fatigue,
• flaccid paralysis,
• absent or diminished deep tendon reflexes,
• weak and irregular pulse,
• paresthesias,
• leg cramps,
• electrocardiographic changes.

Question 14

14. Know manifestations for hyperkalemia

Answer 14

• Irritability,
• anxiety,
• listlessness,
• mental confusion,
• nausea,
• diarrhea,
• abdominal distress,
• GI hyperactivity,
• paresthesias,
• weakness and heaviness of the legs,
• flaccid paralysis,
• hypotension,
• cardiac arrhythmias,
• electrocardiographic changes.

Question 15

15. What are nursing considerations (K,H,K) for a client on a loop diuretic?

Answer 15

Hypokalemia- nursing intervention increase potassium
Hyperglycemia
Photosensitivity
Increase urine output
Take med in the morning
One of the most powerful diuretics-first choice

Question 16

16. What are nursing considerations (K,H,K) for a client on a thiazide?

Answer 16

K,H,K
1. Hypokalemia (will see low/slow, bradycardia, fatigue, muscle twitching) decrease k and monitor labs (potassium normal range 3.5-5.0)
2.chemically similar to sulfonamides (not a good choice for someone that has allergy to sulfa drugs)

Question 17

17. What are nursing considerations (K,H,K) for a client on a potassium sparing diuretic

Answer 17

K,H,K
1.hyperkalemia (increase in k)(potassium normal range 3.5-5.0)
Seen on ekg:Tall T waves, dysthymias, increase BS, muscle cramps, numbness/tingling in extremities
2. Gynecomasia (breast growth in males)
3.menstural problems
4.erectile dysfunction
5.voice changes

Question 18

18. What are nursing considerations (K,H,K) for a client on digoxin

Answer 18

K,H,K
-Toxicity (n/v, visual changes, fatigue and weakness) check apical pulse for a full minute and hold if <60, check digoxin levels 0.8-2
St.john’s wort is a no no
Antidote is digibind
Monitor i&o’s and weight

Question 19

19. What are nursing considerations (K,H,K) for a client on amiodorone?

Answer 19

Use (LAST RESORT)
AFIB, TACCY
K,H,K
-pulmonary toxicity (SOB, dry Cough)
-liver toxicity (yellowing of eyes)
-thyroid disfunction (bluish tone of skin, rash)

To do for toxicity:
Thyroid labs
LFTs
Chest X-ray

Question 20

Potassium sparing diuretic Spironolactone (aldactone) are the weakest diuretic