Final Exam Study Guide
Vasodialator and loop diuretics- use for hyper tension, orthostatic
hypotension, watch for dizziness
Digoxin discharge teaching, what must a client know how to do?
Patient must know how to take their pulse (hold if less than 60 or
more than 100)
Therapeutic range is 0.5-2.0
Treat heart failure and heart rhythm problems
If you miss a dose, do not doubt dose. Skip the dose if the next
dose is due in less than 12 hours. If the next dose is due in more
than 12 hours, take the dose as soon as remembered.
Maintain adequate hydration *Symptoms of
toxicity
Antacids delay absorption
It is best to take digoxin without food. Peak concentration is
reduced if taken with food. Meals containing increased fiber or
foods high in pectin may decrease absorption.
Maintain adequate potassium in diet
VBAK- Visual, bradycardia, ABD distress, potassium
Toxicity- hallow, bradycardia, GI upset.
How to monitor and interpret labs for potassium wasting diuretics.
Normal potassium ranges. Nursing interventions, potassium rich
foods
Normal range: 3.5-5.0
Causes dysrhythmias with too much or too little
, Loop diuretics or thiazide also need to monitor weight and report
any gain (greater than 2 lbs in 48 hours or 5 lbs in a week)-
pertains to all diuretics
Only prescribe Loop diuretics if HCTZ (hydrochlorothiazide-
potassium wasting diuretic) treatment fails
Thiazide diuretic- (HCTZ) only used in patient who have normal
renal function
Potassium wasting mean you lose more potassium
Sweet potato, avocado, squash, spinach
Assess response to treatment and prevent adverse events:
electrolyte imbalance and decline in renal function
Potassium low offer- foods like bananas, avocado, squash, and
notify physician.
Actions of ACE inhibitors, think about chronotropic, inotropic etc.
“Pril” medications- prevent angiotensin
ACE inhibitors block angiotensin to cause diuresis by
blocking aldosterone production
Reduce cardiac work, helps with circulation
Vasodilator- opens blood vessels so heart doesn’t have to
work hard to push blood through system
Decreases calcium level
Chronotropic effects changes the heart rate
inotropic effects can be applies to the effect of a transmitter
substance or hormone on its target
Chronotropic: conduction speed
Inotropic: strength of conduction
What meds should not be given with grapefruit juice
Statins
, Calcium channel blockers- can cause toxicity and arrhythmias
Calcium channel blockers- edema raises feet up.
Client teaching with use of nitro and other vasodilators- should they
continue to perform a task causing pain?
Teach patient to lie or sit before taking this medication
Nitro can be take X3 with 5 minutes in between each dose but
patient cannot restart strenuous activity after taking it- they need to
rest
Sublingual=tingle
Dark, room temp area
How do calcium channel blockers work in the heart, the rest of the
body?
Decrease BP by opening blood vessels, relieves and prevents chest
pain
Vasodilators
Relax & widen blood vessels with the heart to prevent chest pain
Nifedipine
Maintenance
Open arteries going to the heart
When to hold beta blockers- what do they impact? HR, BP
Heartrate is below 60
Blood pressure is less than 100 systolic
Change positions slowly
Minipress (Prozasin) teaching- alpha blocker/ treats high blood
pressure& urinary retention
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